Background: Tuberculosis (TB) remains a major public health challenge globally, particularly in high-burden countries such as South Africa. Treatment interruption is a critical barrier to effective TB control, contributing to poor treatment outcomes, increased risk of multidrug-resistant tuberculosis (MDR-TB), and continued community transmission. Understanding the determinants of treatment interruption in rural healthcare settings is essential for strengthening TB programme implementation. Methods: This qualitative study explored the factors influencing TB treatment interruption from the perspectives of professional nurses working in primary healthcare facilities in the Nyandeni Subdistrict, Eastern Cape, South Africa. Semi-structured interviews were conducted with nurses involved in TB programme implementation. Data were analysed using thematic analysis following the six-phase approach described by Braun and Clarke. Descriptive statistical analyses were also used to summarize participant characteristics, including age and years of nursing experience. Conceptual frameworks were developed to illustrate the multilevel determinants of TB treatment interruption. Results: Participants had a mean age of 40.6 years and an average of 14.2 years of nursing experience, reflecting a workforce with substantial clinical exposure to TB management. Thematic analysis identified multiple interconnected determinants of treatment interruption. Key barriers included poverty, food insecurity, transport costs, long distances to healthcare facilities, limited family support, and challenges related to patient tracing. These factors interact across structural, community, health system, and interpersonal levels to influence patient adherence behaviour. Conceptual models developed from the findings illustrate the complex pathways through which these determinants contribute to treatment interruption and programme-level consequences such as reduced treatment success and increased risk of MDR-TB. Conclusions: TB treatment interruption in rural settings is driven by multilevel socioeconomic and health system determinants rather than individual patient behaviour alone. Strengthening community health worker programmes, improving patient tracing systems, addressing socioeconomic barriers, and enhancing community-based support mechanisms are essential for improving treatment adherence. Integrated, multisectoral interventions are required to strengthen TB programme outcomes in rural high-burden settings.

Background: HIV self-testing (HIVST) can improve access to HIV testing among adolescents and young adults (AYAs); however, gaps remain in post-test linkage to care. This study examined post-HIVST outcomes and factors associated with reported linkage to HIV care among AYAs in the Eastern Cape, South Africa. Methods: A facility-based cross-sectional study was conducted among 170 AYAs aged 15–24 years who had used HIVST within the preceding five months. Socio-demographic characteristics, HIVST results, post-test care-seeking, and linkage to HIV care were assessed. Bivariate analyses and Firth penalized logistic regression were used to identify factors associated with reported linkage to HIV care among participants reporting a positive HIVST result. Results: Of 156 participants who disclosed their HIVST result, 67 (42.9%) reported a positive result. Among these, 29 (43.3%) sought confirmatory testing, 38 (56.7%) sought care within 1–4 weeks, and 53 (79.1%) reported linkage to HIV care. More than half (55.2%) reported that counselling was not offered, and 59.7% perceived linkage-to-care services as not easily accessible. In multivariable analysis, female participants had higher odds of reporting linkage to HIV care than male participants (AOR = 5.54, 95% CI: 1.49–20.67, p = 0.011). Conclusions: Among AYAs with previous HIVST use, important gaps were observed in confirmatory testing and timely care-seeking. Male AYAs may require targeted support to improve engagement with HIV care services.