Multidrug-resistant tuberculosis in KwaZulu-Natal, South Africa: An overview of patients’ reported knowledge and attitudes

Abstract

BackgroundThe incidence and prevalence of multidrug–resistant tuberculosis (MDR TB) in the province of KwaZulu-Natal, South Africa, are amongst the highest in the world. Previously, interventions have been largely biomedical based; however, there is growing opinion that interventions must include social aspects such as patient education and attitudes.MethodsThis observational study assessed the knowledge and attitudes of 380 patients diagnosed with MDR TB at a centralised MDR TB unit in Durban. Data were collected using a questionnaire that was distributed to every third patient attending the outpatient MDR TB clinic. Data were collected over an 8-week period and analysed descriptively.ResultsJust under half of the respondents had primary MDR TB. Most respondents were young, female unemployed and did not receive a social grant. Knowledge around diagnosis of MDR TB was generally adequate. There were important misconceptions about spread of the disease and duration of treatment. Most respondents received knowledge of MDR TB from healthcare workers. Some respondents received knowledge from friends, family and Sangomas and believed that the disease was caused by bewitchment or as a form of punishment.DiscussionThe need for strengthening the role of primary care physicians in promoting education and providing support is highlighted. Further study is needed to investigate the high rate of primary MDR TB and to identify the unique challenges faced by women who have MDR TB. Future research could include the possibility of involving traditional healers in a contextually sensitive MDR TB education, training and support programme.

Multidrug-Resistant Tuberculosis Disease in North-Kivu Province, Democratic Republic of Congo

“…The prevalence of MDR-TB in this study was 122 cases per 100,000 populations. This prevalence is largest burden compared to DRC national prevalence in 2017 ( Figure 1) and to Kwazulu-Natal MDR-TB prevalence in South-Africa [27]. This prevalence we reported represent an important proportion of all MDR-TB patient in Democratic Republic of Congo which have 26 Provinces.…”

Knowledge toward Drugs Resistant Tuberculosis in One of the Highest Burden Drug Resistant Country

“…This study showed that most of the patients had poor knowledge regarding DR-TB. Different results were found in the study by Myet et al 9 in Myanmar, and Maharaj et al 20 in South Africa, which reported that patients have adequate knowledge regarding DR-TB. Patients enrolled in this study are mostly still unaware of the exact etiology of DR-TB, either the type or the name of the microorganism which cause DR-TB, risk factor of DR-TB, the transmission of DR-TB and the name of the drugs they received during the treatment period for DR-TB.…”

“…Patients enrolled in this study are mostly still unaware of the exact etiology of DR-TB, either the type or the name of the microorganism which cause DR-TB, risk factor of DR-TB, the transmission of DR-TB and the name of the drugs they received during the treatment period for DR-TB. Maharaj et al 20 suggested that by knowing the name of the drugs they received, patients would be more aware of the side effects of the drugs so that they would be more compliant towards the treatment regiments.…”

Prolongation of acid-fast bacilli sputum smear positivity in patients with multidrug-resistant pulmonary tuberculosis

“…Ranged only behind India and Russia, South Africa occupies the third position because the country has the highest number of patients diagnosed with drug-resistant tuberculosis (DR-TB) in the world (1). The raise of DR-TB cases in South Africa and other parts of the world threatens the efforts to end TB (1).…”

“…Ranged only behind India and Russia, South Africa occupies the third position because the country has the highest number of patients diagnosed with drug-resistant tuberculosis (DR-TB) in the world (1). The raise of DR-TB cases in South Africa and other parts of the world threatens the efforts to end TB (1). Globally, studies have shown that one of the major public health challenges today is the fact that numerous countries, particularly countries with limited resources, have the highest rates of multidrug resistant tuberculosis (MDR-TB) and extensively-drug resistant tuberculosis (XDR-TB) (2,3).…”