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Person-centred care and short oral treatment for rifampicin-resistant tuberculosis improve retention in care in Kandahar, Afghanistan

Trop Med Int Health. 2022 Jan 3. doi: 10.1111/tmi.13716. Online ahead of print.

ABSTRACT

OBJECTIVES: To describe the effect of adaptations to a person-centred care with short oral regimens on retention in care for rifampicin-resistant TB (RR-TB) in Kandahar province, Afghanistan.

METHODS: The study included people with RR-TB registered in the programme between 01 October 2016 and 18 April 2021. From 19 November 2019 the programme implemented a trial investigating the safety and effectiveness of short oral RR-TB regimens. During the trial, person-centred care was adapted. We included data from people living with RR-TB treated in the period before and after the care model was adapted and applied Kaplan-Meier statistics to compare rates of retention in care.

RESULTS: Of 236 patients registered in the RR-TB programme, 146 (61.9%) were registered before and 90 (38.1%) after the model of care was adapted. Before adaptations enhancing person-centred care, pre-treatment attrition was 23.3% (n=34/146), while under the adapted care model it was 5.6% (n=5/90). Attrition on treatment was 22.3% (n=25/112) before adaptations, while during the study period none of the participants were lost to follow-up on treatment and 3.3% died (n=3/90).

CONCLUSIONS: As person-centred care delivery and treatment regimens were adapted to better fit specific contextual challenges and the needs of the target population, retention in care improved among people with RR-TB in Kandahar, Afghanistan.

PMID:34978748 | DOI:10.1111/tmi.13716

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