‘They prefer hidden treatment': anti-tuberculosis drug-taking practices and drug regulation in Karakalpakstan

Stringer, Beverley, Lowton, Karen, Tillashaikhov, Mirzagalib, Parpieva, Nargiza, Ulmasova, Dilrabo, du Cros, Philipp, Hasker, Epco and Sergeeva, Natasha (2016) ‘They prefer hidden treatment': anti-tuberculosis drug-taking practices and drug regulation in Karakalpakstan. International Journal of Tuberculosis and Lung Disease, 20 (8). pp. 1084-1090. ISSN 1027-3719

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Setting: The joint Médecins Sans Frontières/Ministry of Health multidrug-resistant tuberculosis (MDR-TB) programme; Karakalpakstan, Uzbekistan.
Objective: Uzbekistan has high rates of MDR-TB. We aimed to understand patients’ and prescribers’ attitudes to TB drug prescription, regulation, and drug-taking behaviour.
Methods: Participants (12 patients, 12 practitioners) were recruited purposively. Data were gathered qualitatively using field notes and in-depth interviews and analysed thematically.
Findings: Our analysis highlighted two main themes. First, shame and stigma were reported to increase the likelihood of self-treatment and incorrect use of TB drugs, most commonly at initial stages of illness. A health system failure to promote health information was perceived, leading to wrong diagnoses and inappropriate therapies. Motivated by shame, patients hid their condition by resorting to drug-treatment options outside the programme, compounding the risk of chaotic management and dissemination of erroneous information through lay networks. Second, positive influences on treatment were reported through patients, practitioners and peers working effectively together to deliver the correct information and support, which acted to normalise TB, reduce stigma and prevent misuse of TB drugs.
Conclusion: Effective case finding, patient support and community education strategies are essential. Patients, practitioners and peers working together can help reduce stigma and prevent misuse of TB drugs.

Item Type: Article
Keywords: MDR-TB, Uzbekistan, Qualitative, Stigma
Schools and Departments: School of Law, Politics and Sociology > Sociology
Depositing User: Karen Lowton
Date Deposited: 19 Aug 2016 11:35
Last Modified: 24 Mar 2017 16:38
URI: http://srodev.sussex.ac.uk/id/eprint/62442

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