# Acceptability of hair harvest as a method of tuberculosis therapeutic drug monitoring among adult pulmonary TB patients: a qualitative study

## TL;DR

This study explores whether TB patients in African settings accept using hair testing to monitor treatment adherence, finding it acceptable if done by medical professionals.

## Contribution

The study provides novel insights into the cultural acceptability of hair-based TB drug monitoring in African multi-cultural contexts.

## Key findings

- Hair harvest for TB drug monitoring was acceptable to patients if conducted by medical workers.
- Participants' cultural beliefs and perceptions influenced their views on hair testing.
- Patients identified both advantages and disadvantages of using hair for adherence monitoring.

## Abstract

The current six months regimen for drug-susceptible tuberculosis (TB) is long, complex, and requires adherence monitoring. TB hair drug level assay is one innovative approach to monitor TB treatment adherence however, its acceptability in the context of African multi-cultural settings is not known.

To determine the acceptability of hair harvest and testing as a TB therapeutic drug monitoring method.

The study explored perceptions, and lived experiences among TB patients with regard to using hair harvest and testing as a method of tuberculosis therapeutic drug monitoring in the context of their cultural beliefs, and faith. We used a descriptive phenomenological approach.

Four main themes emerged namely: participants' perceptions about the cultural meaning of their body parts; perceptions about hair having any medical value or meaning; perceptions about hospitals starting to use hair harvest and testing for routine hospital TB treatment adherence monitoring; and perceived advantages and disadvantages of using hair for treatment adherence monitoring. Overall, we found that using hair to monitor adherence was acceptable to TB patients provided the hair was harvested and tested by a medical worker.

Hair harvest for medical testing is acceptable to TB patients on the condition that it is conducted by a medical worker.