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Research
Psychosocial wellbeing of patients with multidrug resistant tuberculosis voluntarily confined to long-term hospitalisation in Nigeria
  1. Olanrewaju Oladimeji1,2,
  2. Boniface Ayanbekongshie Ushie3,
  3. Ekerette Emmanuel Udoh3,
  4. Kelechi Elizabeth Oladimeji2,4,
  5. Olusoji Mayowa Ige5,
  6. Olusegun Obasanya6,
  7. Daisy Lekharu7,
  8. Olayinka Atilola8,
  9. Lovett Lawson9,
  10. Osman Eltayeb10,
  11. Mustapha Gidado11,
  12. Joyce M Tsoka-Gwegweni2,
  13. Chikwe A Ihekweazu6,
  14. Charles S Chasela1
  1. 1HIV/AIDS, STIs & TB (HAST) Programme, Human Sciences Research Council (HSRC), South Africa
  2. 2Discipline of Public Health Medicine, College of Health Science, Howard College Campus, University of KwaZulu-Natal, Durban, South Africa
  3. 3Regional Psychosocial Support Initiative (REPSSI), Randburg, South Africa
  4. 4HIV/AIDs Treatment Unit, Centre for the Aids Programme of Research in South Africa (CAPRISA)
  5. 5Respiratory Unit, Department of Medicine, College of Medicine, University College Hospital, Ibadan, Nigeria
  6. 6Nigeria Center for Disease Control, Abuja, Nigeria
  7. 7Stop TB Partnership, Geneva, Switzerland
  8. 8Department of Behavioral Medicine, Lagos State University College of Medicine Ikeja Lagos, Ikeja, Lagos, Nigeria
  9. 9Department of Community Medicine and Primary Healthcare, Bingham University, Nasarawa, Nigeria
  10. 10Damien Foundation Belgium, Nigeria
  11. 11Programme Management Unit, KNCV Tuberculosis Foundation, Nigeria
  1. Correspondence to Dr Olanrewaju Oladimeji; droladfb{at}gmail.com

Abstract

Background and objective Patient isolation, which is a widely successful treatment strategy for tuberculosis (TB), has been suspected to have effects on patient psychosocial wellbeing. We assessed the psychosocial wellbeing of multidrug resistant TB (MDR-TB) patients in voluntary and isolated long-term hospitalisation in Nigeria.

Methods 98 accessible and consenting patients in four drug-resistant treatment centres (University College Hospital and Government Chest Hospital, Ibadan; Mainland Hospital, Lagos, and Lawrence Henshaw Memorial Hospital, Calabar) were enrolled in this study. Data were collected using an 18-item psychosocial wellbeing questionnaire including sociodemographic characteristics. We used descriptive statistics to present demographic characteristics; the χ2 test was used to assess associations between psychosocial wellbeing and independent variables and the relationship was modelled using logistic regression.

Results The mean age of respondents was 36.1±11.9 years and 63% were males. Respondents had been in hospital an average of 4.5±1.9 months. Females had more psychosocial concerns compared with males. The most common concerns recorded among respondents were concern that people will get to know that the respondent had a bad type of TB (70%), discontent with being separated from and longing for the company of their marital partner (72%), concerns that they may have taken too many drugs (73%), and displeasure with being unable to continue to engage in their usual social and economic activities (75%). Respondents who were employed had eight times the odds of having more psychosocial concerns than the median number among respondents. Respondents who were supported by their own families during hospitalisation experienced a lower burden of psychosocial concerns compared with those who were supported by third parties.

Conclusions Prolonged hospitalisation resulted in significant psychosocial burden for the MDR-TB patients in our study centres. There is a need to consider alternative approaches that place less psychosocial burden on patients without compromising quality of care.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjgh-2015-000006

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    Footnotes

    • Handling editor Seye Abimbola

    • Contributors Conceived and designed the experiments: OO, BAU, KEO; performed the experiments: OO, KEO, BAU, EEU; analysed the data: OO, KEO, BAU, EEU, MG, OO, DL, OA, LL, OMI, OE, JMT; contributed reagents/materials/analysis tools: OO, KEO, BAU, EEU, MG, OO, DL, OA, LL, OMI, OE, JMT, CSC, CAI; wrote and approved the final version of the manuscript: OO, KEO, BAU, EEU, MG, OO, DL, OA, LL, OMI, OE, JMT, CSC, CAI.

    • Funding This study was supported by the Center for Community Health Care, Research and Development, Nigeria (CCHARD) http://www.cchrad.org.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval Oyo state, Ministry of Health, Ethics Committee.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data are available.