Quality of Life of Multi Drug Resistant Tuberculosis Patients: a Study of North India

  • Raman Sharma Mail Department of Hospital Administration, Government Medical College & Hospital, Chandigarh, India.
  • Ravinder Yadav Department of Medical Records, Government Medical College & Hospital, Chandigarh, India.
  • Meenakshi Sharma Postgraduate Institute of Medical Education & Research, Faculty of Public Health, Chandigarh, India.
  • Varinder Saini Department of Medical Records, Government Medical College & Hospital, Chandigarh, India.
  • Vipin Koushal Department of Hospital Administration, Government Medical College & Hospital, Chandigarh, India.
Quality of life, Impact, Physical, Psychological, Social, Environment


Tuberculosis is still one of the leading causes of mortality and morbidity. Besides clinical impact, the disease affects the quality of life (QOL) too. With the rise of 21st century, multi-drug-resistant TB (MDR TB) has risen as a significant public health problem due to emergence of resistance to anti-tuberculosis therapy (ATT) drugs. This study was planned to analyze the impact of MDRTB on QOL. It was a six month analysis, with a sample size of 60 cases each of MDRTB and PTB. It was based on a pre-designed, pre-tested questionnaire using WHOQOL BREF scale.  Out of each group, 38 (63.33%) and 36 (60.0%) were in the 21-40 years of age groups, more than 60% married and were residing in the urban/urban slums. It was found that QoL of MDRTB patients was worse than PTB counterparts. The psychological and environmental domains (MDRTB vs. PTB 17.46 vs. 15.23 and 22.00 vs 18.91) were more affected as compared to physical and social domains (19.03 vs 20.05 and 7.88 vs 9.61) in MDRTB and PTB. Financially, MDRTB patients were worst suffers as compared to PTB as former were not being covered under any program, while both groups are affected socially due to social stigma attached with the disease. Thus, there is a need to design an applicable, reliable measure to better address the quality issues methodologically. This would further enable the health care professionals and management to devise relevant interventions to improve the quality of the patients, as well as the programme.


WHO Report. Global tuberculosis control: Epidemiology, strategy, financing. Geneva: World Health Organization; 2009.

Chakraborty AK. Epidemiology of tuberculosis: Current status in India. Indian J Med Res 2004;120(4):248-76

Central TB Division, Directorate General of Health Services, Ministry of Health & Family Welfare. DOTSPlus Guidelines 2006. Nirman Bhavan, New Delhi: Revised National Tuberculosis Control Programme; 2007: p. 1-46.

Cassileth BR, Lusk EJ, Strouse TB, et al. Psychosocial status in chronic illness. A comparative analysis of six diagnostic groups. N Engl J Med 1984;311(8):506-11.

Singh MM. Tuberculosis: Triumphs and tragedy. J Indian Med Assoc 2003;101(3):190-2.

Chow SP, Yau A. Tuberculosis of the knee-- A long term follow-up. Int Orthop 1980;4(2):87-92.

Rajeswari R, Muniyandi M, Balasubramanian R, et al. Perceptions of tuberculosis patients about their physical, mental and social well-being: A field report from south India. Soc Sci Med 2005;60(8):1845-53.

Khan A, Walley J, Newell J, et al. Tuberculosis in Pakistan: Socio-cultural constraints and opportunities in treatment. Soc Sci Med 2000;50(2):247-54.

Liefooghe R, Michiels N, Habib S, et al. Perception and social consequences of tuberculosis: A focus group study of tuberculosis patients in Sialkot, Pakistan. Soc Sci Med 1995;41(12):1685-92.

Mata JI. Integrating the client's perspective in planning a tuberculosis education and treatment program in Honduras. Med Anthropol 1985;9(1):57-64.

Rajeswari R, Balasubramanian R, Muniyandi M, et al. Socio-economic impact of tuberculosis on patients and family in India. Int J Tuberc Lung Dis 1999;3(10):869-77.

Marra CA, Marra F, Cox VC, et al. Factors influencing quality of life in patients with active tuberculosis. Health Qual Life Outcomes 2004;2(1):58.

Kelly-Rossini L, Perlman DC, Mason DJ. The experience of respiratory isolation for HIV-infected persons with tuberculosis. J Assoc Nurses AIDS Care 1996;7(1):29-36.

Barnhoorn F, Adriaanse H. In search of factors responsiblefor noncompliance among tuberculosis patients in Wardha District, India. Soc Sci Med 1992;34(3):291-306.

Rubel AJ, Garro LC. Social and cultural factors in the successful control of tuberculosis. Public Health Rep 1992;107(6):626-36.

Johansson E, Long NH, Diwan VK, et al. Attitudes to compliance with tuberculosis treatment among women and men in Vietnam. Int J Tuberc Lung Dis 1999;3(10):862-8.

Johansson E, Diwan VK, Huong ND, et al. Staff andpatient attitudes to tuberculosis and compliance with treatment: An exploratory study in a district in Vietnam. Tuber Lung Dis 1996;77(2):178-83.

Hudelson P. Gender differentials in tuberculosis: The role of socio-economic and cultural factors. Tuber Lung Dis 1996;77(5):391-400.

Dhingra VK, Rajpal S. Health related quality of life scoring in tuberculosis. Indian J Tuberc 2003;50(1):99-104.

Hansel NN, Wu AW, Chang B, et al. Quality of life in tuberculosis: Patient and provider perspectives. Qual Life Res 2004;13(3):639-52

Chamla D. The assessment of patients' health-related quality of life during tuberculosis treatment. Int J Tuberc Lung Dis 2004;8(9):1100-6

FitzGerald JM, Menzies D. Undiagnosed respiratory illness. Commentary. Agency for Healthcare Research and Quality. (Accessed in Jan 2014, 7, at http://webmm.ahrq.gov).

Kelly P. Isolation and stigma: the experience of patients with active tuberculosis. J Community Health Nurs 1999;16(4):233-41.

Long NH, Johansson E, Diwan VK, et al. Fear and social isolation as consequences of tuberculosis in VietNam: a gender analysis. Health Policy 2001;58(1):69-81.

Macq J, Solis A, Martinez G, et al. An exploration of the social stigma of tuberculosis in five 'municipios' of Nicaragua to reflect on local interventions. Health Policy 2005;74(2):205-17.

Mirza I, Jenkins R. Risk factors, prevalence, and treatment of anxiety and depressive disorders in Pakistan: systematic review. BMJ 2004;328(10):794-8.

Skevington SM, Lofty M, O’connell KA, et al. The World Health Organization’s WHOQOL – BREF quality of life assessment: psychometric properties and results of the minternational field trial. A report from the WHOQOLn group. Qual Life Res 2004;13(2):299-310.

How to Cite
Sharma R, Yadav R, Sharma M, Saini V, Koushal V. Quality of Life of Multi Drug Resistant Tuberculosis Patients: a Study of North India. Acta Med Iran. 52(6):448-453.