TREATMENT OUTCOMES IN DRUG-SENSITIVE TUBERCULOSIS PATIENTS WITH AND WITHOUT NON-COMMUNICABLE CO-MORBIDITIES AT A TERTIARY HEALTH CARE FACILITY IN NORTHERN INDIA: A PROSPECTIVE COHORT STUDY

Background: Tuberculosis is a leading global health issue, with a high burden in developing countries. Non-communicable co-morbidities (NCCs) such as diabetes, hypertension, and chronic respiratory diseases are increasingly recognized as factors that complicate TB treatment. This study investigates the impact of NCCs on treatment outcomes in drug-sensitive TB patients. Methods: This prospective cohort study was conducted at UPUMS Saifai Etawah between January 2023 and July 2024. A total of 144 drug-sensitive TB patients were divided into two groups: group 1 (TB patients with co-morbidities) and group 2 (TB patients without co-morbidities). The primary outcomes assessed were cure rate, treatment completion, treatment failure, mortality, and loss to follow-up. Statistical analyses, including Chi-square tests and relative risk (RR) calculations, were performed to evaluate the impact of co-morbidities. Results: Group 1 had a significantly worse treatment outcome compared to group 2. The cure rate was lower in group 1 (23.61% vs. 38.89%), while mortality was higher (22.22% vs. 8.33%). Treatment failure occurred in 5.56% of group 1 but was absent in group 2. Smoking/tobacco use (73.61%) and malnutrition (44.44%) were the most common co-morbidities in group 1, both contributing to poorer treatment outcomes. Group 1 also had a higher mean age, a predominance of males, and lower literacy rates, all of which contributed to the disparity in outcomes. Conclusions: The presence of NCCs significantly worsens treatment outcomes in TB patients, leading to lower cure rates and higher mortality. Diabetes and hypertension were the most impactful co-morbidities. Integrated care approaches that address both TB and NCCs are essential to improve treatment success and reduce mortality in TB patients with co-morbidities.