Advancing Patient-centered Care: Harnessing Interventions to Address Risk Factors of Drug-resistant Tuberculosis- A Multicentric Prospective Study
Vishwa Rajakumar Byakod, Madiwalayya Shivakantayya GanachariIntroduction:
Drug-resistant tuberculosis (DR-TB) persists as a significant public health issue and continues to obstruct worldwide tuberculosis control initiatives. Determining factors linked to drug resistance is crucial for prompt intervention and efficient preventive strategies. This study aimed to identify key risk factors linked to DR-TB among high-risk patients and to provide counselling tailored to these risks.
Materials and Methods:
A prospective interventional study was initiated in April 2025 at the District Tuberculosis Centre, District Government Hospital (BIMS), and four affiliated Primary Health Centres in North Karnataka, India. Patients receiving treatment for drug-resistant tuberculosis were enrolled based on predefined inclusion and exclusion criteria. Risk factors were evaluated using standardized questionnaires. After assessment, patients received structured counselling supported by educational materials and nutritional guidance. Data were analysed using statistical methods, including logistic regression, to estimate odds ratios with 95% confidence intervals.
Results:
Logistic regression analysis showed that extreme obesity was significantly associated with rifampicin-resistant tuberculosis, with markedly increased odds (OR = 24.40, 95% CI: 3.90–152.60; p < 0.001). A history of tuberculosis was inversely associated with rifampicin resistance (OR = 0.08, 95% CI: 0.01–1.04; p = 0.015). In addition, patients in the retreatment category showed a borderline association with rifampicin resistance (p = 0.057).
Discussion:
The findings suggest that metabolic and host-related factors may contribute to rifampicin resistance. Extreme obesity may influence immune and metabolic responses, thereby affecting disease progression. The inverse association with prior TB history may reflect greater awareness of and adherence to treatment among previously treated individuals.
Conclusion:
Extreme obesity and treatment history appear to influence rifampicin resistance. Early identification of high-risk patients and targeted counselling may help improve treatment outcomes and reduce the development of resistance.