title: Social, economic, and psychological impacts of MDR-TB treatment in Tijuana, Mexico: a patient's perspective.
abstract: METHODS
  The State of Baja California, Mexico, had the highest prevalence of multidrug-resistant tuberculosis (MDR-TB) in Mexico in 2009.
  
  
  OBJECTIVE
  To understand the socio-economic burden of MDR-TB disease and its treatment on patients in Tijuana and Mexicali, Mexico.
  
  
  METHODS
  From July to November 2009, qualitative interviews were conducted with 12 patients enrolled in a US-Mexico binational MDR-TB treatment program, Puentes de Esperanza (Bridges of Hope), which was designed to support MDR-TB patients. In-depth interviews were coded to identify major themes in patient experiences of MDR-TB diagnosis and care.
  
  
  RESULTS
  While some patients were able to maintain their pre-MDR-TB lives to a limited extent, most patients reported losing their sense of identity due to their inability to work, social isolation, and stigmatization from family and friends. The majority of participants expressed appreciation for Puentes' role in 'saving their lives'.
  
  
  CONCLUSIONS
  Being diagnosed with MDR-TB and undergoing treatment imposes significant psychological, social and economic stress on patients. Strong social support elements within Puentes helped alleviate these burdens. Improvements to the program might include peer-support groups for patients undergoing treatment and transitioning back into the community after treatment.
authors.affiliation: Division of Global Public Health, Department of Medicine, University of California, San Diego, San Diego, CA 92093, USA.
authors.forename: M D
authors.initials: MD
authors.lastname: Morris
authors.forename: L
authors.initials: L
authors.lastname: Quezada
authors.forename: P
authors.initials: P
authors.lastname: Bhat
authors.forename: K
authors.initials: K
authors.lastname: Moser
authors.forename: J
authors.initials: J
authors.lastname: Smith
authors.forename: H
authors.initials: H
authors.lastname: Perez
authors.forename: R
authors.initials: R
authors.lastname: Laniado-Laborin
authors.forename: J
authors.initials: J
authors.lastname: Estrada-Guzman
authors.forename: T C
authors.initials: TC
authors.lastname: Rodwell
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000191:economics / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007391:International Cooperation; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D009313:National Health Programs / Q000458:organization & administration*; D010865:Pilot Projects; D015995:Prevalence; D012934:Social Isolation / Q000523:psychology; D012959:Socioeconomic Factors; D013240:Stereotyping; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology
chemical_list: D000995:Antitubercular Agents