IDEAS home Printed from https://ideas.repec.org/a/plo/pgph00/0001706.html
   My bibliography  Save this article

Coping with drug resistant tuberculosis alongside COVID-19 and other stressors in Zimbabwe: A qualitative study

Author

Listed:
  • Collins Timire
  • Katharina Kranzer
  • Debora Pedrazzoli
  • Fungai Kavenga
  • Samuel Kasozi
  • Fredrick Mbiba
  • Virginia Bond

Abstract

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.

Suggested Citation

  • Collins Timire & Katharina Kranzer & Debora Pedrazzoli & Fungai Kavenga & Samuel Kasozi & Fredrick Mbiba & Virginia Bond, 2023. "Coping with drug resistant tuberculosis alongside COVID-19 and other stressors in Zimbabwe: A qualitative study," PLOS Global Public Health, Public Library of Science, vol. 3(8), pages 1-18, August.
  • Handle: RePEc:plo:pgph00:0001706
    DOI: 10.1371/journal.pgph.0001706
    as

    Download full text from publisher

    File URL: https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0001706
    Download Restriction: no

    File URL: https://journals.plos.org/globalpublichealth/article/file?id=10.1371/journal.pgph.0001706&type=printable
    Download Restriction: no

    File URL: https://libkey.io/10.1371/journal.pgph.0001706?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Sweeney, Sedona & Mukora, Rachel & Candfield, Sophie & Guinness, Lorna & Grant, Alison D. & Vassall, Anna, 2018. "Measuring income for catastrophic cost estimates: Limitations and policy implications of current approaches," Social Science & Medicine, Elsevier, vol. 215(C), pages 7-15.
    2. Collins Timire & Charles Sandy & Rashida A Ferrand & Regina Mubau & Peter Shiri & Obert Mbiriyawanda & Fredrick Mbiba & Rein M G J Houben & Debora Pedrazzoli & Virginia Bond & Nicola Foster & Katharin, 2022. "Coverage and effectiveness of conditional cash transfer for people with drug resistant tuberculosis in Zimbabwe: A mixed methods study," PLOS Global Public Health, Public Library of Science, vol. 2(12), pages 1-18, December.
    3. Rebecca Tadokera & Stella Huo & Grant Theron & Collins Timire & Salome Manyau-Makumbirofa & John Z Metcalfe, 2021. "Health care seeking patterns of rifampicin-resistant tuberculosis patients in Harare, Zimbabwe: A prospective cohort study," PLOS ONE, Public Library of Science, vol. 16(7), pages 1-12, July.
    4. repec:plo:pone00:0150849 is not listed on IDEAS
    5. Lieve Vanleeuw & Wanga Zembe-Mkabile & Salla Atkins, 2022. "“I’m suffering for food”: Food insecurity and access to social protection for TB patients and their households in Cape Town, South Africa," PLOS ONE, Public Library of Science, vol. 17(4), pages 1-16, April.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Collins Timire & Rein M G J Houben & Debora Pedrazzoli & Rashida A Ferrand & Claire J Calderwood & Virginia Bond & Fredrick Mbiba & Katharina Kranzer, 2024. "Higher loss of livelihood and impoverishment in households affected by tuberculosis compared to non-tuberculosis affected households in Zimbabwe: A cross-sectional study," PLOS Global Public Health, Public Library of Science, vol. 4(6), pages 1-16, June.
    2. Susmita Chatterjee & Palash Das & Guy Stallworthy & Gayatri Bhambure & Radha Munje & Anna Vassall, 2024. "Catastrophic costs for tuberculosis patients in India: Impact of methodological choices," PLOS Global Public Health, Public Library of Science, vol. 4(4), pages 1-22, April.
    3. Lieve Vanleeuw & Wanga Zembe-Mkabile & Salla Atkins, 2022. "Falling through the cracks: Increased vulnerability and limited social assistance for TB patients and their households during COVID-19 in Cape Town, South Africa," PLOS Global Public Health, Public Library of Science, vol. 2(7), pages 1-18, July.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pgph00:0001706. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: globalpubhealth (email available below). General contact details of provider: https://journals.plos.org/globalpublichealth .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.