Burden of Comorbidity and Treatment Outcome in Tuberculosis – A Descriptive Study from a Tertiary Care Center, Kerala, India

Abstract Background: Identification and management of comorbidities are an important strategy for successful treatment outcome in Tuberculosis. Aims and Objective: The aim of the study was to estimate the burden of comorbidities associated with tuberculosis (TB) and the outcome of treatment with anti tubercular drugs in patients presented to a tertiary care setting. Materials and Methods: This was a nonconcurrent cohort study done in a tertiary care teaching hospital. Patient’s data collected from the hospital database and patient’s demographic features and characteristics of the disease and comorbidities were captured by using a performa and was entered in Microsoft Excel version 2007. All patients diagnosed with TB and those treatments started during the first and second quarters of the year of 2016 were included in the study. Comorbidity of all TB patients listed. Treatment outcomes were categorized as successful outcome and unsuccessful outcome. Results: Of the 150 patients, 70 patients (46.67%) were pulmonary TB (PTB) and 80 patients (53.33%) were extra PTB. 42.6% (64/150) had at least one comorbidity. The most common comorbidity observed was diabetes mellitus (DM) at 28% (42/150), followed by chronic respiratory diseases at 19.33% (29/150). Overall success rate of treatment is 86.67% (130/150). Overall unsuccessful outcome was 12.6% (19/150). Diabetes was the most common comorbidity with unsuccessful outcome (16.6%). In 42.8% (18/42) of patients with DM, ATT were extended beyond 6 months for a successful outcome. Forty six patients (30.67%) patients needed extended treatment for more than 6 months. In this study, diabetes and chronic respiratory disease were found to be the common comorbidities. Conclusion: Comorbidities can lead to delayed treatment response, which in turn may lead to extension of treatment for a successful outcome.