“I am afraid that others will feel scared and disgusted with me. So, I will keep it a secret until I die”: A qualitative study among patients with tuberculosis receiving DOTS regimen in Thailand


burden of disease
holistic care

How to Cite

Koontalay, A., Suksatan, W., & Prabsangob, K. (2021). “I am afraid that others will feel scared and disgusted with me. So, I will keep it a secret until I die”: A qualitative study among patients with tuberculosis receiving DOTS regimen in Thailand. Belitung Nursing Journal, 7(6), 516–521. https://doi.org/10.33546/bnj.1678


Background: Tuberculosis (TB) has become a significant public health problem leading to a top ten morality. Directly Observed Therapy, Short-course (DOTS) is recommended as a critical element for curing and preventing TB. However, patients who have been living with TB often receive barriers and challenges, which may lead them to discontinue the DOTS treatment.

Objective: This study aimed to understand patients’ experiences living with TB and receiving DOTS regimens.

Methods: A qualitative descriptive study was employed. Semi-structured interviews were done among twenty tuberculosis patients selected using convenience sampling from the slum community in Bangkok, Thailand. The thematic approach was used for data analysis.

Results: Two main themes were developed: (1) troublesome disease and (2) emotional challenges. The first theme comprises three subthemes: confronting death, accepting lifestyle change, and DOTS challenges. The second theme consists of two subthemes: isolation from others and stigma.

Conclusion: The findings could guide nurses and other healthcare professionals to develop the treatment guideline and the DOTS strategy using a holistic approach.


Copyright (c) 2021 Apinya Koontalay, Wanich Suksatan, Kantapong Prabsangob

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Ahmad, N., Ahuja, S. D., Akkerman, O. W., Alffenaar, J.-W. C., Anderson, L. F., Baghaei, P., . . . Menzies, D. (2018). Treatment correlates of successful outcomes in pulmonary multidrug-resistant tuberculosis: An individual patient data meta-analysis. The Lancet, 392(10150), 821-834. https://doi.org/10.1016/S0140-6736(18)31644-1

Bastos, M. L., Lan, Z., & Menzies, D. (2017). An updated systematic review and meta-analysis for treatment of multidrug-resistant tuberculosis. European Respiratory Journal, 49(3), 1600803. https://doi.org/10.1183/13993003.00803-2016

Brown, J., Capocci, S., Smith, C., Morris, S., Abubakar, I., & Lipman, M. (2015). Health status and quality of life in tuberculosis. International Journal of Infectious Diseases, 32, 68-75. https://doi.org/10.1016/j.ijid.2014.12.045

Choowong, J., Maneechote, P., & Sawatdee, D. (2019). People with tuberculosis in Thailand impacts of stigma and directly observed treatment practice guidelines. Southern College Network Journal of Nursing and Public Health 6(1), 237-245.

Culqui, D. R., Munayco E, C. V., Grijalva, C. G., Cayla, J. A., Horna-Campos, O., Alva Ch, K., & Suarez O, L. A. (2012). Factors associated with the non-completion of conventional anti-tuberculosis treatment in Peru. Archivos de Bronconeumología (English Edition), 48(5), 150-155. https://doi.org/10.1016/j.arbr.2011.12.005

Dias, A. A. L., de Oliveira, D. M. F., Turato, E. R., & de Figueiredo, R. M. (2013). Life experiences of patients who have completed tuberculosis treatment: A qualitative investigation in southeast Brazil. BMC Public Health, 13(1), 595. https://doi.org/10.1186/1471-2458-13-595

Dodor, E. A. (2012). The feelings and experiences of patients with tuberculosis in the Sekondi-Takoradi Metropolitan district: Implications for TB control efforts. Ghana Medical Journal, 46(4), 211-218.

Getahun, B., Wubie, M., Dejenu, G., & Manyazewal, T. (2016). Tuberculosis care strategies and their economic consequences for patients: The missing link to end tuberculosis. Infectious Diseases of Poverty, 5(1), 93. https://doi.org/10.1186/s40249-016-0187-9

Gugssa, B. C., Shimels, T., & Bilal, A. I. (2017). Factors contributing to non-adherence with treatment among TB patients in Sodo Woreda, Gurage Zone, Southern Ethiopia: A qualitative study. Journal of Infection and Public Health, 10(5), 527-533. https://doi.org/10.1016/j.jiph.2016.11.018

Gyimah, F. T., & Dako-Gyeke, P. (2019). Perspectives on TB patients' care and support: A qualitative study conducted in Accra Metropolis, Ghana. Globalization and Health, 15(1), 19. https://doi.org/10.1186/s12992-019-0459-9

Imsanguan, W., Bupachat, S., Wanchaithanawong, V., Luangjina, S., Thawtheong, S., Nedsuwan, S., . . . Ngamvithayapong-Yanai, J. (2020). Contact tracing for tuberculosis, Thailand. Bulletin of the World Health Organization, 98(3), 212-218. https://doi.org/10.2471/BLT.19.239293

Johnston, J. C., Shahidi, N. C., Sadatsafavi, M., & Fitzgerald, J. M. (2009). Treatment outcomes of multidrug-resistant tuberculosis: A systematic review and meta-analysis. PloS One, 4(9), e6914. https://doi.org/10.1371/journal.pone.0006914

Kigozi, G., Heunis, C., Chikobvu, P., Botha, S., & van Rensburg, D. (2017). Factors influencing treatment default among tuberculosis patients in a high burden province of South Africa. International Journal of Infectious Diseases, 54, 95-102. https://doi.org/10.1016/j.ijid.2016.11.407

Kim, H. J., Bai, G.-H., Kang, M. K., Kim, S. J., Lee, J. K., Cho, S.-I., & Lew, W. J. (2009). A public-private collaboration model for treatment intervention to improve outcomes in patients with tuberculosis in the private sector. Tuberculosis and Respiratory Diseases, 66(5), 349-357. https://doi.org/10.4046/trd.2009.66.5.349

Orenstein, E. W., Basu, S., Shah, N. S., Andrews, J. R., Friedland, G. H., Moll, A. P., . . . Galvani, A. P. (2009). Treatment outcomes among patients with multidrug-resistant tuberculosis: Systematic review and meta-analysis. The Lancet Infectious Diseases, 9(3), 153-161. https://doi.org/10.1016/S1473-3099(09)70041-6

Saks, M., & Allsop, J. (2012). Researching health: Qualitative, quantitative and mixed methods (2nd ed.). Thousand Oaks, California: Sage Publications Inc.

Tadesse, S. (2016). Stigma against Tuberculosis patients in Addis Ababa, Ethiopia. PloS One, 11(4), e0152900. https://doi.org/10.1371/journal.pone.0152900

Tadesse, T., Demissie, M., Berhane, Y., Kebede, Y., & Abebe, M. (2013). Long distance travelling and financial burdens discourage tuberculosis DOTS treatment initiation and compliance in Ethiopia: A qualitative study. BMC Public Health, 13(1), 424. https://doi.org/10.1186/1471-2458-13-424

World Health Organization. (2019). Global tuberculosis report 2019. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/329368/9789241565714-eng.pdf?ua=1

Yu, M.-C., Chiang, C.-Y., Lee, J.-J., Chien, S.-T., Lin, C.-J., Lee, S.-W., . . . Huang, Y.-W. (2018). Treatment outcomes of multidrug-resistant tuberculosis in Taiwan: Tackling loss to follow-up. Clinical Infectious Diseases, 67(2), 202-210. https://doi.org/10.1093/cid/ciy066