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Coping with drug resistant tuberculosis alongside COVID-19 and other stressors in Zimbabwe: A qualitative study
Households in low-resource settings are more vulnerable to events which adversely affect their livelihoods, including shocks e.g. death of family members, droughts and more recently COVID-19. Drug Resistant Tuberculosis (DR-TB) is another shock that inflicts physical, psychological and socioeconomic...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10406177/ https://www.ncbi.nlm.nih.gov/pubmed/37549111 http://dx.doi.org/10.1371/journal.pgph.0001706 |
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author | Timire, Collins Kranzer, Katharina Pedrazzoli, Debora Kavenga, Fungai Kasozi, Samuel Mbiba, Fredrick Bond, Virginia |
author_facet | Timire, Collins Kranzer, Katharina Pedrazzoli, Debora Kavenga, Fungai Kasozi, Samuel Mbiba, Fredrick Bond, Virginia |
author_sort | Timire, Collins |
collection | PubMed |
description | Households in low-resource settings are more vulnerable to events which adversely affect their livelihoods, including shocks e.g. death of family members, droughts and more recently COVID-19. Drug Resistant Tuberculosis (DR-TB) is another shock that inflicts physical, psychological and socioeconomic burden on individuals and households. We describe experiences and coping strategies among people affected by DR-TB and their households in Zimbabwe during the COVID-19 pandemic, 2020–2021. We purposively selected 16 adults who had just completed or were completing treatment for DR-TB for in-depth interviews. We transcribed audio-recordings verbatim and translated the transcripts into English. Data were coded both manually and using NVivo 12 (QSR International), and were analysed thematically. Health seeking from providers outside the public sector, extra-pulmonary TB and health system factors resulted in delayed DR-TB diagnosis and treatment and increased financial drain on households. DR-TB reduced productive capacity and narrowed job opportunities leading to income loss that continued even after completion of treatment. Household livelihood was further adversely affected by lockdowns due to COVID-19, outbreaks of bird flu and cattle disease. Stockouts of DR-TB medicines, common during COVID-19, exacerbated loss of productive time and transport costs as medication had to be accessed from other clinics. Reversible coping strategies included: reducing number of meals; relocating in search of caregivers and/or family support; spending savings; negotiating with school authorities to keep children in school. Some households adopted irreversible coping strategies e.g. selling productive assets and withdrawing children from school. DR-TB combined with COVID-19 and other stressors and pushed households into deeper poverty and vulnerability. Multisectoral approaches that combine health systems and socioeconomic interventions are crucial to mitigate diagnostic delays and suffering, and meaningfully support people with DR-TB and their households to compensate the loss of livelihoods during and post DR-TB treatment. |
format | Online Article Text |
id | pubmed-10406177 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-104061772023-08-08 Coping with drug resistant tuberculosis alongside COVID-19 and other stressors in Zimbabwe: A qualitative study Timire, Collins Kranzer, Katharina Pedrazzoli, Debora Kavenga, Fungai Kasozi, Samuel Mbiba, Fredrick Bond, Virginia PLOS Glob Public Health Research Article Households in low-resource settings are more vulnerable to events which adversely affect their livelihoods, including shocks e.g. death of family members, droughts and more recently COVID-19. Drug Resistant Tuberculosis (DR-TB) is another shock that inflicts physical, psychological and socioeconomic burden on individuals and households. We describe experiences and coping strategies among people affected by DR-TB and their households in Zimbabwe during the COVID-19 pandemic, 2020–2021. We purposively selected 16 adults who had just completed or were completing treatment for DR-TB for in-depth interviews. We transcribed audio-recordings verbatim and translated the transcripts into English. Data were coded both manually and using NVivo 12 (QSR International), and were analysed thematically. Health seeking from providers outside the public sector, extra-pulmonary TB and health system factors resulted in delayed DR-TB diagnosis and treatment and increased financial drain on households. DR-TB reduced productive capacity and narrowed job opportunities leading to income loss that continued even after completion of treatment. Household livelihood was further adversely affected by lockdowns due to COVID-19, outbreaks of bird flu and cattle disease. Stockouts of DR-TB medicines, common during COVID-19, exacerbated loss of productive time and transport costs as medication had to be accessed from other clinics. Reversible coping strategies included: reducing number of meals; relocating in search of caregivers and/or family support; spending savings; negotiating with school authorities to keep children in school. Some households adopted irreversible coping strategies e.g. selling productive assets and withdrawing children from school. DR-TB combined with COVID-19 and other stressors and pushed households into deeper poverty and vulnerability. Multisectoral approaches that combine health systems and socioeconomic interventions are crucial to mitigate diagnostic delays and suffering, and meaningfully support people with DR-TB and their households to compensate the loss of livelihoods during and post DR-TB treatment. Public Library of Science 2023-08-07 /pmc/articles/PMC10406177/ /pubmed/37549111 http://dx.doi.org/10.1371/journal.pgph.0001706 Text en © 2023 Timire et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Timire, Collins Kranzer, Katharina Pedrazzoli, Debora Kavenga, Fungai Kasozi, Samuel Mbiba, Fredrick Bond, Virginia Coping with drug resistant tuberculosis alongside COVID-19 and other stressors in Zimbabwe: A qualitative study |
title | Coping with drug resistant tuberculosis alongside COVID-19 and other stressors in Zimbabwe: A qualitative study |
title_full | Coping with drug resistant tuberculosis alongside COVID-19 and other stressors in Zimbabwe: A qualitative study |
title_fullStr | Coping with drug resistant tuberculosis alongside COVID-19 and other stressors in Zimbabwe: A qualitative study |
title_full_unstemmed | Coping with drug resistant tuberculosis alongside COVID-19 and other stressors in Zimbabwe: A qualitative study |
title_short | Coping with drug resistant tuberculosis alongside COVID-19 and other stressors in Zimbabwe: A qualitative study |
title_sort | coping with drug resistant tuberculosis alongside covid-19 and other stressors in zimbabwe: a qualitative study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10406177/ https://www.ncbi.nlm.nih.gov/pubmed/37549111 http://dx.doi.org/10.1371/journal.pgph.0001706 |
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