"This is not my body": Therapeutic experiences and post-treatment health of people with rifampicin-resistant tuberculosis.

Journal: PloS one

Volume: 16

Issue: 10

Year of Publication: 2021

Affiliated Institutions:  HIV Prevention Research Unit, South African Medical Research Council, KwaZulu-Natal, South Africa. Greytown Specialised TB Hospital, KwaZulu-Natal Department of Health, Pietermaritzburg, South Africa. Institute for Infectious Disease and Molecular Medicine and Wellcome Centre for Infectious Disease Research in Africa, University of Cape Town, Cape Town, South Africa. Médecins Sans Frontières, Khayelitsha, Cape Town, South Africa. Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, United States of America.

Abstract summary 

There are few data on the on post-treatment experiences of people who have been successfully treated for rifampicin-resistant (RR-)TB.To describe the experiences and impact of RR-TB disease and therapy on post-treatment life of individuals who were successfully treated.In this qualitative study in-depth interviews were conducted among a purposively selected sample from a population of individuals who were successfully treated for RR-TB between January 2008 and December 2018. Interview transcripts and notes were analysed using a thematic network analysis which included grounded theory and a framework for understanding pathophysiological mechanisms for post-TB morbidity and mortality. The analysis was iterative and the coding system developed focused on disease, treatment and post-treatment experiences of individuals. This paper follows the COREQ guidelines.For all 12 participants interviewed, the development of RR-TB disease, its diagnosis and the subsequent treatment were a major disruption to their lives as well as a transformative experience. On diagnosis of RR-TB disease, participants entered a liminal period in which their lives were marked with uncertainty and dominated by physical and mental suffering. Irrespective of how long ago they had completed their treatment, they all remembered with clarity the signs and symptoms of the disease and the arduous treatment journey. Post-treatment participants reported physical, social, psychological and economic changes as consequences of their RR-TB disease and treatment. Many participants reported a diminished ability to perform physical activities and, once discharged from the RR-TB hospital, inadequate physical rehabilitation. For some, these physical limitations impacted on their social life, and ultimately on their psychological health as well as on their ability to earn money and support their families.The experiences and impact of RR-TB disease and therapy on post-treatment life of individuals successfully treated, highlights gaps in the current health care system that need to be addressed to improve the life of individuals post-treatment. A more holistic and long-term view of post-TB health, including the provision of comprehensive medical and social services for post-treatment care of physical ailments, social re-integration and the mitigation of the perceived fear and risk of getting TB again could be a central part of person-centred TB care.

Authors & Co-authors:  Loveday Marian M Hlangu Sindisiwe S Larkan Lee-Megan LM Cox Helen H Daniels Johnny J Mohr-Holland Erika E Furin Jennifer J

Study Outcome 

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Statistics
Citations :  World Health Organization. Global Tuberculosis Report 2020. Licence: CC BY-NC-SA 3.0 IGO. Geneva.
Authors :  7
Identifiers
Doi : e0251482
SSN : 1932-6203
Study Population
Male,Female
Mesh Terms
Adult
Other Terms
Study Design
Grounded Theory,Cross Sectional Study
Study Approach
Qualitative
Country of Study
Publication Country
United States