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'I cry every day': experiences of patients co-infected with HIV and multidrug-resistant tuberculosis

Identifieur interne : 000023 ( PascalFrancis/Corpus ); précédent : 000022; suivant : 000024

'I cry every day': experiences of patients co-infected with HIV and multidrug-resistant tuberculosis

Auteurs : Petros Isaakidis ; Sheela Rangan ; Anagha Pradhan ; Joanna Ladomirska ; Tony Reid ; Karina Kielmann

Source :

RBID : Pascal:13-0283019

Descripteurs français

English descriptors

Abstract

OBJECTIVES To understand patients' challenges in adhering to treatment for MDR-TB/HIV co-infection within the context of their life circumstances and access to care and support. METHODS Qualitative study using in-depth interviews with 12 HIV/MDR-TB co-infected patients followed in a Médecins Sans Frontières (MSF) clinic in Mumbai, India, five lay caregivers and ten health professionals. The data were thematically analysed along three dimensions of patients' experience of being and staying on treatment: physiological, psycho-social and structural. RESULTS By the time patients and their families initiate treatment for co-infection, their financial and emotional resources were often depleted. Side effects of the drugs were reported to be severe and debilitating, and patients expressed the burden of care and stigma on the social and financial viability of the household. Family caregivers were crucial to maintaining the mental and physical health of patients, but reported high levels of fatigue and stress. Médecins Sans Frontières providers recognised that the barriers to patient adherence were fundamentally social, rather than medical, yet were limited in their ability to support patients and their families. CONCLUSIONS The treatment of MDR-TB among HIV-infected patients on antiretroviral therapy is hugely demanding for patients, caregivers and families. Current treatment regimens and case-holding strategies are resource intensive and require high levels of support from family and lay caregivers to encourage patient adherence and retention in care.

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Pour connaître la documentation sur le format Inist Standard.

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A03   1    @0 TM IH, Trop. med. int. health
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A08 01  1  ENG  @1 'I cry every day': experiences of patients co-infected with HIV and multidrug-resistant tuberculosis
A11 01  1    @1 ISAAKIDIS (Petros)
A11 02  1    @1 RANGAN (Sheela)
A11 03  1    @1 PRADHAN (Anagha)
A11 04  1    @1 LADOMIRSKA (Joanna)
A11 05  1    @1 REID (Tony)
A11 06  1    @1 KIELMANN (Karina)
A14 01      @1 Médecins Sans Frontières @2 Mumbai @3 IND @Z 1 aut. @Z 4 aut.
A14 02      @1 The Maharashtra Association of Anthropological Sciences @2 Pune @3 IND @Z 2 aut.
A14 03      @1 Independent Researcher @2 Mumbai @3 IND @Z 3 aut.
A14 04      @1 Médecins Sans Frontières, Operational Research Unit @2 Luxembourg @3 LUX @Z 5 aut.
A14 05      @1 Institute of International Health & Development, Queen Margaret University @2 Edinburgh @3 GBR @Z 6 aut.
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A21       @1 2013
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C01 01    ENG  @0 OBJECTIVES To understand patients' challenges in adhering to treatment for MDR-TB/HIV co-infection within the context of their life circumstances and access to care and support. METHODS Qualitative study using in-depth interviews with 12 HIV/MDR-TB co-infected patients followed in a Médecins Sans Frontières (MSF) clinic in Mumbai, India, five lay caregivers and ten health professionals. The data were thematically analysed along three dimensions of patients' experience of being and staying on treatment: physiological, psycho-social and structural. RESULTS By the time patients and their families initiate treatment for co-infection, their financial and emotional resources were often depleted. Side effects of the drugs were reported to be severe and debilitating, and patients expressed the burden of care and stigma on the social and financial viability of the household. Family caregivers were crucial to maintaining the mental and physical health of patients, but reported high levels of fatigue and stress. Médecins Sans Frontières providers recognised that the barriers to patient adherence were fundamentally social, rather than medical, yet were limited in their ability to support patients and their families. CONCLUSIONS The treatment of MDR-TB among HIV-infected patients on antiretroviral therapy is hugely demanding for patients, caregivers and families. Current treatment regimens and case-holding strategies are resource intensive and require high levels of support from family and lay caregivers to encourage patient adherence and retention in care.
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Format Inist (serveur)

NO : PASCAL 13-0283019 INIST
ET : 'I cry every day': experiences of patients co-infected with HIV and multidrug-resistant tuberculosis
AU : ISAAKIDIS (Petros); RANGAN (Sheela); PRADHAN (Anagha); LADOMIRSKA (Joanna); REID (Tony); KIELMANN (Karina)
AF : Médecins Sans Frontières/Mumbai/Inde (1 aut., 4 aut.); The Maharashtra Association of Anthropological Sciences/Pune/Inde (2 aut.); Independent Researcher/Mumbai/Inde (3 aut.); Médecins Sans Frontières, Operational Research Unit/Luxembourg/Luxembourg (5 aut.); Institute of International Health & Development, Queen Margaret University/Edinburgh/Royaume-Uni (6 aut.)
DT : Publication en série; Niveau analytique
SO : TM & IH. Tropical medicine & international health; ISSN 1360-2276; Royaume-Uni; Da. 2013; Vol. 18; No. 9; Pp. 1128-1133; Bibl. 3/4 p.
LA : Anglais
EA : OBJECTIVES To understand patients' challenges in adhering to treatment for MDR-TB/HIV co-infection within the context of their life circumstances and access to care and support. METHODS Qualitative study using in-depth interviews with 12 HIV/MDR-TB co-infected patients followed in a Médecins Sans Frontières (MSF) clinic in Mumbai, India, five lay caregivers and ten health professionals. The data were thematically analysed along three dimensions of patients' experience of being and staying on treatment: physiological, psycho-social and structural. RESULTS By the time patients and their families initiate treatment for co-infection, their financial and emotional resources were often depleted. Side effects of the drugs were reported to be severe and debilitating, and patients expressed the burden of care and stigma on the social and financial viability of the household. Family caregivers were crucial to maintaining the mental and physical health of patients, but reported high levels of fatigue and stress. Médecins Sans Frontières providers recognised that the barriers to patient adherence were fundamentally social, rather than medical, yet were limited in their ability to support patients and their families. CONCLUSIONS The treatment of MDR-TB among HIV-infected patients on antiretroviral therapy is hugely demanding for patients, caregivers and families. Current treatment regimens and case-holding strategies are resource intensive and require high levels of support from family and lay caregivers to encourage patient adherence and retention in care.
CC : 002B01; 002B05C02D; 002B05B02O
FD : Infection mixte; SIDA; Tuberculose; Résistance multiple; Adhérence; Inde; Homme; Virus immunodéficience humaine; Médecine tropicale
FG : Virose; Infection; Mycobactériose; Bactériose; Asie; Lentivirus; Retroviridae; Virus; Immunodéficit; Immunopathologie
ED : Mixed infection; AIDS; Tuberculosis; Multiple resistance; Adhesion; India; Human; Human immunodeficiency virus; Tropical medicine
EG : Viral disease; Infection; Mycobacterial infection; Bacteriosis; Asia; Lentivirus; Retroviridae; Virus; Immune deficiency; Immunopathology
SD : Infección mixta; SIDA; Tuberculosis; Resistencia múltiple; Adherencia; India; Hombre; Human immunodeficiency virus; Medicina tropical
LO : INIST-26295.354000506590030130
ID : 13-0283019

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Pascal:13-0283019

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<s0>002B05C02D</s0>
</fC02>
<fC02 i1="03" i2="X">
<s0>002B05B02O</s0>
</fC02>
<fC03 i1="01" i2="X" l="FRE">
<s0>Infection mixte</s0>
<s5>01</s5>
</fC03>
<fC03 i1="01" i2="X" l="ENG">
<s0>Mixed infection</s0>
<s5>01</s5>
</fC03>
<fC03 i1="01" i2="X" l="SPA">
<s0>Infección mixta</s0>
<s5>01</s5>
</fC03>
<fC03 i1="02" i2="X" l="FRE">
<s0>SIDA</s0>
<s5>02</s5>
</fC03>
<fC03 i1="02" i2="X" l="ENG">
<s0>AIDS</s0>
<s5>02</s5>
</fC03>
<fC03 i1="02" i2="X" l="SPA">
<s0>SIDA</s0>
<s5>02</s5>
</fC03>
<fC03 i1="03" i2="X" l="FRE">
<s0>Tuberculose</s0>
<s5>03</s5>
</fC03>
<fC03 i1="03" i2="X" l="ENG">
<s0>Tuberculosis</s0>
<s5>03</s5>
</fC03>
<fC03 i1="03" i2="X" l="SPA">
<s0>Tuberculosis</s0>
<s5>03</s5>
</fC03>
<fC03 i1="04" i2="X" l="FRE">
<s0>Résistance multiple</s0>
<s5>07</s5>
</fC03>
<fC03 i1="04" i2="X" l="ENG">
<s0>Multiple resistance</s0>
<s5>07</s5>
</fC03>
<fC03 i1="04" i2="X" l="SPA">
<s0>Resistencia múltiple</s0>
<s5>07</s5>
</fC03>
<fC03 i1="05" i2="X" l="FRE">
<s0>Adhérence</s0>
<s5>08</s5>
</fC03>
<fC03 i1="05" i2="X" l="ENG">
<s0>Adhesion</s0>
<s5>08</s5>
</fC03>
<fC03 i1="05" i2="X" l="SPA">
<s0>Adherencia</s0>
<s5>08</s5>
</fC03>
<fC03 i1="06" i2="X" l="FRE">
<s0>Inde</s0>
<s2>NG</s2>
<s5>09</s5>
</fC03>
<fC03 i1="06" i2="X" l="ENG">
<s0>India</s0>
<s2>NG</s2>
<s5>09</s5>
</fC03>
<fC03 i1="06" i2="X" l="SPA">
<s0>India</s0>
<s2>NG</s2>
<s5>09</s5>
</fC03>
<fC03 i1="07" i2="X" l="FRE">
<s0>Homme</s0>
<s5>10</s5>
</fC03>
<fC03 i1="07" i2="X" l="ENG">
<s0>Human</s0>
<s5>10</s5>
</fC03>
<fC03 i1="07" i2="X" l="SPA">
<s0>Hombre</s0>
<s5>10</s5>
</fC03>
<fC03 i1="08" i2="X" l="FRE">
<s0>Virus immunodéficience humaine</s0>
<s2>NW</s2>
<s5>11</s5>
</fC03>
<fC03 i1="08" i2="X" l="ENG">
<s0>Human immunodeficiency virus</s0>
<s2>NW</s2>
<s5>11</s5>
</fC03>
<fC03 i1="08" i2="X" l="SPA">
<s0>Human immunodeficiency virus</s0>
<s2>NW</s2>
<s5>11</s5>
</fC03>
<fC03 i1="09" i2="X" l="FRE">
<s0>Médecine tropicale</s0>
<s5>13</s5>
</fC03>
<fC03 i1="09" i2="X" l="ENG">
<s0>Tropical medicine</s0>
<s5>13</s5>
</fC03>
<fC03 i1="09" i2="X" l="SPA">
<s0>Medicina tropical</s0>
<s5>13</s5>
</fC03>
<fC07 i1="01" i2="X" l="FRE">
<s0>Virose</s0>
</fC07>
<fC07 i1="01" i2="X" l="ENG">
<s0>Viral disease</s0>
</fC07>
<fC07 i1="01" i2="X" l="SPA">
<s0>Virosis</s0>
</fC07>
<fC07 i1="02" i2="X" l="FRE">
<s0>Infection</s0>
</fC07>
<fC07 i1="02" i2="X" l="ENG">
<s0>Infection</s0>
</fC07>
<fC07 i1="02" i2="X" l="SPA">
<s0>Infección</s0>
</fC07>
<fC07 i1="03" i2="X" l="FRE">
<s0>Mycobactériose</s0>
</fC07>
<fC07 i1="03" i2="X" l="ENG">
<s0>Mycobacterial infection</s0>
</fC07>
<fC07 i1="03" i2="X" l="SPA">
<s0>Micobacteriosis</s0>
</fC07>
<fC07 i1="04" i2="X" l="FRE">
<s0>Bactériose</s0>
</fC07>
<fC07 i1="04" i2="X" l="ENG">
<s0>Bacteriosis</s0>
</fC07>
<fC07 i1="04" i2="X" l="SPA">
<s0>Bacteriosis</s0>
</fC07>
<fC07 i1="05" i2="X" l="FRE">
<s0>Asie</s0>
<s2>NG</s2>
</fC07>
<fC07 i1="05" i2="X" l="ENG">
<s0>Asia</s0>
<s2>NG</s2>
</fC07>
<fC07 i1="05" i2="X" l="SPA">
<s0>Asia</s0>
<s2>NG</s2>
</fC07>
<fC07 i1="06" i2="X" l="FRE">
<s0>Lentivirus</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="06" i2="X" l="ENG">
<s0>Lentivirus</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="06" i2="X" l="SPA">
<s0>Lentivirus</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="07" i2="X" l="FRE">
<s0>Retroviridae</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="07" i2="X" l="ENG">
<s0>Retroviridae</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="07" i2="X" l="SPA">
<s0>Retroviridae</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="08" i2="X" l="FRE">
<s0>Virus</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="08" i2="X" l="ENG">
<s0>Virus</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="08" i2="X" l="SPA">
<s0>Virus</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="09" i2="X" l="FRE">
<s0>Immunodéficit</s0>
<s5>37</s5>
</fC07>
<fC07 i1="09" i2="X" l="ENG">
<s0>Immune deficiency</s0>
<s5>37</s5>
</fC07>
<fC07 i1="09" i2="X" l="SPA">
<s0>Inmunodeficiencia</s0>
<s5>37</s5>
</fC07>
<fC07 i1="10" i2="X" l="FRE">
<s0>Immunopathologie</s0>
<s5>39</s5>
</fC07>
<fC07 i1="10" i2="X" l="ENG">
<s0>Immunopathology</s0>
<s5>39</s5>
</fC07>
<fC07 i1="10" i2="X" l="SPA">
<s0>Inmunopatología</s0>
<s5>39</s5>
</fC07>
<fN21>
<s1>266</s1>
</fN21>
<fN44 i1="01">
<s1>OTO</s1>
</fN44>
<fN82>
<s1>OTO</s1>
</fN82>
</pA>
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<server>
<NO>PASCAL 13-0283019 INIST</NO>
<ET>'I cry every day': experiences of patients co-infected with HIV and multidrug-resistant tuberculosis</ET>
<AU>ISAAKIDIS (Petros); RANGAN (Sheela); PRADHAN (Anagha); LADOMIRSKA (Joanna); REID (Tony); KIELMANN (Karina)</AU>
<AF>Médecins Sans Frontières/Mumbai/Inde (1 aut., 4 aut.); The Maharashtra Association of Anthropological Sciences/Pune/Inde (2 aut.); Independent Researcher/Mumbai/Inde (3 aut.); Médecins Sans Frontières, Operational Research Unit/Luxembourg/Luxembourg (5 aut.); Institute of International Health & Development, Queen Margaret University/Edinburgh/Royaume-Uni (6 aut.)</AF>
<DT>Publication en série; Niveau analytique</DT>
<SO>TM & IH. Tropical medicine & international health; ISSN 1360-2276; Royaume-Uni; Da. 2013; Vol. 18; No. 9; Pp. 1128-1133; Bibl. 3/4 p.</SO>
<LA>Anglais</LA>
<EA>OBJECTIVES To understand patients' challenges in adhering to treatment for MDR-TB/HIV co-infection within the context of their life circumstances and access to care and support. METHODS Qualitative study using in-depth interviews with 12 HIV/MDR-TB co-infected patients followed in a Médecins Sans Frontières (MSF) clinic in Mumbai, India, five lay caregivers and ten health professionals. The data were thematically analysed along three dimensions of patients' experience of being and staying on treatment: physiological, psycho-social and structural. RESULTS By the time patients and their families initiate treatment for co-infection, their financial and emotional resources were often depleted. Side effects of the drugs were reported to be severe and debilitating, and patients expressed the burden of care and stigma on the social and financial viability of the household. Family caregivers were crucial to maintaining the mental and physical health of patients, but reported high levels of fatigue and stress. Médecins Sans Frontières providers recognised that the barriers to patient adherence were fundamentally social, rather than medical, yet were limited in their ability to support patients and their families. CONCLUSIONS The treatment of MDR-TB among HIV-infected patients on antiretroviral therapy is hugely demanding for patients, caregivers and families. Current treatment regimens and case-holding strategies are resource intensive and require high levels of support from family and lay caregivers to encourage patient adherence and retention in care.</EA>
<CC>002B01; 002B05C02D; 002B05B02O</CC>
<FD>Infection mixte; SIDA; Tuberculose; Résistance multiple; Adhérence; Inde; Homme; Virus immunodéficience humaine; Médecine tropicale</FD>
<FG>Virose; Infection; Mycobactériose; Bactériose; Asie; Lentivirus; Retroviridae; Virus; Immunodéficit; Immunopathologie</FG>
<ED>Mixed infection; AIDS; Tuberculosis; Multiple resistance; Adhesion; India; Human; Human immunodeficiency virus; Tropical medicine</ED>
<EG>Viral disease; Infection; Mycobacterial infection; Bacteriosis; Asia; Lentivirus; Retroviridae; Virus; Immune deficiency; Immunopathology</EG>
<SD>Infección mixta; SIDA; Tuberculosis; Resistencia múltiple; Adherencia; India; Hombre; Human immunodeficiency virus; Medicina tropical</SD>
<LO>INIST-26295.354000506590030130</LO>
<ID>13-0283019</ID>
</server>
</inist>
</record>

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