Peer-led education on treatment success and patient-reported outcomes in drug-susceptible pulmonary TB

BACKGROUND Peer-led education has shown effectiveness in improving adherence and psychosocial outcomes for HIV and chronic disease through shared experience and social learning. Despite its potential, peer involvement remains underutilised in TB care, particularly in low-income settings. Existing studies primarily focus on microbiological cure and treatment completion with minimal attention to patient-reported outcomes such as quality of life, disability, and mental health. OBJECTIVE The aim of this study is to evaluate the effect of a peer-led educational intervention on treatment success, quality of life, disability, and depression among adults with drug-susceptible pulmonary TB in South Omo and Ari zones, in southern Ethiopia. METHODS A cluster randomised controlled trial will be conducted in 30 randomly selected health facilities, enrolling 250 participants. Data will be collected at three time points using structured questionnaires. Mixed-effects logistic regression will assess treatment outcomes. Changes in quality of life, disability, and depression will be analysed using generalised estimating equations. Statistical significance will be set at P < 0.05 with 95% confidence intervals. CONCLUSION The study aims to provide evidence on whether peer-led education improves TB treatment and psychosocial outcomes, informing patient-centred TB control strategies in Ethiopia.