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Understanding pathways to chronic disease management for patients with tuberculosis in Haiti: A qualitative study

J Ellis(1) H Gilber(1) E Wroe(1,2) J Mukherjee(1)

1:Harvard Medical School; 2:Partners in Health

Despite the increase in access to tuberculosis treatment globally, patients who have successfully been treated for tuberculosis remain at higher risk of mortality compared with the general population. Multimorbidity with non-communicable diseases (NCD) has been hypothesized to contribute to worsened TB outcomes. 

This study is a qualitative study that investigated clinicians’ and patients’ perspectives on pathways to chronic disease management for patients with TB in a rural hospital network in Haiti. We enrolled twelve clinicians and three patients for semi-structured interviews.   

The qualitative analysis found that while a formal pathway to chronic disease management existed, clinicians worked to devise informal workaround to get patients better access to care. Clinicians emphasized the promise of more integrated TB and NCD programs, while also recognizing the potential workload challenges this integration could create. 

Health systems must be built to address the synergistic relationship between TB and NCD care together as essential components of universal health care. To truly end TB, health systems must establish supportive, integrated connections between NCD and TB programs to improve patient outcomes without overburdening clinical staff.

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