The approval of the Institutional Ethics committee will be obtained to conduct the study. After obtaining permission from the district tuberculosis officer the TB register at District tuberculosis office (DTO) will be referred and the list of eligible patients registered under RNTCP Udupi district from 2013 onwards will be obtained and their TB register numbers will be collected. Also the DTO will be requested to share the information about the DR TB patients with the respective PHC Medical officer and the respective area ANM. With the help of ANM the patients will be traced and visited. Patient details will be obtained from PHC. The subject who are non-traceable will be excluded from the study.  A face to face interview will be conducted using a pre tested semi structured questionnaire to gather the information regarding socio demographic characteristics, treatment and follow up details and substance abuse after obtaining written informed consent. The confidentiality about the identity and the information collected will be ensured. The HRQoL of the patients will be assessed using SF-36, a validated questionnaire and also the information regarding the challenges towards drug adherence during their course of therapy will be collected followed by symptomatic screening of patients and available household contacts for Chest pain , Cough with expectoration ,Coughing up blood ,Fever, Loss of appetite ,Unexplained weight loss. Symptomatically positive subjects referred to the nearest Designated Microscopy Centre (DMC) for further evaluation. The evaluation status of symptomatically positive patients will be confirmed telephonically from the respective Primary Health Centre. Patients who are not available at the time of first visit for interview will be given second visit and patient who is unavailable even at the time of second visit will be termed as non-respondents. The information about subjects who have died post completion of treatment due to any cause will be obtained from the respective PHC medical officer and the household members will be contacted and will be screened symptomatically.