title: Language in tuberculosis services: can we change to patient-centred terminology and stop the paradigm of blaming the patients?
abstract: The words 'defaulter', 'suspect' and 'control' have been part of the language of tuberculosis (TB) services for many decades, and they continue to be used in international guidelines and in published literature. From a patient perspective, it is our  opinion that these terms are at best inappropriate, coercive and disempowering, and at worst they could be perceived as judgmental and criminalising, tending to place the blame of the disease or responsibility for adverse treatment outcomes on one side-that of the patients. In this  article, which brings together a wide range of authors and institutions from Africa, Asia, Latin America, Europe and the Pacific, we discuss the use of the words 'defaulter', 'suspect' and 'control' and argue why it is detrimental to continue using them  in the context of TB. We propose that 'defaulter' be replaced with 'person lost to follow-up'; that 'TB suspect' be replaced by 'person with presumptive TB' or 'person to be evaluated for TB'; and that the term 'control'  be replaced with 'prevention and care' or simply deleted. These terms are non-judgmental and patient-centred. We appeal to the global Stop TB Partnership to lead discussions on this issue and to make concrete steps towards changing the current paradigm.
authors.affiliation: Medical Department, Médecins Sans Frontières, Operational Centre Brussels, MSF-Luxembourg, Luxembourg. zachariah@internet.lu
authors.forename: R
authors.initials: R
authors.lastname: Zachariah
authors.forename: A D
authors.initials: AD
authors.lastname: Harries
authors.forename: S
authors.initials: S
authors.lastname: Srinath
authors.forename: S
authors.initials: S
authors.lastname: Ram
authors.forename: K
authors.initials: K
authors.lastname: Viney
authors.forename: E
authors.initials: E
authors.lastname: Singogo
authors.forename: P
authors.initials: P
authors.lastname: Lal
authors.forename: A
authors.initials: A
authors.lastname: Mendoza-Ticona
authors.forename: A
authors.initials: A
authors.lastname: Sreenivas
authors.forename: N W
authors.initials: NW
authors.lastname: Aung
authors.forename: B N
authors.initials: BN
authors.lastname: Sharath
authors.forename: H
authors.initials: H
authors.lastname: Kanyerere
authors.forename: N
authors.initials: N
authors.lastname: van Soelen
authors.forename: N
authors.initials: N
authors.lastname: Kirui
authors.forename: E
authors.initials: E
authors.lastname: Ali
authors.forename: S G
authors.initials: SG
authors.lastname: Hinderaker
authors.forename: K
authors.initials: K
authors.lastname: Bissell
authors.forename: D A
authors.initials: DA
authors.lastname: Enarson
authors.forename: M E
authors.initials: ME
authors.lastname: Edginton
mesh_terms: D000349:Africa; D001208:Asia; D001291:Attitude of Health Personnel; D003068:Coercion; D004644:Emotions; D005060:Europe; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007600:Judgment; D007802:Language; D007843:Latin America; D059012:Lost to Follow-Up; D018802:Patient-Centered Care / Q000145:classification*; D010361:Patients / Q000523:psychology*; D011209:Power, Psychological; D009626:Terminology as Topic; D014376:Tuberculosis / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*