Evidence map›Paper›PMID 39844137›Full record

ArticleBMC health services research2025

Navigating DR-TB Treatment care: a qualitative exploration of barriers and facilitators to retention in care among people with history of early disengagement from drug-resistant tuberculosis treatment in Johannesburg, South Africa.

Ndiviwe Mphothulo, Sindisiwe Hlangu, Jennifer Furin, Mosa Moshabela, Marian Loveday

Abstract read
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Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Ndiviwe MphothuloSchool of Public Health and Nursing, University of KwaZulu Natal, Durban, South Africa. nmphothulo@yahoo.com.
Sindisiwe HlanguHIV and Other Infectious Diseases Research Unit (HIDRU), South African Medical Research Council, Durban, South Africa.
Jennifer FurinDepartment of Global Health and Social Medicine, Harvard Medical School, Boston, USA.
Mosa MoshabelaUniversity of KwaZulu Natal, Durban, South Africa.
Marian LovedayHIV and Other Infectious Diseases Research Unit (HIDRU), South African Medical Research Council: CAPRISA-MRC HIV-TB Pathogenesis and Treatment Research Unit, Free State, South Africa.

Funding

South African Medical Research Council UKZN clinician 23/24
6 · The paper itself

Abstract

backgroundDespite advances in drug-resistant tuberculosis (DR-TB) diagnosis, treatment, and service delivery, individuals with DR-TB often face significant socioeconomic and psychosocial challenges due to limited resources. These challenges can hinder retention in care, undermining the progress made in DR-TB management. As a consequence, advances in DR-TB diagnostics and treatment have not resulted in DR-TB programs meeting the 75% treatment success targets set by the World Health Organization (WHO).

methodsWe interviewed people with DR-TB who had disengaged from care and their family members to identify barriers and facilitators to retention in care as well as possible strategies to address these barriers. We recruited 16 people with DR-TB and 8 family members from five health facilities in Johannesburg, Gauteng Province, South Africa. All DR-TB patients disengaged from DR-TB care for ≥ 45 days. Semi-structured interviews and focus group discussions were used to collect data, which were analysed through thematic content analysis using a multidimensional adherence model.

resultsThe facilitators of retention in care were positive interactions with health care workers (HCWs), nutritional support, transport from local clinics to DR-TB sites, self-motivation, and emotional support from family members. Barriers to optimal retention in care included a limited understanding of DR-TB disease and treatment, transport challenges, side effects of the medication, pill burden, stigma and discrimination experienced at health care facilities other than DR-TB facilities, food insecurity, and financial difficulties, which included loss of income and a lack of transport money and mental health challenges such as fear, anxiety and feeling lonely and unsupported.

conclusionThe findings from this study highlight the need for TB treatment programs to collaborate with people being treated for DR-TB and their families to understand facilitators and barriers to retention in care and how these could be addressed to facilitate optimal retention in care.

Indexed as

Antitubercular AgentsRetention in CareTuberculosis, Multidrug-ResistantAdultFemaleFocus GroupsHealth Services AccessibilityHumansInterviews as TopicMaleMiddle AgedQualitative ResearchSocial StigmaSouth AfricaAntitubercular AgentsAnd facilitators of retentionBarriersDR-TBDR-TB patientsFamily membersSocioeconomic and psychosocial challenges

Identifiers

PMID39844137
PMCPMC11755869

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.