‘TB is a disease whichhidesin the body’: Qualitative data on conceptualisations of tuberculosis recurrence among patients in Zambia and South Africa

Abstract

The WHO estimates 58 million people experienced one or more TB disease episodes between 2000 and 2018. These 'former TB patients' are at greater risk of future TB infection and death than TB naïve people. Additionally, former TB patients experience social, psychological, and physiological difficulties after microbiological cure. Drawing on semi-structured interviews collected with 28 people from communities in Zambia (n = 8) and South Africa (n = 2) between October 2018 and March 2019, we describe their perceptions of having two or more TB episodes. Utilising a discursive analytic approach, we interrogated how participants conceptualise their risk of disease recurrence. Despite being surprised by subsequent TB episodes, participants utilised their bodily experiences of TB signs and symptoms alongside their experiential knowledge of health systems processes to procure timely diagnosis and care. Yet, many participants were unable to resume social and economic participation. Experiences of multiple TB episodes and correlating social, economic, and physiological vulnerabilities, challenged participants biomedical understanding of TBs curability. Through notions of dirt and 'staining', participants conceptualise TB as a sinister, malicious presence they are bound to encounter time and again. Health providers should discuss the risk of TB recurrence with patients and promote prevention, early detection, and diagnosis of TB disease.

Healthcare seeking patterns for TB symptoms: Findings from the first national TB prevalence survey of South Africa, 2017–2019

“…People who had with TB In the past were more likely to seek care and this was also previously shown in Zambia [37]. This is a notable finding since individuals with a prior history of TB have a greater risk of developing active TB, and their healthcare seeking behavior could reflect better understanding of the significance of TB symptoms.…”

Practical and psychosocial challenges faced by caregivers influence the acceptability of multidrug-resistant tuberculosis preventive therapy for young children

“…The challenges to administering TPT reported by caregivers in our study were compounded by their concurrent experience of MDR-TB disease and experiences of stigma. People with (MDR-) TB experience their diagnosis as devaluing and as a mark upon their bodies, which may negatively impact patients’ willingness to access and engage with healthcare services [ 53 , 54 ]. According to Naidu and colleagues [ 55 ], people with MDR-TB experienced higher levels of stigma than people with DS-TB and are at increased risk of developing depression.…”

Hydrazone‐Tethered 5‐(Pyridin‐4‐yl)‐4H‐1,2,4‐triazole‐3‐thiol Hybrids: Synthesis, Characterisation, in silico ADME Studies, and in vitro Antimycobacterial Evaluation and Cytotoxicity

“…[1] Despite concerted efforts to eradicate this disease, it continues to kill more people worldwide. [2,3] In 2020, the World Health Organization (WHO) estimated that the global number of TB deaths could rise by approximately 0.2-0.4 million per annum. [4] Regrettably, the ongoing COVID-19 pandemic caused by a novel pathogen -Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) -has put the management and control of TB in endemic countries at risk.…”

“…[24][25][26] Similarly, 1,2,4-triazole, a five-membered heterocyclic ring system, is a remarkable structural motif also with a broad spectrum of biological activities, including antibacterial, antifungal, antiviral, anti-inflammatory, and analgesic properties. [27,28] Alprazolam (1) and ribavirin (2) are typical examples (Figure 1) of 1,2,4-triazole-containing therapeutic drugs for the treatment of anxiety and viral infection, respectively. [27] Previously, we reported on the utilisation of the molecular hybridisation strategy to design novel compounds with anti-TB and antiparasitic activities, respectively.…”

“…Since the discovery of Mycobacterium tuberculosis (MTB) by Dr Robert Koch in 1882, tuberculosis (TB) remains a long‐standing health risk globally [1] . Despite concerted efforts to eradicate this disease, it continues to kill more people worldwide [2,3] . In 2020, the World Health Organization (WHO) estimated that the global number of TB deaths could rise by approximately 0.2–0.4 million per annum [4] .…”