2023-09-28 14:46:10 +00:00
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abstract: 'Background: Non-adherence to tuberculosis (TB) treatment is an important
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barrier for TB control programs because incomplete treatment may result
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in prolonged infectiousness, drug resistance, relapse, and death. The
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aim of the present study is to explore enablers and barriers in the
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management of TB treatment during the first five months of treatment in
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Addis Ababa, Ethiopia.
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Methods: Qualitative study which included 50 in-depth interviews and two
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focus groups with TB patients, their relatives and health personnel.
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Results: We found that loss of employment or the possibility to work led
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to a chain of interrelated barriers for most TB patients. Daily
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treatment was time-consuming and physically demanding, and rigid
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routines at health clinics reinforced many of the emerging problems.
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Patients with limited access to financial or practical help from
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relatives or friends experienced that the total costs of attending
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treatment exceeded their available resources. This was a barrier to
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adherence already during early stages of treatment. A large group of
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patients still managed to continue treatment, mainly because relatives
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or community members provided food, encouragement and sometimes money
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for transport. Lack of income over time, combined with daily
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accumulating costs and other struggles, made patients vulnerable to
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interruption during later stages of treatment. Patients who were poor
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due to illness or slow progression, and who did not manage to restore
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their health and social status, were particularly vulnerable to
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non-adherence. Such patients lost access to essential financial and
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practical support over time, often because relatives and friends were
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financially and socially exhausted by supporting them.
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Conclusion: Patients'' ability to manage TB treatment is a product of
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dynamic processes, in which social and economic costs and other burdens
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change and interplay over time. Interventions to facilitate adherence to
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TB treatment needs to address both time-specific and local factors.'
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affiliation: 'Sagbakken, M (Corresponding Author), Univ Oslo, Sect Int Hlth, Inst
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Gen Practice \& Community Med, POB 1130, NO-0318 Oslo, Norway.
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Sagbakken, Mette, Univ Oslo, Sect Int Hlth, Inst Gen Practice \& Community Med,
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NO-0318 Oslo, Norway.
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Frich, Jan C., Univ Oslo, Res Unit Gen Practice, Inst Gen Practice \& Community
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Med, NO-0318 Oslo, Norway.
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Bjune, Gunnar, Univ Oslo, Sect Int Hlth, Inst Gen Practise \& Community Med, NO-0318
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Oslo, Norway.'
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article-number: '11'
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author: Sagbakken, Mette and Frich, Jan C. and Bjune, Gunnar
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author-email: 'mette.sagbakken@medisin.uio.no
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j.c.d.frich@medisin.uio.no
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g.a.bjune@medisin.uio.no'
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author_list:
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- family: Sagbakken
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given: Mette
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- family: Frich
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given: Jan C.
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- family: Bjune
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given: Gunnar
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da: '2023-09-28'
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doi: 10.1186/1471-2458-8-11
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files: []
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issn: 1471-2458
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journal: BMC PUBLIC HEALTH
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keywords-plus: 'DIRECTLY OBSERVED THERAPY; PATIENT COMPLIANCE; RURAL DISTRICT; TB
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CLUBS;
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COMMUNITY; OPPORTUNITIES; AFRICA; DOTS; CARE; DETERMINANTS'
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language: English
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month: JAN 11
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number-of-cited-references: '46'
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orcid-numbers: Frich, Jan C./0000-0001-9079-7508
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papis_id: efcdd653a5c199ee374205bd213bebea
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ref: Sagbakken2008barriersenablers
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times-cited: '75'
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title: 'Barriers and enablers in the management of tuberculosis treatment in Addis
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Ababa, Ethiopia: a qualitative study'
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000253869300001
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usage-count-last-180-days: '1'
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usage-count-since-2013: '10'
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volume: '8'
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web-of-science-categories: Public, Environmental \& Occupational Health
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year: '2008'
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