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Journal Article > Research

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

Loveday M, Hlangu S, Larkan LM, Cox HS, Daniels J, Mohr-Holland E, Furin J
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Abstract
BACKGROUND
There are few data on the on post-treatment experiences of people who have been successfully treated for rifampicin-resistant (RR-)TB.

OBJECTIVE
To describe the experiences and impact of RR-TB disease and therapy on post-treatment life of individuals who were successfully treated.

METHODS
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.

RESULTS
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.

CONCLUSION
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.
Countries
South Africa
Subject Area
tuberculosisantimicrobial resistance
DOI
10.1371/journal.pone.0251482
Published Date
18-Oct-2021
PubMed ID
34662887
Languages
English
Journal
PLOS One
Volume / Issue / Pages
Volume 16, Issue 10, Pages e0251482
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