Quality of life and its determinants among pulmonary tuberculosis and multidrug-resistant tuberculosis patients receiving DOTS therapy in Lucknow District, Uttar Pradesh: a cross-sectional study

Abstract

Background: Tuberculosis (TB) continues to be a major public health challenge in India despite substantial progress under the National Tuberculosis Elimination Programme (NTEP). While treatment outcomes are commonly assessed using bacteriological and clinical indicators, the impact of TB on patients’ quality of life (QoL) remains inadequately explored. Multidrug-resistant tuberculosis (MDR-TB) further compounds the physical, psychological, and social burden experienced by patients. Objectives were to assess the quality of life among pulmonary tuberculosis (PTB) and multidrug-resistant tuberculosis (MDR-TB) patients and to identify determinants influencing QoL in Lucknow district, Uttar Pradesh.

Methods: A cross-sectional analytical study was conducted among 214 tuberculosis patients receiving treatment under urban DOTS centres of Lucknow district. The study period was September 2014 to October 2015. Of the total participants, 157 were PTB patients and 57 were MDR-TB patients. Data regarding socio-demographic characteristics, treatment history, psychosocial issues, stigma, and healthcare-related factors were collected using a structured questionnaire. Quality of life was assessed using the medical outcomes study short form-36 (SF-36). Multiple linear regression analysis was performed to identify predictors of QoL.

Results: PTB patients demonstrated significantly better QoL scores compared with MDR-TB patients (42.7±18.8 versus 34.6±17.8). Physical health was more adversely affected than mental health in both groups. Significant differences were observed between PTB and MDR-TB patients in physical functioning, role physical, bodily pain, general health, vitality, and social functioning. Poor social relationships emerged as the strongest predictor of reduced QoL among PTB patients, whereas unsatisfactory DOTS centre services were the strongest predictor among MDR-TB patients.

Conclusions: Tuberculosis significantly impairs quality of life, with MDR-TB patients experiencing a greater burden. Psychosocial support, stigma reduction, strengthening DOTS services, and improving patient-provider interactions should be integrated into TB control strategies to enhance patient-centred outcomes.