Understanding tuberculosis-related stigma: Impacts on patients, contacts, and society – A mixed study
Authors: Alselwi Khaled Abdo 
Published: December 2023

Objectives:
This mixed-methods study aimed to explore the experiences of 62 participants with tuberculosis (TB) diagnoses, 57 participants with direct contact with patients, and 61 participants from the general public, regarding TB-related stigma.

Materials and Methods:
This study used both qualitative and quantitative research methods to understand the issue of TB. A representative sample of 62 participants with TB diagnoses, 57 with direct patient contact, and 61 from the general public was selected. Data was collected through structured questionnaires and in-depth interviews, and trends and patterns were identified using descriptive statistics and the Chi-Squared test.

Results:
Over half of TB patients expressed internalized stigma involving self-stigmatization by feeling ashamed, afraid that others would see them as contagious or different due to their illness. A total of 42 of 62 participants, or 68%, expressed anticipated stigma involving fear of discrimination and changing the topic of conversation or avoid discussing the disease openly. (6/62, 10%) expressed enacted stigma and discrimination reporting they lacked respect from medical staff. Females were more likely than males to show both anticipated stigma by feeling different and being afraid of transmitting the disease (p-value), and more likely to avoid talking about their disease or changing the subject (p-value). There was no significant association between gender and feeling respected by medical professionals (p-value = 0.172). Contacts believed poverty caused TB (17/57, 30%); they feared community infection risk (45/57, 79%). Most contacts with patients viewed patients with compassion (36/57, 63%), and most were willing to associate (47/57, 82%). Male contacts are more likely to fear infection risks. The investigation of sociodemographic characteristics and stigmatization of TB patients among contacts of TB patients found that education level, gender, and economic position were substantially linked with stigmatization towards TB patients. On the other hand, men were more likely than females to anticipate infection risks in the community (p-value < 0.001). Ordinary people feared infection (44/61, 72%) and thought poverty caused TB (17/61, 28%). Most saw the patients with compassion (35/61, 57%); they were willing to associate (45/61, 74%). Education level in the ordinary people was strongly connected with fear of infection and their opinions about whether TB patients deserve their disease. As opposed to this, perceptions of TB patients were strongly associated with gender and economic status. Based on the data supplied, there may be a link between socioeconomic status and stigmatization towards TB patients; however, more studies would be required to establish whether this association is statistically significant. Overall, the research employed a comprehensive and extensive methodology, offering valuable insights into the stigmatization of TB patients. This might influence policy and practice in the field.

Conclusion:
The results show that there is still a need for programs to minimize TB-related stigma and promote public knowledge of the illness, and medical workers should be educated to treat patients with respect. Efforts should be undertaken to educate the public about TB causes to lessen the stigma associated with the illness. It is vital to create treatments targeted at eliminating TB stigma and supporting TB patients’ social integration.