Health-related quality of life and associated factors following final treatment outcomes in patients with multidrug-resistant tuberculosis

Objective: To assess health-related quality of life (HRQoL) and identify factors associated with HRQoL among patients who had documented a final treatment outcome following multidrug-resistant tuberculosis (MDR-TB). Methods: A cross-sectional study was conducted among 116 patients with MDR-TB who had documented a final treatment outcome at Haji Hospital, Surabaya, Indonesia. HRQoL was assessed using the World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire. Independent predictors of HRQoL were identified using binary logistic regression analysis. Results: HRQoL scores across all WHOQOL-BREF domains remained at a moderate level, with the physical domain showing the lowest mean score of 59.65±12.18. Overall, 52.6% of patients had HRQoL below the study average. Patients with favorable treatment outcomes (cured or treatment completed) were significantly less likely to experience poor HRQoL than those with unfavorable outcomes (treatment failure or loss to follow-up) (a OR 0.03; 95% CI 0.01-0.11; P <0.001). In addition, patients with persistent peripheral neuropathy were 6.69 times more likely to report poor HRQoL than those without persistent neuropathy (a OR 6.69; 95% CI 1.61-27.84; P =0.009). Conclusions: HRQoL among patients with MDR-TB remained suboptimal despite reaching a final treatment outcome. Unfavorable treatment outcomes and persistent peripheral neuropathy were the principal determinants of poor HRQoL. These findings highlight the need to integrate routine HRQoL assessment, peripheral neuropathy monitoring, physical rehabilitation, and psychosocial support into post-TB care to optimize the long-term recovery of MDR-TB survivors.