Abstract

IRUEDO, Joshua O.  and  PATHER, Michael K.. Lived experiences of patients and families with decentralised drug-resistant tuberculosis care in the Eastern Cape, South Africa. Afr. j. prim. health care fam. med. (Online) [online]. 2023, vol.15, n.1, pp.1-16. ISSN 2071-2936.  http://dx.doi.org/10.4102/phcfm.v15i1.4255.

BACKGROUND: South Africa adopted the decentralised Drug Resistant Tuberculosis (DR-TB) care model in 2011 with a view of improving clinical outcomes. AIM: This study explores the experiences and perceptions of patients and family members on the effectiveness of a decentralised community DR-TB care model in the Oliver Reginald Kaizana (OR) Tambo district municipality of the Eastern Cape, South Africa. METHOD: In this phenomenological qualitative research design, a semi-structured interview with prompts was conducted on 30 participants (15 patients and 15 family members). Framework approach to thematic content analysis was adopted for qualitative data analysis. RESULTS: Four themes emerged from the patients' interviews: adequate knowledge of DR-TB and its transmission, fear of death and isolation, long travel distances, and exorbitant transportation cost. A 'ready' health system influenced the effectiveness of community DR-TB management, while interviews with family members yielded five themes: misconceptions about DR-TB, rapid diagnosis and adherence counselling, long travel distances, activated healthcare workers, and little role of traditional healer. CONCLUSION: A perceived effectiveness of a community DR-TB care model in the OR Tambo district was demonstrated through the quality and comprehensiveness of care rendered by a 'ready' health system with activated health care workers (HCWs) who provided robust support and adequate knowledge of DR-TB and its treatment/side effects. However, misconceptions about DR-TB, long travel distances to treatment facilities, high cost of transportation and stigma remained challenging for most patients and family members. CONTRIBUTION: This study provides insight into the lived experiences of a decentralised community DR-TB care model in the OR Tambo district in 2020.

Keywords : DR-TB; HIV; decentralised community care; OR Tambo district; South Africa.

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