Multi-Drug Resistant Tuberculosis Is Feared More Than HIV; Even Doctors Fear It Very Much: A Hermeneutic Phenomenological Study

Background:In 2016 alone, 490,000 multidrug-resistant TB (MDR-TB) cases reported worldwide. The failure to control the disease in the presence of effective drugs to cure it implies that psychosocial and economic factors of the cases need to be addressed and such studies are uncommon in Ethiopia. Objective: To understand psycho-social challenges patients with multi drug resistant tuberculosis face and the perception of patients with multi drug resistant tuberculosis as a threat to community Methods: A hermeneutic phenomenological study design was used to explore the lived experience of patients with MDR/XDR-TB at ALERT hospital during December 28, 2017. Purposive sampling technique was employed to recruit the study participants. A semi-structured interview guide which had main questions and probing question was developed to undertake in-depth face-to-face interview. Open Code software version 4.02 was employed to make the analysis. Emergent codes were assigned to segments of the transcript that were relevant to the study objective. Finally, themes were developed from the categories. In reporting the findings, the consolidated criteria for reporting qualitative research (CORE-Q) which is a 32-items checklist was followed. Lastly, the inter-relationship among codes, categories and themes was displayed using a diagram. Results:From the analysis, 6 categories were identified from the codes as contributors of psychosocial problems in MDR-TB patients. Those were; Apprehension about economy for survival of dependent family or self, phobia development against risk factors of TB disease, regretting of handling previous life condition to protect self from TB, feeling hated or stigmatized, hopelessness and harm to mind. These categories in turn used to develop two major themes, namely anxiety/depression and intending revenge to transmit the disease to others. Conclusions:Control of MDR-TB spread demands beyond therapeutic treatment of the patients Recommendation Psychological therapy and designing income generation mechanism for MDR-TB patients while they are at treatment center are commendable.