The challenges that individuals with MDRTB and TB experience when returning to work after completing TB treatment in the Western Cape, South Africa

TL;DR

This study explores the challenges and supports for people with TB or MDR-TB returning to work in South Africa, highlighting socio-economic barriers and the role of rehabilitation.

Contribution

The study introduces a return-to-work program and identifies key barriers and enablers specific to TB and MDR-TB patients in the Western Cape.

Findings

Contextual barriers like poverty and poor public resources hinder return to work for TB patients.

Engagement in activities and early work skills training can alleviate despondency and support rehabilitation.

Occupational therapy services are seen as critical for TB rehabilitation outcomes.

Abstract

Tuberculosis (TB) and multi-drug resistant (MDR) TB have been identified as one of the largest health problems in the world, and notably recognised as a major concern in South Africa. Socio-demographic factors such as poverty and unemployment has been identified as major contributing factors to the epidemic.

The aim of the study was to explore the barriers and enablers of return to work (RTW) for individuals living with MDRTB and Pulmonary Tuberculosis (PTB) in the Western Cape, South Africa. The qualitative exploration was part of a larger study that resulted in a return-to-work programme for individuals with MDRTB and TB.

Qualitative methodology was employed for this study. Semi-structured interviews were used with 5 key informants and 4 participants diagnosed with PTB and MDR-TB. The data was analysed by means of thematic analysis.

The participants described the barriers and facilitators of their RTW process and the factors that were of critical importance in the resumption of the worker role. Two themes represent the barriers, and two themes represent the enablers of RTW. The four major themes were 1) A sense of disbelief in one's own potential, 2) The contextual environment influences an individual's worker role, 3) The future of Occupational Therapy (OT) services in TB rehabilitation, and 4) Engagement in activities alleviates feelings of despondency.

The study highlighted that contextual barriers such as poor socio-economic factors negatively influenced individuals diagnosed with PTB/MDRTB from initiating and completing rehabilitation programmes. The lack of resources in public facilities were also noted as one of the main barriers described by the rehabilitation care specialists. The facilitators that supported the completion of rehabilitation programmes enhancing the life skills of and work related skills as part of the PTB/MDRTB intervention provided to clients or patients. Early engagement in work skills improvement programmes may enhance the worker roles of individuals with PTB/MDRTB.

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