Psychosocial wellbeing of patients with multidrug resistant tuberculosis voluntarily confined to long-term hospitalisation in Nigeria

• Published in: BMJ global health 2016, Vol.1 (3), p.e000006-e000006
• Main Authors: Oladimeji, Olanrewaju, Ushie, Boniface Ayanbekongshie, Udoh, Ekerette Emmanuel, Oladimeji, Kelechi Elizabeth, Ige, Olusoji Mayowa, Obasanya, Olusegun, Lekharu, Daisy, Atilola, Olayinka, Lawson, Lovett, Eltayeb, Osman, Gidado, Mustapha, Tsoka-Gwegweni, Joyce M, Ihekweazu, Chikwe A, Chasela, Charles S
• Format: Article
• Language: English
• Subjects: Chronic illnesses; Drug resistance; Global health; Hospitals; Mortality; Multidrug resistant organisms; Patients; Public health; Questionnaires; Tuberculosis
• ISSN: 2059-7908; 2059-7908
• DOI: 10.1136/bmjgh-2015-000006

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. 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 χ test was used to assess associations between psychosocial wellbeing and independent variables and the relationship was modelled using logistic regression. 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. 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.