Study: Take TB drugs to the patient
Last week I discussed South Africa’s exponential growth in TB incidence over the past two decades and hypothesized, with support from the literature mind you, that HIV is the confounding factor that has thrown South Africa so radically off-track.
Veloshnee Govender has a different, though not mutually exclusive, explanation. The UCT health economist identifies weaknesses in South Africa’s public health care system as a reason for the rise in TB incidence. A study** in South Africa that looked at barriers patients face in taking their TB treatment consistently identified taking treatment at a clinic as the key variable. According to The Guardian article on Govender’s presentation at the Strategies to Overcome Poverty & Inequalities conference,
Taking treatment at a clinic was the key variable that determined whether someone missed their daily dose. Patients who missed treatment at clinics said the reasons they did so included the cost of transport, their distance from facilities and the conflict between taking medication and meeting work and other domestic responsibilities.
These findings call for more research and pilot projects focused on patient-centered and community-based TB treatment delivery: to measure adherence, health outcomes, costs and cost-effectiveness. Perhaps the model of TB treatment delivery can and should move closer to diabetes and HIV/AIDS treatment delivery?
**The study is currently under review for publication.
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