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    A qualitative exploration of tuberculosis patients who were lost to follow-up in Malaysia

    Tok, Peter Seah Keng
    Wong, Li Ping
    Liew, Su May
    Razali, Asmah
    Mahmood, Mohd Ihsani
    Chinnayah, Thilaka
    Kawatsu, Lisa
    Toha, Haidar Rizal
    Yusof, Khalijah Mohd
    RahmanI, Rozanah Abd
    Che Mat Din, Shaharom Nor Azian
    Loganathan, Tharani
    2023-09-07

    Background: Loss to follow-up (LTFU) is an unsuccessful treatment outcome for tuberculosis (TB) patients. In Malaysia, LTFU affects around 1 in 20 TB patients. Integration of qualitative research methods and evidence will provide a better understanding of LTFU and its underlying issues. In this study, we qualitatively explored TB patients’ experiences in receiving treatment and their reasons for leaving TB care. Method: In-depth interviews of 15 patients with a history of LTFU were conducted from January to September 2020. Interview guides were developed to explore TB patients’ experiences while receiving treatment, including challenges faced and reasons for treatment interruption. Data were thematically analysed using the framework method. Results: We identified 11 emerging themes that occurred at four levels of interaction with TB patients. First, at the patient personal level, TB beliefs referring to patients’ perception of illness and wellness, patients’ perceived role of traditional and complementary medicine, and substance abuse were important. Second, the healthcare system and treatment factors that were highlighted included the organisation of care and treatment, interaction with healthcare professionals, particularly in communication and counselling, and TB medications’ side effects. Third, structural factors including financial burden, logistical and transportation issues and work-related factors were identified to be barriers to treatment continuation. Fourth, the interpersonal level interaction of patients should not be neglected; this includes family relationships and support as well as peer influence. Conclusion: Study findings put forth issues and challenges faced by TB patients while receiving treatment and underscore areas where actions can be taken. This will contribute to informing the development and implementation of future TB control strategies that are responsive to TB patients’ needs and concerns, to effectively address LTFU and ensure better treatment completion rates among TB patients in Malaysia.

    tuberculosis
    malaysia
    loss to follow-up
    Research paper
    Text
    application/pdf
    This work is licensed under a Creative Commons Attribution 4.0 International license (CC BY 4.0).
    Open access
    Copyright (c) 2023 Tok et al.
    https://resources.equityinitiative.org/handle/ei/627
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