ABSTRACT
Tuberculosis (TB) is one of the main causes of deaths related to antimicrobial resistance and the leading killer of people with HIV. The emergence of strains with multidrug-resistant TB (MDR-TB) has led to a resurgence of TB as a major public health menace worldwide, and MDR-TB has been an area of growing concern in recent years and is posing threat to global efforts for TB control. It has been seen that apart from physical symptoms, TB patients face various problems that are social, economic, and psychological in nature. Therefore, for the assessment of patients’ health status, it is necessary to consider the overall effect of TB on health and patients’ perception of well-being, besides routine clinical, radiological, and bacteriological assessments, so this present cross-sectional study was conducted to explore the burden of MDR-TB on the social, economic, and psychological well-being of the patients residing at Ballari. Methods: There are 79 MDR-TB cases registered at DR-TB center and residing in Ballari district. The data were collected from individual patients by home visits according to TB units, using a pre-designed pre-tested semi-structured questionnaire to measure the social, economic, and psychological burden of MDR-TB using standard tools. The data were entered into Microsoft Excel 2007 spreadsheet. Final analysis was done using SPSS for Windows 20.0 version. Social, economic, and psychological burden was analyzed with 95% confidence interval. Results: 68.3% patients became unemployed because of disease, 62 (78.5%) patients have to depend on others/family member for their daily routine work, and 69 (87.3%) patients are worried or had mental anguish about their disease status. The mean total cost incurred per patient is ₹58,061.99 (approximately US$ 855). The mean total direct cost incurred per patient is ₹21,318.8 (US$ 314). The mean total indirect cost incurred per patient is ₹36,743 (US$ 514). The mean pre-diagnosis and diagnosis cost per patient is ₹11,628 (US$ 171). The mean guardian cost per patient is ₹3,991.3 (US$ 59). The mean direct hospitalization cost incurred per patient is ₹6,315.44 (US$ 93). 14 (35%) patients from upper and middle class (Classes 1, 2, and 3) are shifted to lower socioeconomic classes (Classes 4 and 5). 60 (75.9%) patients have stopped working/doing household work for more than equal to 6 months because of disease. Conclusions: Study finding indicates that there is a significant social, economic, and psychological impact of MDR-TB that has a direct impact on the quality of life of MDR-TB patients and their families. There is a need for psychosocial intervention model (strategies) for MDR-TB patients and their caregivers to mitigate the negative effects of disease.Key words: Burden, multidrug-resistant tuberculosis, socioeconomic burden, tuberculosis