The Failed Treatment of MDR-TB in Three Generations: A Case Study of the Household in Northeastern, Thailand

Orathai Srithongtham, Ubonsri Thabuddha, Supasai Sangawong

Abstract


Introduction: In Thailand TB and MDR-TB treatment was found in all levels of the unit of health service system, but the failed treatment especially for MDRTB was found 8.2% in the lower part of northeastern Thailand. In the complex situation, only the medical care cannot eradicate MDR-TB.

This study aimed to explain the failure treatment of patient with MDR-TB over 3 generations within 1household.

Method: This qualitative method collected data by in-depth in the province located at northeast Thailand; 5 patients and failure treatment of MDR-TB were investigated. The data was analyzed using content analysis.

Introduction: In Thailand TB and MDR-TB treatment was found in all levels of the unit of health service system, but the failed treatment especially for MDRTB was found 8.2% in the lower part of northeastern Thailand. In the complex situation, only the medical care cannot eradicate MDR-TB. This study aimed to explain the failure treatment of patient with MDR-TB over 3 generations within 1household. Method: This qualitative method collected data by in-depth in the province located at northeast Thailand; 5 patients and failure treatment of MDR-TB were investigated. The data was analyzed using content analysis. Result: One grandmother, 78 years old, have had twice received treatments and still alive. The mother failed treatment and died from MDR-TB at 54 years old aggravated by noncompliance to drug treatment. The father defaulted treatment due to alcohol consumption, and the second treatment was cured but the subject died at 61 years old. The son and daughter comprised default treatment caused from the household problem of low income, drug addiction, alcohol consumption and divorce. The elder brother did not return to treatment and his symptoms worsened. However, the younger sister, 21 years old, returned to treatment for 4 months. The supportive factors of failed treatment that led patients to cease taking drugs more than 2 months and deny continuing treatment included low income, household problems and drug addiction. Recommendation: Only the medication could not cure or achieve successful treatment, but socio-economic factors such as the understanding of the patient’s context was crucial equally the same as the MDR-TB drug. This factor was effecting to compliance of MDR-TB patient care and treatment.


Keywords


Failure Treatment, MDR-TB

Full Text:

PDF

References


WHO. 2010. Multidrug and extensively drug-resistant TB (M/XDR-TB), 2010 global report on surveillance and response.

The Bureau of TB, Department of Disease Contron, Ministry of Public Health. 2013. Guidline of the National TB Program, Thailand. Press by Chomnumsahakornkarnkasate; Bangkok, Thailand.

Leimane V, Riekstina V, Holtz TH, Zarovska E, Skripconoka V, Thorpe LE, Laserson KF, and Wells CD . 2005. Clinical Outcomes of Individual Treatment of Multidrug Resistance Tuberculosis in Latvia: A Retrospect Cohort Study. Lancet, Vol 365 January 22.

Sonya Shina, Jennifer Furina, Jaime Bayonab , Kedar Matec , Jim YongKima,c, and Paul Farmera. 2004. Community-Based Treatment of Multidrug Resistance Tuberculosis in Lima, Peru: 7 years of experience. Social Science and Medicine, 59: 1529-1539.

S. S. Shin, A. D. Pasechnikov, I. Y. Gelmanova, G. G. Peremitin, A. K. Strelis, Y. G. Andreev, V. T. Golubchikova and et., al. 2006. Treatment Outcome in an Integrated Civilian and Prison MDR-TB Treatment program in Russia. International Journal of Tuberculoss and Lung Disease, 10(4: 402-408.)

Somsak and et. Al.2006. The study of the factors related to TB care by DOTS with care giver. Funded by Thailad Research Fund(TRF.).

Hye-Ryoun Kim, Seung Sik Hwang, Hyun Ji Kim, Sang Min Lee, Chul-Gyu Yoo, Young Whan Kim, Sung Koo Han, Young-Soo Shim, and Jae-Joon Yim. 2007. Impact of Extensive Drug Resistance on Treatment Outcomes in Non-HIV-Infected Patients with Multidrug-Resistant Tuberculosis. Clinical Infectious Disease (15 November 2007): 1290-5.

Marie-Laure Uffredi, Chantal Truffot-Pernot, Bertrand Dautzenberg, Muriel Renard, Vincent Jarlier, And Jérôme Robert .2006. An intervention program for the management of multidrug-resistant tuberculosis in France. International journal of Antimicrobial Agents 29(2007): 434-439.

Eva Nathanson, Catharina Lambregts-van Weezenbeek, Michael Rich, Rajesh Gupta, Jaime Bayona, Kai Blöndal, José A. Caminero, J. Peter Cegielski, Manfred Danilovits, Marcos A. Espinal, Vahur Hollo, Ernesto Jaramillo, Vaira Leimane, Carole D. Mitnick, Joia S. Mukherjee, Paul Nunn, Alexander Pasechnikov, Thelma E. Tupasi, Charles Wells, and Mario C. Raviglione. 2007. Multidrug-resistance Tuberculosis Management in Resources-Limited Settings. Emerging Infectious Disease, www.cdc.gov/eid, Vol 12, No.9, September 2006.

Srithongtham, Orathai, (2008). Social capital process of the community care for people living with HIV/AIDS. Dissertation (Population Education), Social science and humanity, Mahidol University.




DOI: https://doi.org/10.23954/osj.v3i2.1167

Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

Open Science Journal (OSJ) is multidisciplinary Open Access journal. We accept scientifically rigorous research, regardless of novelty. OSJ broad scope provides a platform to publish original research in all areas of sciences, including interdisciplinary and replication studies as well as negative results.