Understanding Structural Impediments to the Management of MDR-TB on Patients and Families in Post-Conflict and Post-Ebola Setting, Liberia

Abstract

The global burden of tuberculosis (TB) has become unbearable, especially in middle-and low-income countries. Liberia is classified among the 30 countries with high burden of TB.6 The country has the 4th lowest treatment coverage among the 30 high-burden countries, and the largest gap between resources allocated and those needed for TB care in 2018. We conducted a qualitative study to examine the structural impediments to the management of MDR-TB in Liberia. Data collection consisted of individual interviews with MDR-TB in-patients (n=15), ambulatory patients (n=4), completed patients (n=8), Administrators (n=2) and clinicians(n=10). Two focus group discussion (FGD) were conducted, each with 8 16). A thematic, inductive content analytic approach was used to identify thematic concepts that shed light on participants’ experiences of MDR-TB management. Reported challenges highlight the need for more social support, well-supervised ambulatory care and psychosocial support for families delivered in homes. Community awareness programs should be conducted periodically. The conduct of periodically Community awareness programs will mitigate stigma and discrimination and increase knowledge capacity of community dwellers about multi-drug resistant tuberculosis.