A systematic review and meta-analysis on the prevalence of stigma in infectious diseases, including COVID-19: a call to action

Abstract

Infectious diseases, including COVID-19, are crucial public health issues and may lead to considerable fear among the general public and stigmatization of, and discrimination against, specific populations. This meta-analysis aimed to estimate the pooled prevalence of stigma in infectious disease epidemics. We systematically searched PubMed, PsycINFO, Embase, MEDLINE, Web of Science, and Cochrane databases since inception to June 08, 2021, and reported the prevalence of stigma towards people with infectious diseases including SARS, H1N1, MERS, Zika, Ebola, and COVID-19. A total of 50 eligible articles were included that contributed 51 estimates of prevalence in 92722 participants. The overall pooled prevalence of stigma across all populations was 34% [95% CI: 28−40%], including enacted stigma (36% [95% CI: 28−44%]) and perceived stigma (31% [95% CI: 22−40%]). The prevalence of stigma in patients, community population, and health care workers, was 38% [95% CI: 12− 65%], 36% [95% CI: 28−45%], and 30% [95% CI: 20−40%], respectively. The prevalence of stigma in participants from low- and middle-income countries was 37% [95% CI: 29−45%], which is higher than that from high-income countries (27% [95% CI: 18−36%]) though this difference was not statistically significant. A similar trend of prevalence of stigma was also observed in individuals with lower education (47% [95% CI: 23−71%]) compared to higher education level (33% [95% CI: 23−4%]). These findings indicate that stigma is a significant public health concern, and effective and comprehensive interventions are needed to counteract the damaging effects of the infodemics during infectious disease epidemics, including COVID-19, and reduce infectious disease-related stigma.

Validity and reliability of a modified short version of a stigma scale for use among Tunisian COVID‐19 patients after quarantine: A cross‐sectional study

“…6 However, a variety of tools was used to measure this issue in these countries. [6][7][8] Actually, little interest was given to develop and valid specific scales measuring COVID-19-related stigma among patients worldwide. 9,10 Furthermore, several studies focused on stigma toward healthcare providers, while fewer studies assessed stigma among the general population.…”

COVID-19-related Stigma Among the Affected Individuals: A Cross-Sectional Study From Kerala, India

“… 2 COVID-19 also has a high potential to increase the stigma associated with the illness. Studies and case report from various parts of the world show discrimination and stigma associated with COVID-19, 3 – 7 more against people from a specific ethnicity like East Asians, health care workers (HCW), persons under quarantine, and COVID-19 affected and recovered patients.…”

The Impact of Quarantine on Pain Sensation among the General Population in China during the COVID-19 Pandemic

“…Longer quarantine durations were correlated with poorer mental health [ 50 , 51 ]. People who experienced long-term quarantines were exposed to lengthy and jumbled media coverage; and worries about being infected, unmet medical needs, job concerns, and economic issues are pervasive [ 52 ]. Catastrophizing was shown to mediate the relationship between negative events and pain symptoms [ 53 ].…”