Coping with drug resistant tuberculosis alongside COVID-19 and other stressors in Zimbabwe: a qualitative study Article Swipe
Collins Timire
,
Katharina Kranzer
,
Debora Pedrazzoli
,
Fungai Kavenga
,
Samuel Kasozi
,
Fredrick Mbiba
,
Virginia Bond
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1101/2023.02.24.23286187
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1101/2023.02.24.23286187
Background Households in low-resource settings are more vulnerable to events which adversely affect their livelihoods, including shocks such as the death of a family member, inflation, droughts and more recently COVID-19. Drug Resistant Tuberculosis (DR-TB) is also another shock that inflicts physical, psychological and socioeconomic burden on individuals and households. We describe experiences and coping strategies among people affected by DR-TB and their households in Zimbabwe during the COVID-19 pandemic, 2020 to 2021. Methods We conducted 16 in-depth interviews with adults who had just completed or were completing treatment. Interview themes included health seeking behaviour, impact of DR-TB on livelihoods and coping strategies adopted during treatment. We analysed data using thematic analyses. Results Health seeking from providers outside the public sector, extra-pulmonary TB and health system factors resulted in delayed DR-TB diagnosis and treatment and increased financial drain on households. DR-TB reduced productive capacity and narrowed job opportunities leading to income loss that continued even after completion of treatment. Household livelihood was further adversely affected by lockdowns due to COVID-19, outbreaks of bird flu and cattle disease. Stockouts of DR-TB medicines, common during COVID-19, exacerbated loss of productive time and transport costs as medication had to be accessed from other clinics that were further away. Reversible coping strategies included: reducing number of meals; relocating in search of caregivers and/or family support; spending savings; negotiating with school authorities to keep children in school. Some households had to adopt irreversible coping strategies such as selling productive assets and withdrawing children from school. Conclusion DR-TB combined with COVID-19 and other stressors pushed households into deeper poverty, and vulnerability. Multi-sectoral approaches that combine health systems, psychosocial and economic interventions are crucial to mitigate diagnostic delays and suffering, and meaningfully support people with DR-TB and their households to compensate the loss of livelihoods during and post DR-TB treatment.
Related Topics
Concepts
Livelihood
Coping (psychology)
Thematic analysis
Tuberculosis
Pandemic
Medicine
Stressor
Qualitative research
Socioeconomic status
Environmental health
Business
Economic growth
Disease
Coronavirus disease 2019 (COVID-19)
Infectious disease (medical specialty)
Psychiatry
Agriculture
Geography
Population
Economics
Social science
Sociology
Pathology
Archaeology
Metadata
- Type
- preprint
- Language
- en
- Landing Page
- https://doi.org/10.1101/2023.02.24.23286187
- https://www.medrxiv.org/content/medrxiv/early/2023/02/27/2023.02.24.23286187.full.pdf
- OA Status
- green
- Cited By
- 5
- References
- 35
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4322630514
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4322630514Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1101/2023.02.24.23286187Digital Object Identifier
- Title
-
Coping with drug resistant tuberculosis alongside COVID-19 and other stressors in Zimbabwe: a qualitative studyWork title
- Type
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preprintOpenAlex work type
- Language
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enPrimary language
- Publication year
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2023Year of publication
- Publication date
-
2023-02-27Full publication date if available
- Authors
-
Collins Timire, Katharina Kranzer, Debora Pedrazzoli, Fungai Kavenga, Samuel Kasozi, Fredrick Mbiba, Virginia BondList of authors in order
- Landing page
-
https://doi.org/10.1101/2023.02.24.23286187Publisher landing page
- PDF URL
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https://www.medrxiv.org/content/medrxiv/early/2023/02/27/2023.02.24.23286187.full.pdfDirect link to full text PDF
- Open access
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YesWhether a free full text is available
- OA status
-
greenOpen access status per OpenAlex
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https://www.medrxiv.org/content/medrxiv/early/2023/02/27/2023.02.24.23286187.full.pdfDirect OA link when available
- Concepts
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Livelihood, Coping (psychology), Thematic analysis, Tuberculosis, Pandemic, Medicine, Stressor, Qualitative research, Socioeconomic status, Environmental health, Business, Economic growth, Disease, Coronavirus disease 2019 (COVID-19), Infectious disease (medical specialty), Psychiatry, Agriculture, Geography, Population, Economics, Social science, Sociology, Pathology, ArchaeologyTop concepts (fields/topics) attached by OpenAlex
- Cited by
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5Total citation count in OpenAlex
- Citations by year (recent)
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2025: 1, 2024: 2, 2023: 2Per-year citation counts (last 5 years)
- References (count)
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35Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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| abstract_inverted_index.treatment. | 89, 106, 159, 303 |
| abstract_inverted_index.vulnerable | 8 |
| abstract_inverted_index.authorities | 227 |
| abstract_inverted_index.exacerbated | 185 |
| abstract_inverted_index.experiences | 53 |
| abstract_inverted_index.households. | 50, 140 |
| abstract_inverted_index.individuals | 48 |
| abstract_inverted_index.livelihoods | 100, 298 |
| abstract_inverted_index.negotiating | 224 |
| abstract_inverted_index.withdrawing | 247 |
| abstract_inverted_index.Tuberculosis | 34 |
| abstract_inverted_index.irreversible | 238 |
| abstract_inverted_index.livelihoods, | 15 |
| abstract_inverted_index.low-resource | 4 |
| abstract_inverted_index.meaningfully | 285 |
| abstract_inverted_index.psychosocial | 272 |
| abstract_inverted_index.interventions | 275 |
| abstract_inverted_index.opportunities | 148 |
| abstract_inverted_index.psychological | 43 |
| abstract_inverted_index.socioeconomic | 45 |
| abstract_inverted_index.Multi-sectoral | 266 |
| abstract_inverted_index.vulnerability. | 265 |
| abstract_inverted_index.extra-pulmonary | 122 |
| cited_by_percentile_year.max | 96 |
| cited_by_percentile_year.min | 91 |
| corresponding_author_ids | https://openalex.org/A5008602563 |
| countries_distinct_count | 5 |
| institutions_distinct_count | 7 |
| corresponding_institution_ids | https://openalex.org/I24122438, https://openalex.org/I4210089966, https://openalex.org/I4210099665 |
| sustainable_development_goals[0].id | https://metadata.un.org/sdg/1 |
| sustainable_development_goals[0].score | 0.75 |
| sustainable_development_goals[0].display_name | No poverty |
| citation_normalized_percentile.value | 0.75825139 |
| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | False |