Exploring perceptions of multi drug resistant tuberculosis patients and their supporters on hospital based and ambulatory care treatment models

Abstract

Background: Despite the existence of several studies reporting on the challenges and benefits of MDR TB patients being treated under hospital and ambulatory care models, there is a dearth of information on patients’ and treatment supporters’ perceptions regarding the effectiveness of the models. Methodology: A cross sectional study was conducted whereby thirty-six (36) participants were interviewed. This number included 21 males and 15 females from three Municipalities in Dar es Salaam and the Kibong’oto Infectious Disease Hospital. The selected facilities were chosen because, Dar es Salaam is one of the phase one ambulatory site and has many patients compared to other regions and KIDH was chosen because is the only facility where MDR TB patients are hospitalized. The data collected were analyzed using thematic approach. Permission to conduct this study was sought from the Institutional Review Board (IRB) at the Muhimbili University of Health and Allied Sciences (MUHAS). Permission to interview study participants was sought and granted using consent form. The study respondents were purposefully selected. In-depth interviews (IDIs) were used to collect primary data. Data was recorded, transcribed and later manually analyzed qualitatively. Results: The analysis of the study findings has generated themes that explain the perceptions of MDR TB patients and treatment supporters’ regarding the models. These themes are: - the first section presents introduction, the second section is on socio demographic information of the study participants, the third section presents patients’ perceptions on ambulatory care model and hospital based model of MDR-TB treatment (care and treatment, opportunity to learn about drug use ,patients and relatives awareness of the model, stigma) . The fourth section addresses the treatment supporters’ perceptions on the ambulatory care model and hospital based model (family support, economic status of relative, misconception about hospital care model). The firth section covers the perceived benefits for MDR TB patients receiving treatment under hospital and ambulatory care models (health improvements, availability of basic needs, close follow up by family members). The last section presents the results on the perceived challenges for MDR TB patients receiving treatment under hospital and ambulatory care models (inadequate medication and supplies, distance to the facility, inadequate staffs, unfavorable environment and infrastructures and limited choice of food). Conclusion and Recommendation: Perceptions of patients and supporters regarding the models, benefits and challenges faced by patients and relatives are worth explored because it will help to institute interventions or improvements that might be introduced as there are scientific evidences to support them, these models of MDR TB treatment are all of crucial importance for the betterment of patients’ health. The models complement each other. Therefore, it is recommended that the Government should strategize i.e. increasing funding to TB clinics to utilize both models for the overall successful treatment outcomes. Conclusion: it can be argued that the perceptions of patients and their supporters on the benefits and challenges of the two models are both positive but also show challenges for both models. Both models are however considered important and complement each other