The social determinants of tuberculosis treatment adherence in a remote region of Papua New Guinea
Abstract Background Papua New Guinea (PNG) is a diverse and culturally-rich country with severe infrastructural and health problems. Tuberculosis (TB) is widespread, and the number of cases with drug resistance is rising. Treatment adherence is known to be important for both effective treatment and...
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| Format: | Article |
| Language: | English |
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BMC
2017-01-01
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| Series: | BMC Public Health |
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| Online Access: | http://link.springer.com/article/10.1186/s12889-016-3935-7 |
| _version_ | 1818518968669831168 |
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| author | Tanya Diefenbach-Elstob David Plummer Robert Dowi Sinba Wamagi Bisato Gula Keyanato Siwaeya Daniel Pelowa Peter Siba Jeffrey Warner |
| author_facet | Tanya Diefenbach-Elstob David Plummer Robert Dowi Sinba Wamagi Bisato Gula Keyanato Siwaeya Daniel Pelowa Peter Siba Jeffrey Warner |
| author_sort | Tanya Diefenbach-Elstob |
| collection | DOAJ |
| description | Abstract Background Papua New Guinea (PNG) is a diverse and culturally-rich country with severe infrastructural and health problems. Tuberculosis (TB) is widespread, and the number of cases with drug resistance is rising. Treatment adherence is known to be important for both effective treatment and limiting the emergence of drug resistance. The aim of this study was to construct a matrix of the factors that act as facilitators or barriers to TB treatment adherence in a remote region of PNG. Methods The study was based in the Balimo region of the Western Province. People known to have undergone TB treatment, as well as staff involved in managing people with TB, were asked to participate in an in-depth interview about their experiences. Purposive sampling was used to identify a diverse range of participants, from different geographic locations, social backgrounds, and with successful and unsuccessful treatment outcomes. The interview data was analysed based on grounded theory methodology. Results The study identified a range of factors that influence TB treatment adherence, with these being classified as personal, systems, and sociocultural. These factors are presented along with suggested recommendations for adaptations to DOTS-based treatment in this region. Barriers included the challenges associated with travel to treatment sites, and the difficulties of undertaking treatment alongside the daily need to maintain subsistence food production. However, facilitators were also identified, including the positive influence of religious beliefs, and high confidence in the ability of DOTS-based treatment to cure TB. Conclusions Documenting the wide range of factors that influence treatment adherence in a severely affected remote population will assist in improving TB control. These results provide impetus for further community-based efforts aimed at improving access to TB diagnosis and treatment, and maintaining successful treatment outcomes in the face of emerging drug resistance. |
| first_indexed | 2024-12-11T01:17:29Z |
| format | Article |
| id | doaj.art-3a142dc4396846ac883864fe945f7ab6 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-12-11T01:17:29Z |
| publishDate | 2017-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-3a142dc4396846ac883864fe945f7ab62022-12-22T01:25:50ZengBMCBMC Public Health1471-24582017-01-0117111210.1186/s12889-016-3935-7The social determinants of tuberculosis treatment adherence in a remote region of Papua New GuineaTanya Diefenbach-Elstob0David Plummer1Robert Dowi2Sinba Wamagi3Bisato Gula4Keyanato Siwaeya5Daniel Pelowa6Peter Siba7Jeffrey Warner8College of Public Health, Medical & Veterinary Sciences, James Cook UniversitySchool of Medicine, Griffith UniversityBalimo District HospitalBalimo District HospitalBalimo District HospitalDistrict Health Services HospitalBalimo District HospitalCollege of Public Health, Medical & Veterinary Sciences, James Cook UniversityCollege of Public Health, Medical & Veterinary Sciences, James Cook UniversityAbstract Background Papua New Guinea (PNG) is a diverse and culturally-rich country with severe infrastructural and health problems. Tuberculosis (TB) is widespread, and the number of cases with drug resistance is rising. Treatment adherence is known to be important for both effective treatment and limiting the emergence of drug resistance. The aim of this study was to construct a matrix of the factors that act as facilitators or barriers to TB treatment adherence in a remote region of PNG. Methods The study was based in the Balimo region of the Western Province. People known to have undergone TB treatment, as well as staff involved in managing people with TB, were asked to participate in an in-depth interview about their experiences. Purposive sampling was used to identify a diverse range of participants, from different geographic locations, social backgrounds, and with successful and unsuccessful treatment outcomes. The interview data was analysed based on grounded theory methodology. Results The study identified a range of factors that influence TB treatment adherence, with these being classified as personal, systems, and sociocultural. These factors are presented along with suggested recommendations for adaptations to DOTS-based treatment in this region. Barriers included the challenges associated with travel to treatment sites, and the difficulties of undertaking treatment alongside the daily need to maintain subsistence food production. However, facilitators were also identified, including the positive influence of religious beliefs, and high confidence in the ability of DOTS-based treatment to cure TB. Conclusions Documenting the wide range of factors that influence treatment adherence in a severely affected remote population will assist in improving TB control. These results provide impetus for further community-based efforts aimed at improving access to TB diagnosis and treatment, and maintaining successful treatment outcomes in the face of emerging drug resistance.http://link.springer.com/article/10.1186/s12889-016-3935-7TuberculosisPapua New GuineaTreatment adherenceDOTSRemote healthSubsistence |
| spellingShingle | Tanya Diefenbach-Elstob David Plummer Robert Dowi Sinba Wamagi Bisato Gula Keyanato Siwaeya Daniel Pelowa Peter Siba Jeffrey Warner The social determinants of tuberculosis treatment adherence in a remote region of Papua New Guinea BMC Public Health Tuberculosis Papua New Guinea Treatment adherence DOTS Remote health Subsistence |
| title | The social determinants of tuberculosis treatment adherence in a remote region of Papua New Guinea |
| title_full | The social determinants of tuberculosis treatment adherence in a remote region of Papua New Guinea |
| title_fullStr | The social determinants of tuberculosis treatment adherence in a remote region of Papua New Guinea |
| title_full_unstemmed | The social determinants of tuberculosis treatment adherence in a remote region of Papua New Guinea |
| title_short | The social determinants of tuberculosis treatment adherence in a remote region of Papua New Guinea |
| title_sort | social determinants of tuberculosis treatment adherence in a remote region of papua new guinea |
| topic | Tuberculosis Papua New Guinea Treatment adherence DOTS Remote health Subsistence |
| url | http://link.springer.com/article/10.1186/s12889-016-3935-7 |
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