New Study on drug-resistant tuberculosis (DRTB)-HIV care among patients in South Africa

Researchers led by Dr. Amrita Daftary, Faculty Member at the Dahdaleh Institute for Global Health Research, recently published a study which describes experiences of DRTB-HIV care among patients in KwaZulu-Natal province, South Africa. The study aims to address the lack of evidence of patient acceptability for drug-resistant tuberculosis (DRTB) care in the context of new treatment regimens and HIV co-infection. It highlights the need for information, patient agency, and social protections in DRTB care and treatment, and for decentralised, community peer-support, and differentiated care models that might be ameliorative and help to maximise the promise of new regimens for DRTB.

Speaking on the value of this study, Principal Investigator and Assistant Professor at the School of Global Health at York University, Dr. Amrita Daftary exclaimed “this study fills a gap in the evidence around patient acceptability for new DRTB treatment regimens, particularly in the context of HIV co-infection. Drawing on in-depth qualitative methods and a conceptual framework for chronic illness, this study chronologises challenges and coping strategies among patients receiving bedaquiline-based treatment for multi DRTB or extensively DRTB and concurrent antiretroviral treatment in the high-burden setting of KwaZulu-Natal, South Africa.”

Dr. Daftary led this seminal qualitative study, which was nested into a broader study about adherence in people living with drug resistant TB and HIV. The research reflects a longstanding close collaboration with the Centre for the AIDS Programme of Research in South Africa, where Amrita has worked since 2005, and Columbia University Medical Centre. Other contributors are leading actors in the TB and HIV research community coming to the problem of TB from a multiple disciplinary lens, and with extensive experience working in South Africa.

As People with DRTB and HIV undergo disruptive, life-altering experiences, the authors conclude that the lack of information, agency, and social protections in DRTB care and treatment causes wider-reaching challenges for patients compared with HIV. Based on the study, recommendations include establishing a decentralised, community, peer-support, and differentiated care models which can help maximise the promise of new regimens.

Find out more about the study findings here: https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(20)30548-9/fulltext

Dr. Daftary was also featured by the Canadian Institute for Mental Health for her work to address the absence of a significant reduction in TB incidence over the past decade by tackling the unchecked social determinant and stigma. Check out the feature here: https://cihr-irsc.gc.ca/e/52390.html?fbclid=IwAR3KFQtBMXXQFvp1TZvOCoZA7lgj5XquEuFJJ9gLSzdkwcG_P6dRPEpYgIo

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