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‘They prefer hidden treatment': anti-tuberculosis drug-taking practices and drug regulation in Karakalpakstan

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posted on 2023-06-09, 02:36 authored by Beverley Stringer, Karen LowtonKaren Lowton, Mirzagalib Tillashaikhov, Nargiza Parpieva, Dilrabo Ulmasova, Philipp du Cros, Epco Hasker, Natasha Sergeeva
Setting: The joint Médecins Sans Frontières/Ministry of Health multidrug-resistant tuberculosis (MDR-TB) programme; Karakalpakstan, Uzbekistan. Objective: Uzbekistan has high rates of MDR-TB. We aimed to understand patients’ and prescribers’ attitudes to TB drug prescription, regulation, and drug-taking behaviour. Methods: Participants (12 patients, 12 practitioners) were recruited purposively. Data were gathered qualitatively using field notes and in-depth interviews and analysed thematically. Findings: Our analysis highlighted two main themes. First, shame and stigma were reported to increase the likelihood of self-treatment and incorrect use of TB drugs, most commonly at initial stages of illness. A health system failure to promote health information was perceived, leading to wrong diagnoses and inappropriate therapies. Motivated by shame, patients hid their condition by resorting to drug-treatment options outside the programme, compounding the risk of chaotic management and dissemination of erroneous information through lay networks. Second, positive influences on treatment were reported through patients, practitioners and peers working effectively together to deliver the correct information and support, which acted to normalise TB, reduce stigma and prevent misuse of TB drugs. Conclusion: Effective case finding, patient support and community education strategies are essential. Patients, practitioners and peers working together can help reduce stigma and prevent misuse of TB drugs.

History

Publication status

  • Published

File Version

  • Accepted version

Journal

International Journal of Tuberculosis and Lung Disease

ISSN

1027-3719

Publisher

Intega Connect

Issue

8

Volume

20

Page range

1084-1090

Department affiliated with

  • Sociology and Criminology Publications

Full text available

  • Yes

Peer reviewed?

  • Yes

Legacy Posted Date

2016-08-19

First Open Access (FOA) Date

2017-02-01

First Compliant Deposit (FCD) Date

2016-08-19

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