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

• Published in: Tropical medicine & international health Vol. 27; no. 2; pp. 207 - 215
• Main Authors: Mesic, Anita, Ishaq, Sadiqullah, Khan, Waliullah H., Mureed, Atiqullah, Mar, Htay Thet, Khaing, Ei Ei, Bermudez‐Aza, Elkin, Rose, Letitia, Lynen, Lutgarde, Seddiq, Mohammad Khaled, Amirzada, Hashim Khan, Keus, Kees, Decroo, Tom
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01-02-2022; John Wiley and Sons Inc
• Subjects: Adaptation; Adolescent; Adult; Afghanistan; Afghanistan - epidemiology; Antitubercular Agents - therapeutic use; drug‐resistant tuberculosis; Female; Humans; Kandahar; Male; Patient-Centered Care; person‐centred care; Retention; Retention in Care - statistics & numerical data; Rifampin; Rifampin - therapeutic use; short oral regimen; Tuberculosis; Tuberculosis, Multidrug-Resistant - drug therapy; Young Adult; Afghanistan; short oral regimen; Afghanistan; Kandahar; person-centred care; drug-resistant tuberculosis
• ISSN: 1360-2276; 1365-3156
• DOI: 10.1111/tmi.13716

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 the 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), whilst under the adapted care model it was 5.6% (n = 5/90). Attrition on treatment was 22.3% (n = 25/112) before adaptations, whilst 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 amongst people with RR‐TB in Kandahar, Afghanistan.