Palliative care boosts care quality for DR-TB patients

Palliative care boosts care quality for DR-TB patients

Drug Resistant TB (DR-TB) remains a major source of morbidity and mortality in Zimbabwe, where treatment is successful in only about half of those diagnosed and started on treatment. Faced with these gloomy treatment outcomes, TB patients are at a greater risk of developing mental health challenges, often suffering from depression and anxiety as they try to adjust to their diagnosis and adapt to living with a long-lasting complex treatment accompanied with numerous side effects. Such is the case that was faced by Mandla, an artisanal miner in Insiza District, Matebeleland South.

*Mandla was diagnosed with DR-TB following an outreach by Baines Occupational Health Services.  He was commenced on treatment a few days later and provided with home-based palliative care support.

Under the Kunda-Nqob’ iTB (KN-TB) project, palliative care is offered at the very point of diagnosis, as an intervention to improve the quality of life for patients in care and their families.  This allows for the patient to be treated using a holistic approach and provided with an appropriate symptom assessment from a physical, emotional, social, and spiritual perspective. The most appropriate place of palliative care is right alongside ongoing curative interventions.

An assessment was conducted on Mandla revealed that physically, he was experiencing shortness of breath, a persistent cough and joint pains. He was provided with pain management medication while at home. From a psychosocial perspective, he had financial concerns which were subsequently addressed through a monthly stipend provided to DR-TB patients by the National TB Programme. He also had anxiety for which he received routine counselling in the comfort of his home, through a trained volunteer.

On the road to recovery. Measuring palliative care outcomes for a DRTB patient with the participation of his wife. Photo credit: Frank Mudzingwa

Most of his and his wife’s fears and worries were  addressed by providing relevant information through health education and provision of infection control masks, with regular screening conducted for contacts at risk. The palliative care trained community volunteer visited regularly to provide support for the family, with occasional support by the local community nurse. In the end, all of this home-based care support helped encourage a more positive treatment journey and outcome for Mandla who is now living DR-TB free.

USAID funds the Kunda-Nqob’ iTB (KN-TB) project, a local organisation network of 4 partners led by Union Zimbabwe Trust (UZT), together with Hospice Palliative Care Association (HOSPAZ), Baines Occupational Health Services (BOHS) and Jointed Hands Welfare Organization (JHWO). KN-TB is being implemented in 8 districts – these districts were selected on account of high disease burden, poor TB treatment outcomes and a high concentration of artisanal small-scale miners (ASMs), an important and often neglected risk group for silicosis and TB.