Love, sex, drugs and women’s sub-optimal adherence to MDR-TB treatment in South Africa: Opportunities for enhanced health education

2021 ◽  
pp. 001789692110351
Author(s):  
Petronella Chipo Mugoni
Keyword(s):  
South Africa ◽  
Treatment Adherence ◽  
Cultural Beliefs ◽  
Infection Prevention And Control ◽  
Adherence To Treatment ◽  
Tb Treatment ◽  
Kwazulu Natal ◽  
Mdr Tb ◽  
Lengthy Treatment ◽  
Optimal Adherence

Objective: Rising incidence of acquired multidrug-resistant tuberculosis (MDR-TB) in South Africa suggests low knowledge and implementation of infection prevention and control strategies in household and congregate settings. This study contributes to the under-researched area of non-biomedical responses to sub-adherence to treatment. Design: The study utilises a quasi-ethnographic qualitative case study of 10 women aged 18 to 34 years to understand their treatment adherence behaviours through the lens of their sex, gender, age, cultural beliefs and socio-economic status. Setting: This study investigated reasons for young women’s sub-optimal adherence to treatment for acquired MDR-TB in eThekwini Metro, KwaZulu-Natal province, South Africa, which records high burdens of tuberculosis (TB), MDR-TB and HIV. Methods: Primary data were collected from 20 participants who were selected through criterion, purposive and snowball sampling. Data were gathered through focus group discussions with women being treated for transmitted MDR-TB and key informant interviews with their family members, health workers and KwaZulu-Natal Provincial Department of Health personnel. Results: Anti-MDR-TB treatment affects women’s sexuality, intimate relationships, family planning intentions and reproductive health. Some vulnerable women struggle to persevere on noxious and lengthy treatment regimes that affect their reproductive and psychological health. Women may skip doses or abandon treatment when high pill burdens and adverse events make intimate and sexual relations with male partners, on whom they may depend for their livelihoods, difficult. Conclusion: It is important to consider the effects of lengthy treatment on young people’s social and sexual lives and self-esteem when (re)designing MDR-TB counselling approaches. This paper advances an evidence-based treatment education and counselling strategy to contribute to improving MDR-TB treatment adherence and success.

scholarly journals Adverse Events in an Integrated Home-Based Treatment Program for MDR-TB and HIV in KwaZulu-Natal, South Africa

2013 ◽  
Vol 62 (4) ◽  
pp. 436-440 ◽  
Author(s):  
James C. M. Brust ◽  
N. Sarita Shah ◽  
Theo L. van der Merwe ◽  
Sheila Bamber ◽  
Yuming Ning ◽  
...  
Keyword(s):  
South Africa ◽  
Adverse Events ◽  
Treatment Program ◽  
Home Based ◽  
Kwazulu Natal ◽  
Mdr Tb

scholarly journals Barriers to tuberculosis and human immunodeficiency virus treatment guidelines adherence among nurses initiating and managing anti-retroviral therapy in KwaZulu-Natal and North West provinces

Curationis ◽  
2018 ◽  
Vol 41 (1) ◽  
Author(s):  
Lufuno Makhado ◽  
Mashudu Davhana-Maselesele ◽  
Jason E. Farley
Keyword(s):  
Human Immunodeficiency Virus ◽  
Treatment Guidelines ◽  
Resistance To Change ◽  
Care Providers ◽  
Adherence To Treatment ◽  
North West ◽  
Tb Treatment ◽  
Kwazulu Natal ◽  
Immunodeficiency Virus ◽  
Guidelines Adherence

Background: Nurses, as front-line care providers in the South Africa’s health care system, are called upon to deliver integrated interventions for tuberculosis and human immunodeficiency virus (TB and HIV) including nurse-initiated management of anti-retroviral therapy (NIMART) and anti-TB treatment. Adherence to treatment guidelines and factors associated with non-adherence to treatment guidelines among nurses remain under explored.Purpose: To explore and describe barriers to treatment guidelines adherence among nurses initiating and managing anti-retroviral therapy and anti-TB treatment in KwaZulu-Natal and North West provinces.Design: This study employed a qualitative exploratory descriptive design.Methods: Four semi-structured focus group interviews were conducted during 2014 each consisting of four to eight NIMART trained nurses. Audiotaped interviews were transcribed verbatim and analysed using Atlas T.I. software.Findings: During data analysis, two themes emerged: (1) NIMART trained nurses’ distress about TB and HIV guidelines adherence that is inclusive of lack of agreement with guidelines, poor motivation to implement guidelines, poor clinical support and supervision, resistance to change, insufficient knowledge or lack of awareness and (2) exterior factors inhibiting nurses’ adherence to treatment guidelines which incorporated organisational factors, guidelines-related factors and patient-related factors.Conclusion: This qualitative study identified that nurses have substantial concerns over guideline adherence. If NIMART trained nurses’ barriers inhibiting adherence to treatment guidelines cannot be remedied, patient outcomes may suffer and South Africa will struggle to meet the 90-90-90 targets.

scholarly journals MDR-TB patients in KwaZulu-Natal, South Africa: Cost-effectiveness of 5 models of care

PLoS ONE ◽  
2018 ◽  
Vol 13 (4) ◽  
pp. e0196003 ◽  
Author(s):  
Marian Loveday ◽  
Kristina Wallengren ◽  
Tarylee Reddy ◽  
Donela Besada ◽  
James C. M. Brust ◽  
...  
Keyword(s):  
South Africa ◽  
Cost Effectiveness ◽  
Models Of Care ◽  
Kwazulu Natal ◽  
Mdr Tb

scholarly journals CHALLENGES IN TUBERCULOSIS COINFECTION TREATMENT IN PEOPLE WITH HIV/AIDS IN ANGOLA

2020 ◽  
Vol 29 ◽  
Author(s):  
Silvano da Silva Cameia ◽  
Betina Hörner Schlindwein Meirelles ◽  
Veridiana Tavares Costa ◽  
Sabrina da Silva de Souza
Keyword(s):  
Treatment Adherence ◽  
Health Professionals ◽  
Adherence To Treatment ◽  
Convergence Group ◽  
Tb Treatment ◽  
Conventional Content Analysis ◽  
Living With Hiv ◽  
Intervening Factors ◽  
Participatory Observation ◽  
Hiv Aids

ABSTRACT Objective: to know the challenges faced during tuberculosis coinfection treatment in people with HIV/AIDS (HIV/TB) in Huambo, Angola. Method: this is a qualitative convergent-care investigation carried out in the antituberculosis dispensary of the sanatorium hospital of Huambo, Angola. It included 18 people co-infected with HIV/TB and 11 health professionals. Data were collected from January to July 2016 through conversation interviews, participatory observation and a convergence group. In data analysis, conventional content analysis of Hsieh and Shannon was used. Results: the data originated two categories: challenges of HIV/TB coinfected people when facing the diseases and treatment adherence, and challenges due to intervening factors upon HIV/TB treatment adherence. Conclusions: people’s conception about living with HIV/TB, associated with the intervening factors upon HIV/TB treatment adherence, results in late search for health services, non-adherence to treatment and worsening of diseases, thus posing as challenges to be overcome for better control of this double epidemic.

scholarly journals Technology And Its Role In Supporting Tuberculosis Treatment Adherence

2021 ◽  
Author(s):  
Era Dorihi Kale ◽  
Moses Pandin
Keyword(s):  
Treatment Adherence ◽  
Economic Condition ◽  
Cost Effective ◽  
Adherence Rate ◽  
Remote Areas ◽  
Tb Treatment ◽  
Use Of Technology ◽  
The Family ◽  
Mdr Tb ◽  
Selection Of

Compliance with TB treatment has now become a problem that must be handled seriously because the high non-adherence rate will give a bad contribution to the success of TB treatment, including MDR-TB and also morbidity and mortality. Many innovations have been made to improve TB treatment adherence, one of which is using mobile-based technology. This article aims to explore the effectiveness of the technology used to improve treatment adherence in TB patients: types, ways of working, advantages, and limitations of each application. This is a systematic review through searching 3 databases, namely Scopus, WoS, and Science Direct. Some of the advantages in applying technology to improve TB treatment adherence are easy to use if you understand how to operate tools/applications are cost-effective because they reduce transportation costs in reaching remote areas or in conditions of transportation difficulties such as after a disaster, the use of this technology provides patient satisfaction in treatment and facilitates the involvement of the family/support system in the treatment of patients. Several things must be considered (limitations) of the technology to be used, including experts, patient knowledge and skills, economic condition, electricity availability, and whether the technology used will not increase the burden on patients related to the stigma of TB disease. We can conclude that the use of technology is indeed very good in supporting the improvement of TB treatment adherence, but the selection of this application must pay attention to the characteristics of the population as well as the advantages and limitations of each application. Keywords: Technology, Adherence, Tuberculosis

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