Clinical Research Centre, University of Zimbabwe, Harare, Zimbabwe; Centre for Health Economics, University of York, York, United Kingdom
Mabugu, T., Clinical Research Centre, University of Zimbabwe, Harare, Zimbabwe; Revill, P., Centre for Health Economics, University of York, York, United Kingdom; van den Berg, B., Centre for Health Economics, University of York, York, United Kingdom
Objectives: The assessment of quality of life (QOL) in children has been underresearched in high- and low-income countries alike. This is partly due to practical and methodological challenges in characterizing and assessing children's QOL. This article explores these challenges and highlights considerations in developing age-specific instruments for children affected by HIV and other health conditions in Africa and other low-income settings. Methods: A literature search identified works that have 1) developed, 2) derived utilities for, or 3) applied QOL tools for use in economic evaluations of HIV interventions for children. We analyzed the existing tools specifically in terms of domains considered, variations in age bands, the recommended respondents, and the relevance of the tools to African and also other low-income country contexts. Results: Only limited QOL research has been conducted in low-income settings on either adults or children with HIV. A few studies have developed and applied tools for children (e.g., in Thailand, Brazil, and India), but none have been in Africa. The existing methodological literature is inconclusive on the appropriate width or depth by which to define pediatric QOL. The existing instruments include QOL domains such as "physical functioning," "emotional and cognitive functioning," "general behavior (social, school, home)," "health perception," "coping and adaptation," "pain and discomfort," "extended effects," "life perspective," and "autonomy.". Conclusions: QOL assessment in children presents a series of practical and methodological challenges. Its application in low-income settings requires careful consideration of a number of context-specific factors. © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR).
antiretrovirus agent; cotrimoxazole; academic achievement; acquired immune deficiency syndrome; adaptive behavior; Africa; age distribution; article; child; cognition; coping behavior; cost benefit analysis; cost effectiveness analysis; cultural factor; economic evaluation; emotion; functional assessment; geographic names; health behavior; home care; human; Human immunodeficiency virus infection; human rights; life event; lowest income country; lowest income group; methodology; pain; priority journal; quality of life; social behavior