Treatment outcomes of fixed-dose combination therapy and functional dependency in activities of daily living among extrapulmonary tuberculosis patients in Bengaluru: A prospective, longitudinal study

Abstract: Background: Treatment is often challenging in extra-pulmonary tuberculosis (EPTB) due to the pauci-bacillary nature of the causative organism and invasive diagnostic procedures. Aims: The study aimed to evaluate the treatment outcomes of fixed-dose combination (FDC) therapy and the functional dependence of activities of daily living (ADL) among notified EPTB cases in Bengaluru. Materials and Methods: The EPTB-notified cases enrolled in FDC therapy in 2020 were selected from tuberculosis units and peripheral health facilities in Bengaluru and were monitored till the continuation phase. The functional evaluation of ADL (Barthel Index Score) and treatment results were documented. IBM SPSS software version 27 was used to analyze the data. Descriptive data were presented as mean, frequency, and percentages. The Friedman test for repeated measures was applied to compare the ADL scores across pretreatment, postintensive phase, and posttreatment timepoints, and associations were examined using the Chi-square test, with P < 0.05 deemed statistically significant. Results: Out of 351 EPTB patients (52.1% female), 320 were successfully treated (309; 88% completed treatment and 11; 3.1% cured). Mean Barthel Index score increased from 17.02 to 19.93 ( P < 0.0001) and percentage of patients without dependency increased from 54.8% to 96.9%. Conclusions: The majority of patients on FDC were treated successfully. Almost half of the patients had some dependency before treatment initiation, which reduced considerably at the end of treatment.