Psychosocial wellbeing of patients with multidrug resistant tuberculosis voluntarily confined to long-term hospitalisation in Nigeria

Abstract

Background and objectivePatient isolation, which is a widely successful treatment strategy for tuberculosis (TB), has been suspected to have effects on patient psychosocial wellbeing. We assessed the psychosocial wellbeing of multidrug resistant TB (MDR-TB) patients in voluntary and isolated long-term hospitalisation in Nigeria.Methods98 accessible and consenting patients in four drug-resistant treatment centres (University College Hospital and Government Chest Hospital, Ibadan; Mainland Hospital, Lagos, and Lawrence Henshaw Memorial Hospital, Calabar) were enrolled in this study. Data were collected using an 18-item psychosocial wellbeing questionnaire including sociodemographic characteristics. We used descriptive statistics to present demographic characteristics; the χ2 test was used to assess associations between psychosocial wellbeing and independent variables and the relationship was modelled using logistic regression.ResultsThe mean age of respondents was 36.1±11.9 years and 63% were males. Respondents had been in hospital an average of 4.5±1.9 months. Females had more psychosocial concerns compared with males. The most common concerns recorded among respondents were concern that people will get to know that the respondent had a bad type of TB (70%), discontent with being separated from and longing for the company of their marital partner (72%), concerns that they may have taken too many drugs (73%), and displeasure with being unable to continue to engage in their usual social and economic activities (75%). Respondents who were employed had eight times the odds of having more psychosocial concerns than the median number among respondents. Respondents who were supported by their own families during hospitalisation experienced a lower burden of psychosocial concerns compared with those who were supported by third parties.ConclusionsProlonged hospitalisation resulted in significant psychosocial burden for the MDR-TB patients in our study centres. There is a need to consider alternative approaches that place less psychosocial burden on patients without compromising quality of care.

Socio-economic drivers of Drug-Resistant Tuberculosis in Africa: A Scoping Review

“…[31], [34]. [42] Transferred out 8 0,002 [31] Treatment outcome not evaluated in study 258295 62,42 [30], [32][33], [35][36][37][38] [41]…”

Factors influencing the length of hospital stay during the intensive phase of multidrug-resistant tuberculosis treatment at Amhara Regional State hospitals, Ethiopia: A retrospective follow up study

“…Africa is characterized by a high burden of drug-resistant tuberculosis and ine cient and inadequate healthcare facilities for the treatment of the disease. Findings from South Africa showed a LOS median of 144 days [23] and those of Nigeria 135 days [8]. Patient functional status, co-morbidities, extensive lung damage, and adverse drug effects were determinants of prolonged hospital stay in the course of MDR-TB treatment [2,11,[23][24][25][26].…”

Factors influencing length of hospital stay during the intensive phase of multidrug resistant tuberculosis treatment at Amhara Regional State hospitals, Ethiopia: retrospective follow up study

“…African countries are characterized by a high burden of drug resistance tuberculosis and inefficient and inadequate health care facilities for the treatment of the disease. Findings from South Africa showed a LOS median of 144 days [12] and those Nigeria 135 days [7]. Patient functional status, co-morbidities, extensive lung damage, and adverse drug reactions were determinants of the length of hospital stay in the course of MDRTB treatment [2,[12][13][14][15][16].…”

“…Despite the recent short regimen approval for drug resistance tuberculosis treatment, the standard treatment took two or more years [7]. The intensive phase, the first 8-12 months, is the period in which patients suffer from critical disease conditions and drug side effects.…”