Prioritizing the tuberculosis burden by the analytic hierarchy process for effective targeted intervention

Tuberculosis (TB) remains a major public health concern in India, with an estimated 2.69 million cases annually. This study aimed to identify priority TB burden groups in Mysuru District using the Analytic Hierarchy Process (AHP) to support targeted interventions. A retrospective cross-sectional analysis was conducted using 8,459 TB case records reported between 2017 and 2019. Urban areas accounted for most cases (64.8%), with Mysuru City alone contributing 36.5%. Integrating AHP with Geographic Information Systems (GIS), a secondary surveillance approach was used to prioritize high-risk populations and geographic zones. Type of resi- dence, gender, age group, and co-morbidities were selected as key risk criteria based on epidemiological evidence and expert judgement. Relative weights were derived through pair-wise comparisons, with consistency verified using Consistency Ratio (CR), a metric used in the AHP to measure how logically consistent a decision-maker's subjective judgments are when comparing pairs of items. Rankings were assigned based on the highest (4) and lowest (1) proportional burden. The analysis identified urban males aged 40- 59 and 20-39 years as the highest-risk groups, classified as "very high" priority, followed by urban females aged 20-39 years and elderly males as "high" priority. Younger and older age groups constituted moderate to low-risk categories. The findings highlight a disproportionately higher TB burden among urban, male, and working-age populations and demonstrate the utility of AHP in guiding targeted, evidence-based TB control strategies used.