Social, economic, and psychological impacts of MDR-TB treatment in Tijuana, Mexico: a patient's perspective

Abstract

Setting The state of Baja California, Mexico had the highest prevalence of multidrug-resistant tuberculosis (MDR-TB) in Mexico in 2009. Objective To understand the socioeconomic burdens of MDR-TB disease and its treatment on patients in Tijuana and Mexicali, Mexico. Design From July to November 2009, qualitative interviews were conducted with 12 patients who were enrolled in a US-Mexico binational MDR-TB treatment program called “Puentes de Esperanza” (Bridges of Hope), which was designed to support MDR-TB patients. In-depth interviews were coded to identify major themes in patient experiences of MDR-TB diagnosis and care. Results While some patients were able to maintain their pre-MDR-TB lives to a limited extent, most patients reported losing their sense of identity due to their inability to work, social isolation, and stigmatization from family and friends. The majority of participants expressed appreciation for Puentes’ role in “saving their life.” Conclusion Being diagnosed with MDR-TB and undergoing treatment imposes significant psychological, social, and economic stress on patients. Strong social support elements within Puentes helped ameliorate these burdens. Improvements to the program might include peer-support groups for patients undergoing treatment and transitioning back into the community after treatment.

Depression and its Associated Factors with Multidrug-Resistant Tuberculosis at Baseline

“…Patients with longer period of illness experienced higher degree of depression. Reason may include hopelessness, sense of worthlessness, hospitalization, social stigmatization and loss of earning all these factors lead to self-depreciation, conscious and unconscious fear of ailment and death [32,33]. Our study showed positive relation of depression with past treatment outcome and previous use of SLDs.…”

The Psychosocial Challenges Facing Multi Drug Resistance Tuberculosis Patients: A Qualitative Study

“…These findings corroborate the findings from other studies, which have highlighted the psychological, social and economic challenges experienced by MDR-TB patients. 7 This result warrants a comprehensive intervention plan to address these issues in a phased manner in order to enhance treatment adherence and better quality of life among MDR-TB patients.…”

Uptake of governmental social protection and financial hardship during drug-resistant tuberculosis treatment in Rio de Janeiro, Brazil

“…consultations), direct non-medical expenses (e.g. transport and food for accessing health services) and lost income from time off work related to disability, discrimination and/or infection control laws [2]. With the treatment duration for drug-resistant TB lasting up to 24 months, affected households are especially vulnerable to TB-related costs [1].…”