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Psycho-Socio-Economic Issues Challenging Multidrug Resistant Tuberculosis Patients: A Systematic Review

Author

Listed:
  • Beena Elizabeth Thomas
  • Poonguzhali Shanmugam
  • Muniyandi Malaisamy
  • Senthanro Ovung
  • Chandra Suresh
  • Ramnath Subbaraman
  • Srividya Adinarayanan
  • Karikalan Nagarajan

Abstract

Background: Limited treatment options, long duration of treatment and associated toxicity adversely impact the physical and mental well-being of multidrug-resistant tuberculosis (MDR-TB) patients. Despite research advances in the microbiological and clinical aspects of MDR-TB, research on the psychosocial context of MDR-TB is limited and less understood. Methodology: We searched the databases of PubMed, MEDLINE, Embase and Google Scholar to retrieve all published articles. The final manuscripts included in the review were those with a primary focus on psychosocial issues of MDR-TB patients. These were assessed and the information was thematically extracted on the study objective, methodology used, key findings, and their implications. Intervention studies were evaluated using components of the methodological and quality rating scale. Due to the limited number of studies and the multiple methodologies employed in the observational studies, we summarized these studies using a narrative approach, rather than conducting a formal meta-analysis. We used ‘thematic synthesis’ method for extracting qualitative evidences and systematically organised to broader descriptive themes. Results: A total of 282 published articles were retrieved, of which 15 articles were chosen for full text review based on the inclusion criteria. Six were qualitative studies; one was a mixed methods study; and eight were quantitative studies. The included studies were divided into the following issues affecting MDR-TB patients: a) psychological issues b) social issues and economic issues c) psychosocial interventions. It was found that all studies have documented range of psychosocial and economic challenges experienced by MDR-TB patients. Depression, stigma, discrimination, side effects of the drugs causing psychological distress, and the financial constraints due to MDR-TB were some of the common issues reported in the studies. There were few intervention studies which addressed these psychosocial issues most of which were small pilot studies. There is dearth of large scale randomized psychosocial intervention studies that can be scaled up to strengthen management of MDR-TB patients which is crucial for the TB control programme. Conclusion: This review has captured the psychosocial and economic issues challenging MDR patients. However there is urgent need for feasible, innovative psychosocial and economic intervention studies that help to equip MDR-TB patients cope with their illness, improve treatment adherence, treatment outcomes and the overall quality of life of MDR-TB patients.

Suggested Citation

  • Beena Elizabeth Thomas & Poonguzhali Shanmugam & Muniyandi Malaisamy & Senthanro Ovung & Chandra Suresh & Ramnath Subbaraman & Srividya Adinarayanan & Karikalan Nagarajan, 2016. "Psycho-Socio-Economic Issues Challenging Multidrug Resistant Tuberculosis Patients: A Systematic Review," PLOS ONE, Public Library of Science, vol. 11(1), pages 1-15, January.
    • Handle: RePEc:plo:pone00:0147397
    DOI: 10.1371/journal.pone.0147397
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    References listed on IDEAS

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    1. Shin, Sonya & Furin, Jennifer & Bayona, Jaime & Mate, Kedar & Kim, Jim Yong & Farmer, Paul, 2004. "Community-based treatment of multidrug-resistant tuberculosis in Lima, Peru: 7 years of experience," Social Science & Medicine, Elsevier, vol. 59(7), pages 1529-1539, October.
    2. Long, Nguyen Hoang & Johansson, Eva & Diwan, Vinod K. & Winkvist, Anna, 2001. "Fear and social isolation as consequences of tuberculosis in VietNam: a gender analysis," Health Policy, Elsevier, vol. 58(1), pages 69-81, October.
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    1. Aklilu Abrham Roba & Tamirat Tesfaye Dasa & Fitsum Weldegebreal & Abyot Asfaw & Habtamu Mitiku & Zelalem Teklemariam & Mahantash Naganuri & Bahubali Jinnappa Geddugol & Frehiwot Mesfin & Hilina Befika, 2018. "Tuberculosis patients are physically challenged and socially isolated: A mixed methods case-control study of Health Related Quality of Life in Eastern Ethiopia," PLOS ONE, Public Library of Science, vol. 13(10), pages 1-14, October.
    2. K. A. T. M. Ehsanul Huq & Michiko Moriyama & David Krause & Habiba Shirin & John Koku Awoonor-Willaims & Mahfuzur Rahman & Md Moshiur Rahman, 2022. "Perceptions, Attitudes, Experiences and Opinions of Tuberculosis Associated Stigma: A Qualitative Study of the Perspectives among the Bolgatanga Municipality People of Ghana," IJERPH, MDPI, vol. 19(22), pages 1-19, November.

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