Once you get TB, life changes’: post-tuberculosis experiences and care needs in East Africa

Abstract

B A C K G R O U N D : Recognition of tuberculosis (TB) se- quelae is growing, and evidence regarding post-TB ex- periences and care needs may inform care models. M E T H O D S : The TB Sentinel Research Network of the International epidemiology Databases to Evaluate AIDS is a global prospective study of people aged �15 with pulmonary TB. In Eldoret, Kenya, and Mbarara, Uganda, we conducted in-depth interviews with a pur- posive sample of individuals treated for TB and multi- disciplinary health care workers (HCWs) providing TB care, using a semi-structured guide. We conducted a reflexive thematic analysis. R E S U L T S : In interviews with 25 HCWs and 61 individ- uals treated for TB, participants described trajectories of TB illness and recovery, and some persistent challenges after TB treatment across physical, economic, social, and mental health domains of wellbeing. Experiences were marked by stigma and isolation. Physical illness exac- erbated economic vulnerability, which compromised physical health and presented barriers to care. There was a lack of care access and need for person-centred post-TB care. Care needs included addressing potential TB re- currence, lung health impairment, and psychosocial, nutritional, and economic challenges. C O N C L U S I O N : Post-TB experiences are marked by persistent symptoms, economic vulnerability, stigma, and psychosocial challenges. These experiences are generally neglected in the current care paradigm, underscoring needs for accessible, person-centred post-TB care models.