Lung life HRQoL measure: psychometric properties and initial data in presumptive TB

Introduction: Health-related quality of life (HRQoL) data in young children with respiratory illnesses, including TB, are limited in low- and middle-income countries (LMICs). This study assessed the psychometric properties of the LuLi-Q measures in South African children with presumptive TB, focusing on children aged 0-5 years.

Methods: In a cross-sectional study within the UMOYA TB diagnostic study, HRQoL data were collected using the LuLi-Q-Tots (0-2 years) and LuLi-Q-Pres (3-5 years) measures. Analyses included descriptive statistics, item-total correlations, and Cronbach’s alpha for reliability.

Results: Among 160 children aged 0-5 years (50 aged 0-2 years, 110 aged 3-5 years), the LuLi-Q-Tots had minimal floor and ceiling effects (6.5%), effectively capturing HRQoL. The LuLi-Q-Pres showed substantial floor and ceiling effects (61%), but removing 29 items improved reliability (Cronbach’s alpha: 0.96-0.97). Caregivers reported daily medication use (54%) and anxiety (72%) in the 0-2 group, while separation anxiety (65%) and jealousy (92%) were common in the 3-5 group.

Conclusion: This study establishes a foundation for reliable HRQoL measures for young children with presumptive TB, guiding future research and patient-centred care in LMICs.