7th SA TB Conference 2022 Poster Presentation

Track 4: Social and community aspects of TB

Authors: Nonhlanhla Ndondo; Dr Suzanne Staples

Background

Increasingly, researchers are recognizing the detrimental impact of mental ill-health on patients with chronic conditions and opportunistic infections. There is a link between poor mental well-being and treatment non-compliance among chronic illness and HIV patients.

South Africa has a high burden of HIV and drug-resistant tuberculosis (DR-TB) comorbidity, but research on how psychological wellbeing impacts DR-TB treatment outcomes is limited. The present study aimed to analyse the effect that DR-TB patients’ self-reported mental and psychological well-being has on their treatment outcomes.

Implementation

  • Qualitative data collected
  • N=10 gender-segmented focus group discussions (FGDs)
  • Participants demographics
    • DR-TB patients (n=61; 52% male; 48% female)
    • On treatment (intensive phase & continuation phase)
    • <12 months post treatment (favourable and unfavourable outcomes)
    • <12 months since becoming lost-to-follow
  • Coding and data management using ATLAS.ti
  • Braun & Clarke’s framework for thematic analysis of data

Results

  • Significant differences were highlighted between male and female self-reported mental health assessments
  • A lack of DR-TB counselling after diagnosis also accounted for these feelings
  • Substance use, fear of stigma and dysregulated mood swings impeded treatment compliance
  • Female patients were less likely to become non-compliant despite the self-reported negative psychological responses to treatment
  • Negative psychological wellbeing adverse effects, pill burdens, and DR-TB-associated stigma.
  • Participants generally stated that they had not received counselling or referrals to address their mental health complexities.

Conclusion

This study examined the psychological complexities that affect DR-TB patients’ treatment outcomes. The study, though limited by the lack of mental health screening, gives valuable insight into participants’ self-perceived negative mental well-being and its adverse impact on their DR-TB treatment journeys. To address DR-TB effectively, it is imperative to integrate culturally and gender-sensitive mental health interventions into TB treatment programs.