Assessment of Health-Related Quality of Life and Influencing Factors among Patients with Advanced Schistosomiasis Japonica in the Southwest of China Using the EQ-5D-5L Scale

Background To assess health-related quality of life (HRQoL) and identify influencing factors impacting HRQoL among patients with Advanced Schistosomiasis (AS) in Sichuan Province, China, utilizing the EQ-5D-5L scale. Methods A cross-sectional study was conducted among 1,276 AS patients in Sichuan Province. Data on demographic characteristics, clinical history, and EQ-5D-5L responses were collected via structured face-to-face interviews and medical record review. Statistical analyses included reliability and validity assessments (Cronbach's α, exploratory/confirmatory factor analyses), univariate analysis, multivariate linear regression, and interaction analysis using Stata 16.0 and R 4.5.1 . Results The mean utility index (UI) score was 0.85 ± 0.20, with 35.6% of subjects reporting no impairment across all dimensions. The EQ-5D-5L demonstrated acceptable internal consistency ( Cronbach’s α  = 0.795) and construct validity (CFA: χ²/df  = 2.191, RMSEA  = 0.031). The domains most affected were anxiety/depression (62.5% reporting any impairment) and pain/discomfort (54.7% reporting any impairment). Multivariate regression analysis identified advanced age ( β = -0.017, P  < 0.001), a history of ascites( β = -0.041, P  < 0.001), Upper Gastrointestinal Bleeding (UGIB) ( β = -0.025, P  = 0.018), hepatitis ( β = -0.033, P  = 0.04), and advanced liver fibrosis ( β = -0.024, P  < 0.001) as significant independent predictors for poorer HRQoL. Interaction analysis revealed synergistic effects among risk factors, demonstrating that the detrimental impact of ascites was concentrated in the elderly, co-occurrence of bleeding and ascites compounded HRQoL reduction, and the effect of hepatitis was contingent upon the severity of liver fibrosis. Conclusion The EQ-5D-5L is a valid and reliable instrument for assessing HRQoL in patients with AS. Targeted interventions should address age-related functional decline, comorbidities(particularly ascites and severe fibrosis), and low educational attainment to enhance patient outcomes. Emphasis should be placed on multidisciplinary care strategies for older patients with advanced fibrosis or ascites in endemic regions.