Giving patients money to reward them from adhering to their tuberculosis treatment may be an effective tool on the long term in the fight against the dreaded disease, a review of studies conducted by the South African Medical Research Council (SAMRC) has found.
The review was conducted by Cochrane South Africa which is a research unit of the SAMRC.
In the review, researchers asked whether providing money, vouchers or food to people with tuberculosis increased the number of people who attended clinic appointments and completed treatment.
“Given the growth of antibiotic resistance tuberculosis over the last decade, ensuring effective treatment has become a public health priority,” principal author of the Cochrane Review Dr. Elizabeth Lutge said in a statement released by the MRC.
“Tuberculosis remains largely a disease of poverty, where overcrowding and undernutrition facilitate the spread of the disease from person-to-person.
“Indeed, tuberculosis can also exacerbate poverty by placing a substantial financial burden on patients even where drugs are given free.
“Patients are often required to attend multiple clinic appointments, incurring travel costs and time off from work.
“Patients are then left with difficult choices to make as they choose between providing for their families or completing their treatment.
“Consequently, there has been public health and research interest in the use of financial interventions to offset the costs of treatment and incentivise patients to attend their appointments.
“We found some evidence that cash incentives, in particular, improved once-off clinic re-attendance” says Dr Elizabeth Lutge.
“But more research is urgently needed to look at the potential long-term effects.
“We only found two studies which had looked at the long-term effects of financial incentives, and the findings were interesting but inconclusive” she continued.
Cochrane South Africa conducts systematic reviews that aim to enhance evidence-informed health policy and practice for South Africa, the African region and internationally.
Its current research focus areas include nutrition and food systems; infectious diseases; immunisation; and, clinical guideline development and implementation in South African primary care.
“Research focusing on adherence is crucial in a South African context where patients’ failure to adhere to treatment schedules plays a major role in the overall mismanagement of curable diseases such as TB,” Lutge added.
“We have to find the most innovative mechanisms to manage treatment adherence.”
Nelson Mandela Bay has the highest number of cases of multidrug-resistant tuberculosis (MDR-TB) in the province, the director of the Eastern Cape Department of Health’s tuberculosis hospitals, Ncedisi Madlavu, said earlier this year.
MDR-TB is a strain of the disease that is resistant to isoniazid and rifampicin, two of the most effective TB drugs. The treatment is painful, has severe side-effects like deafness and lasts for about two years.
Patients with MDR-TB who are supported by the Red Cross Society’s MDR-TB program receives food parcels to support them through their treatment.
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