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It’s complicated : why do tuberculosis patients not initiate or stay adherent to treatment? a qualitative study from South Africa

dc.contributor.authorSkinner, Donalden_ZA
dc.contributor.authorClaassens, Marelien_ZA
dc.date.accessioned2017-01-26T06:01:20Z
dc.date.available2017-01-26T06:01:20Z
dc.date.issued2016-11-25
dc.identifier.citationSkinner, D. & Claassens, M. 2016. It’s complicated : why do tuberculosis patients not initiate or stay adherent to treatment? a qualitative study from South Africa. BMC Infectious Diseases, 16:712, doi:10.1186/s12879-016-2054-5en_ZA
dc.identifier.issn1471-2334 (Online)
dc.identifier.otherdoi:10.1186/s12879-016-2054-5
dc.identifier.urihttp://hdl.handle.net/10019.1/100539
dc.descriptionCITATION: Skinner, D. & Claassens, M. 2016. It’s complicated : why do tuberculosis patients not initiate or stay adherent to treatment? a qualitative study from South Africa. BMC Infectious Diseases, 16:712, doi:10.1186/s12879-016-2054-5.en_ZA
dc.descriptionThe original publication is available at http://bmcinfectdis.biomedcentral.comen_ZA
dc.descriptionPublication of this article was funded by the Stellenbosch University Open Access Fund.en_ZA
dc.description.abstractBackground: Individuals who test positive for active tuberculosis (TB) but do not initiate treatment present a challenge to TB programmes because they contribute to ongoing transmission within communities. To better understand why individuals do not initiate treatment, or are adherent after initiating treatment, South African respondents were approached to obtain insights as to which factors enabled and inhibited the treatment process. Methods: This qualitative work was nested in a larger study investigating initial loss to follow-up (LTFU) amongst new smear positive TB patients across five provinces of South Africa. In-depth interviews were done with 41 adherent and initial LTFU respondents. Results: Key issues contributing to initial LTFU appeared to be a poor knowledge, or low awareness of TB treatment; stigma around TB including its connection to HIV; immediate problems in the respondents’ lives particularly poverty, lack of access to transport and the need to continue working; and problems in the healthcare facilities including under resourced facilities, poor functioning health systems and negative staff attitudes. In contrast the reasons given for being adherent related to the level of illness, support received at home and healthcare facilities, a belief in the health system and positive experiences in the health service including positive attitudes from staff. Conclusions: Key changes need to be made to the healthcare system to enable patients to initiate treatment and remain adherent, but the six month regimen of daily observed treatment presents real practical and personal challenges to patients. Alternative strategies to DOTS at facility level should be investigated to bring services closer to communities to encourage patients to access care, initiate and adhere to treatment.en_ZA
dc.description.urihttp://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-016-2054-5
dc.format.extent9 pagesen_ZA
dc.language.isoen_ZAen_ZA
dc.publisherBioMed Centralen_ZA
dc.subjectTuberculosis -- Treatment -- South Africaen_ZA
dc.subjectTuberculosis -- Patients -- Social aspectsen_ZA
dc.subjectSouth Africa -- Tuberculosis -- Medical careen_ZA
dc.titleIt’s complicated : why do tuberculosis patients not initiate or stay adherent to treatment? a qualitative study from South Africaen_ZA
dc.typeArticleen_ZA
dc.date.updated2016-12-09T11:59:58Z
dc.description.versionPublisher's versionen_ZA
dc.rights.holderAuthor retains copyrighten_ZA


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