Fig. 1.

a: Patient has visited 3 facilities A, B and C several times encountering more than one barrier that contributed in delay in the diagnosis of MDR-TB. In between patient experienced chest pain that was mis-attributed to cardiovascular disease increasing both cost to the patient and delay in diagnosis. b. Patient was aware of TB symptoms yet was treated without considering a TB test. Despite visiting 4 different health facilities, several barriers prevented the diagnosis of MDR-TB. Although at Facility F MDR-TB was correctly considered and sputum collected for MDR-TB diagnosis, results were not available in a timely manner and the patient opted to shift to Facility G where diagnosis of MDR-TB was ultimately made, but the patient still required referral for eventual treatment. A full 3 month later while on MDR-TB treatment, Facility F traced the patient and communicated the MDR-TB results. DST; drug susceptibility testing