Why do tuberculosis patients default in Tashkent City, Uzbekistan? A qualitative study

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Qualitative Research Methods

Background:

• Tuberculosis (TB) control in Tashkent City, Uzbekistan, follows the DOTS strategy, with a 21% defaulter rate in 2005.
• Previous studies identified risk factors for defaulting but did not explore the underlying reasons.
• A qualitative approach was needed to understand patient perspectives on defaulting from TB treatment.

Purpose of the Study:

• To investigate the reasons why patients default from tuberculosis treatment in Tashkent.
• To identify potential solutions to improve treatment adherence and reduce default rates.
• To explore the experiences of patients, healthcare providers, and those who have completed treatment.

Main Methods:

• A qualitative follow-up study was conducted.
• In-depth interviews were performed with 32 participants, including defaulters, patients who completed treatment, and healthcare providers.
• The study aimed to gather rich, detailed insights into the 'why' behind defaulting.

Main Results:

• Poor communication and inadequate information exchange between patients and healthcare staff were identified as significant issues.
• Patients often lack proper understanding of TB and its curability, with a prevalent belief that it is not curable.
• Hospitalisation posed challenges due to poor conditions, patient costs, and the need to earn a living or care for families.

Conclusions:

• Improving communication between healthcare staff and TB patients is crucial to address the root causes of treatment default.
• Reducing the duration of hospitalisation may enhance patient adherence to TB treatment regimens.
• Addressing patient concerns regarding hospitalisation and information gaps is essential for effective TB control programs.