“It is not easy” : experiences of people living with HIV and tuberculosis on Tuberculosis treatment in Uganda
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Background Completion of tuberculosis (TB) treatment presents several challenges to patients, including long treatment duration, medication adverse-effects and heavy pill burden. WHO emphasize the need for patient-centered TB care, but such approaches require understanding of patient experiences and perceptions. Methods In 2020, we nested a qualitative study within a clinical trial that recruited 128 HIV-TB co-infected adults in Kampala receiving rifampicin-based TB treatment, alongside anti-retroviral therapy. A purposively selected sub-sample of 46 trial participants contributed to nine gender segregated focus group discussions. Of these, 12 also participated in in-depth interviews. Sessions were recorded, transcribed verbatim and translated from local languages into English. Thematic analysis focused on drug adverse-effects, use of self-prescribed medications and barriers to treatment adherence. Results Patients seemed more concerned about adverse effects that clinicians sometimes overlook such as change in urine color. Those who remembered pre-treatment counselling advice were disinclined to manage adverse-effects by self-prescription. Difficulty in accessing a medical practitioner was reported as a reason for self-medication. Obstacles to adherence included stigma (especially from visible adverse-effects like “red urine”), difficulties with pill size and number, discomfort with formulation and medication adverse effects. Conclusion Tailored pre-treatment counselling, improved access to clinical services, and simpler drug administration will deliver more patient-centered care.
Nabisere-Arinaitwe , R , Namatende-Sakwa , L , Bayiga , J , Nampala , J , Alinaitwe , L , Aber , F , Otaalo , B , Musaazi , J , King , R , Kesby , M , Sloan , D J & Sekaggya-Wiltshire , C 2023 , ' “It is not easy” : experiences of people living with HIV and tuberculosis on Tuberculosis treatment in Uganda ' , Journal of Clinical Tuberculosis and Other Mycobacterial Diseases , vol. 33 , 100385 . https://doi.org/10.1016/j.jctube.2023.100385
Journal of Clinical Tuberculosis and Other Mycobacterial Diseases
Copyright © 2023 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
DescriptionThis study was funded by the Global Challenges Research Fund through the Scottish Funding Council administered via the University of St Andrews reference SFC/AN/18/2020, and the EDCTP2 programme supported by the European Union (grant number TMA2016CDF-1580). Additional research support was provided by the Fogarty Interntional Centre, National Institutes of Health (grant # 2D43TW009771-06 "HIV and co-infections in Uganda."
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