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Psycho- social issues and wellbeing of multi drug resistant tuberculosis (mdr tb) patients - a review on social work intervention

Author: 
Murugesan, P. and Sathyamurthi, K.
Subject Area: 
Social Sciences and Humanities
Abstract: 

Multi Drug-Resistant Tuberculosis (MDR-TB) is a type of drug resistant TB. It defined as strains of Mycobacterium tuberculosis resistant to at least isoniazid and rifampicin, i.e., the two first-line anti-TB drugs. MDR-TB poses a major threat to public health worldwide, particularly in low-income countries and it represents a major obstacle towards successful TB control programme. The current long (24 months) and arduous treatment regimen uses powerful drugs with side-effects that include mental ill-health. It has a high loss to- follow-up (25%), higher case fatality and lower cure-rates than those with drug sensitive tuberculosis. Global TB strategy aims to end the global TB epidemic, to reduce TB deaths by 95% and to cut new cases by 90% by 2035, hence the management of MDR-TB is much more difficult than drug-susceptible TB. Aim & Objectives: To understand the psychosocial issues faced by MDR-TB patients and their wellbeing through published articles and conference reports to find out the social work intervention methods to strengthen the Programmatic Management of Drug-Resistant Tuberculosis (PMDT). Methods : Based on the pubMed for studies published from January 1995 to November 2018, with the terms: Tuberculosis, MDR TB, and Psychosocial problems / issues/challenges/ wellbeing. A total of 87 published articles were retrieved, of which 53 articles were chosen for full text review and presented in this review. Findings : This review has captured the psychosocial issues and wellbeing of MDR patients. Number of issues for their psycho social and economic issues due to long duration of treatment, high pill burden, drug adverse effects. Psychological disturbances (worries, fear, tension, denial, depression), social problems (disclosure issues, rejection, enacted stigma, perceived stigma, discrimination by family members, community, lack of social support) and economic problems (inability to go for work, work absenteeism, loss of income, borrowings) In addition, challenges they faced during treatment and further to lead normal life. Conclusion : The social workers strive to eliminate discrimination, to reduced Psycho-Social issues and to promote the drug adherence by using the Social Case Work and Group Work method for intervention among MDR TB patients. Social workers engage in direct practice with patients in such roles as counsellor, enabler, case manager, and advocate. It is recommended that the social worker will work as a bridge between TB patients and Health professionals for psychological intervention.

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