Anti-tuberculosis treatment defaulting: an analysis of perceptions and interactions in Chiapas, Mexico.

OBJECTIVE To analyze the perceptions and interactions of the actors involved in anti-tuberculosis treatment, and to explore their influence in treatment defaulting in Los Altos region of Chiapas, Mexico. MATERIAL AND METHODS From November 2002 to August 2003, in-depth interviews were administered to patients with PTB, patients' family members, institutional physicians, community health coordinators, and traditional medicine practitioners. RESULTS We found different perceptions about PTB between patients and their families and among health personnel, as well as communication barriers between actors. Defaulting is considered to be mainly due to the treatment's adverse effects. CONCLUSIONS It is necessary to conduct research and interventions in the studied area with the aim of changing perceptions, improving sensitization, quality and suitability of management of patients with PTB in a multicultural context, and promoting collaboration between institutional and traditional medicine.