Evaluating the Challenges in the Treatment of Multi Drug Resistant Tuberculosis Patients from Patients’ Perspective: A Qualitative Study

India not only has the world’s highest annual incidence of TB and the highest TB-related mortality, it also has the highest number of multi-drug resistant tuberculosis (MDR-TB) cases in the world. Over the past few years, India has witnessed India a rising trend of MDR TB cases. It has to be mentioned though that there is a lack of robust monitoring system and dearth of prevalence studies to estimate the exact burden of the problem. Treatment success rate of patients with DR-TB was reported to be below 50% in India, which resulted in higher death rates. There are various issues related to patient care which has contributed to low treatment success rate of MDR TB patients. This study has been designed to explore the challenges with respect to the diagnosis of MDR-TB, access to appropriate treatment and care, and adherence to treatment basically from a patient’s perspective. The study was conducted among adults (both males and females) diagnosed with MDR TB of > 18 years of age and currently on treatment or having completed treatment within the last 6 months registered in a tuberculosis unit of a rural district. In depth interview guide and focused group discussion were used to collect data from study participants. The patients had raised several concerns during the diagnostic and treatment phase of their treatment. Majority 37 (88%) of the patients reported difficulties in reaching the proper health care facility for getting a correct diagnosis of MDR TB. Many of the patients 23 (54.7%) expressed concern over the irregular supply of drugs for MDR TB treatment. Most of the patients 38(90.4%) complained of having to face stigma at their work place mostly after the diagnosis is revealed. All the patients complained that prolonged and periodic visit to the health centers caused major economic losses for the families being daily wagers. Most of the patients 32 (76.19%) reported facing isolation in the society not only for themselves but for their entire family. A comprehensive approach involving multiple stakeholders is required to address the root causes of patient related challenges in MDR TB treatment.