This morning (June 12th), I had my presentation on TB/HIV drug adherence for nurses at the outpatient department. I started my presentation with questions on what the nurses think the main reasons are why patients default from the medication regimen. The nurses shared their thoughts with genuine concern about the issues.
Poverty, lack of knowledge, stigma, stopping treatment after patients feel better, medication side effects, lack of food, and belief in traditional healers were the main reasons that the nurses thought the patients do not adhere to the regimen. These factors coincide with recent studies. I asked about how poor healthcare worker attitudes affect patients’ adherence. Most nurses agreed that it could be one of the reasons for poor adherence as well.
I also raised a questionabout whether they have seen colleagues contract TB from the patients while taking care of them. The majority of the nurses said they have seen many nurses who got TB from the patients because there is no such a thing as “universal precautions” as seen in U.S. hospitals which is to assume every patient has a transmittable disease therefore, healthcare workers should use precautions when they treat every patient until the test confirms otherwise. Another reason is that they have lack of personal protective equipment (PPE) such as N95 masks.
We offered them the remainder of several boxes of N95 masks we had brought for our own protection with MDR-TB patients. They were so pleased and started to applaud. What a touching moment! We take everything for granted in the U.S. while seemingly small things are appreciated in South Africa.