# Improving Treatment Adherence in Youths With Multidrug‐Resistant Tuberculosis With Psychosocial Intervention

## TL;DR

This study shows that psychosocial support can help young people with drug-resistant tuberculosis stick to their treatment and improve outcomes.

## Contribution

The study identifies specific psychosocial challenges and preferred interventions for adolescents and young adults with MDR-TB.

## Key findings

- Common psychosocial challenges include mental stress, stigma, and socio-economic burdens.
- Most participants preferred individual-level interventions like social media and exercise.
- Early screening for mental and social issues is crucial for improving treatment outcomes.

## Abstract

Multidrug‐resistant tuberculosis (MDR‐TB) deeply impacts the well‐being of adolescents and young adults (AYA), resulting in poor treatment adherence. Identifying psychosocial challenges and preferred interventions is essential to enhance treatment adherence and outcomes in this unique group.

This was a mixed‐method study where participants aged between 15 and 24 years, diagnosed with MDR‐TB, were recruited for in‐depth interviews and a semi‐structured questionnaire.

The individual‐level psychosocial challenges included mental stress, suicidal ideation, reluctance to continue medication, perceived and experienced stigma, and socio‐economic burdens. Health system‐related challenges encompassed delayed diagnosis, drug stockouts, and negative experiences with Health Care Providers (HCPs). Among 75 participants, the median age was 20.5 years, with 57% (n = 41) females, 85% (n = 62) single, and a median treatment duration of 8 months at the interview. Seventy‐two percent (n = 54) of the participants reported psychological issues such as irritation, loneliness, anxiety, sleep disorder, suicidal ideation, and stigma. Individual‐level interventions were preferred by 61% (n = 46) of participants, including social media, deep breathing, and exercise training.

To enhance results in MDR‐TB, it is crucial to develop and assess personalized psychosocial interventions with tailored adjustments to tackle the psychosocial obstacles encountered by adolescents and young adults with MDR‐TB.

This study found that it is crucial to screen AYA with MDR‐TB for mental and social issues at the time of MDR‐TB diagnosis for early identification and intervention. There is an urgent need to include psychosocial intervention for AYA in TB program to improve programmatic treatment outcomes.