Determinants of Non-Adherence to Tuberculosis Treatment in Patients Co-Infected with TB and HIV in Polokwane, Limpopo
1
Health Sciences General Department, University of the Free State, Bloemfontein, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A1247
ABSTRACT
INTRODUCTION:
Tuberculosis (TB) is the primary cause of mortality among those living with Human Immunodeficiency Virus globally, and those infected have a 16% higher chance of developing active TB1,2. Despite multiple interventions in South Africa non-adherence persists, leading to increased disease transmission, treatment resistance, and elevated mortality rates. Limpopo province reported a TB treatment cure rate of 76.3% in 2021, below the national target of 77.9%3. The province experienced a high mortality rate of 13.3% among DS-TB patients, significantly higher than the national norm of 7.7% in 20213. The Department of Health highlighted that high mortality rates in TB/HIV co-infected patients and significant loss to follow-up hindered performance.
METHODS:
This study employed a qualitative methodology grounded in a constructivist paradigm, utilising Becker’s Health Belief Model and a phenomenological framework to examine patients' subjective experiences and perceptions. Data collection involved in-depth interviews with ten purposively chosen participants at a Community Health Centre, as guided by data saturation. The data were systematically organized and analysed using thematic analysis.
RESULTS:
Preliminary findings indicated: structural and socio-economic factors (job insecurity and inconvenient clinic hours), clinical and treatment-related challenges (adverse effects of medication and physical strain), leading to reduced adherence once TB symptoms improved., psychosocial determinants (e.g. alternative belief systems) and social and cultural influences . Perceived susceptibility to poor TB outcomes was generally low, as HIV was regarded as a more serious condition and TB as temporary.
CONCLUSIONS:
Understanding these determinants is crucial for formulating targeted strategies to improve treatment results and reduce the incidence of TB-HIV co-infection in the Limpopo province. Enhancing implemented strategies, including integrated models for chronic illnesses, Social Relief of Distress (SRD), and the inclusion of patients, traditional practitioners and religious leaders, can facilitate the sustainability of local health initiatives and interventions, thereby amplifying their impact across various healthcare settings.
Tuberculosis (TB) is the primary cause of mortality among those living with Human Immunodeficiency Virus globally, and those infected have a 16% higher chance of developing active TB1,2. Despite multiple interventions in South Africa non-adherence persists, leading to increased disease transmission, treatment resistance, and elevated mortality rates. Limpopo province reported a TB treatment cure rate of 76.3% in 2021, below the national target of 77.9%3. The province experienced a high mortality rate of 13.3% among DS-TB patients, significantly higher than the national norm of 7.7% in 20213. The Department of Health highlighted that high mortality rates in TB/HIV co-infected patients and significant loss to follow-up hindered performance.
METHODS:
This study employed a qualitative methodology grounded in a constructivist paradigm, utilising Becker’s Health Belief Model and a phenomenological framework to examine patients' subjective experiences and perceptions. Data collection involved in-depth interviews with ten purposively chosen participants at a Community Health Centre, as guided by data saturation. The data were systematically organized and analysed using thematic analysis.
RESULTS:
Preliminary findings indicated: structural and socio-economic factors (job insecurity and inconvenient clinic hours), clinical and treatment-related challenges (adverse effects of medication and physical strain), leading to reduced adherence once TB symptoms improved., psychosocial determinants (e.g. alternative belief systems) and social and cultural influences . Perceived susceptibility to poor TB outcomes was generally low, as HIV was regarded as a more serious condition and TB as temporary.
CONCLUSIONS:
Understanding these determinants is crucial for formulating targeted strategies to improve treatment results and reduce the incidence of TB-HIV co-infection in the Limpopo province. Enhancing implemented strategies, including integrated models for chronic illnesses, Social Relief of Distress (SRD), and the inclusion of patients, traditional practitioners and religious leaders, can facilitate the sustainability of local health initiatives and interventions, thereby amplifying their impact across various healthcare settings.
| eISSN: | 2654-1459 |
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