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) remains a major public health challenge, and multidrug-resistant TB (MDR-TB) may impose an additional physical, psychological, and social burden. Quality of life (QoL) assessment provides information beyond conventional treatment outcomes. Objectives were to assess QoL among pulmonary tuberculosis (PTB) and MDR-TB patients and identify determinants of QoL in Lucknow district, Uttar Pradesh.

Methods: A cross-sectional analytical study was conducted among 214 TB patients receiving treatment through urban DOTS centres in Lucknow district from 1 September 2017 to 31 August 2018. Systematic random sampling was used; a target of five patients was interviewed each day, and every 10^th registered patient was selected. If the selected patient did not fulfil the inclusion criteria, the next registered patient was included. Of the 214 participants, 157 had PTB and 57 had MDR-TB. Data were collected using a pretested structured questionnaire, and QoL was assessed using the medical outcomes study short form-36 (SF-36). Multiple linear regression was used to identify predictors of QoL.

Results: PTB patients had higher overall QoL scores than MDR-TB patients (42.7±18.8 versus 34.6±17.8). Significant differences were observed in physical functioning, role physical, bodily pain, general health, vitality, and social functioning. Poor social relationships were the strongest predictor of reduced QoL among PTB patients, whereas dissatisfaction with DOTS centre services was the strongest predictor among MDR-TB patients.

Conclusions: TB substantially impairs QoL, with a greater burden among MDR-TB patients. Psychosocial support, stigma reduction, patient-centred DOTS services, and improved patient-provider interactions should be integrated into TB care.