Stigma matters in ending tuberculosis: Nationwide survey of stigma in Ethiopia

Datiko, Daniel Gemechu; Jerene, Degu; Suarez, Pedro

doi:10.1186/s12889-019-7915-6

Cited by 53 publications

(54 citation statements)

References 26 publications

(40 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This did run counter to our initial hypothesis, wherein we assumed that TB-related stigma may be due to a lack of knowledge about TB, and therefore that knowledge of TB would be associated with a decrease in stigma. This was supported by recent work from Datiko, et al, in which persons with higher educational levels, and those with high scores for TB knowledge, had lower stigma scores [25]. However, these findings run contrary to our own, which were derived from a representative population of Brazil, as opposed to a cluster-sampled population in Ethiopia.…”

Section: Discussionsupporting

confidence: 73%

Knowledge and stigma of latent tuberculosis infection in Brazil: implications for tuberculosis prevention strategies

et al. 2020

View full text Add to dashboard Cite

Background: Tuberculosis (TB) elimination requires treatment of millions of persons with latent M. tuberculosis infection (LTBI). LTBI treatment acceptance depends on population-wide TB knowledge and low stigma, but limited data are available on the relationship between stigma and knowledge. We assessed knowledge of TB disease and LTBI throughout Brazil and examined their association with TB stigma and incidence. Methods: We performed a nationwide survey with multi-stage probability design through AmericasBarometer from April-May 2017; the sample was representative of Brazil at regional and national levels. Knowledge of and stigma toward TB were assessed by validated survey questions. Results: Survey-weighted responses of 1532 individuals suggest that 57% of the population knew LTBI can occur, and 90% would seek treatment for it. Regarding active TB, 85% knew TB symptoms, 70% reported they should avoid contact with someone with active TB, and 24% had stigma toward persons with TB (i.e., thought persons with tuberculosis should feel ashamed, or deserved their illness). In regression models adjusting for clinical and demographic variables, knowledge of LTBI was associated with increased stigma toward persons with TB (adjusted odds ratio [OR] = 2.13, 95% confidence interval [CI]: 1•25-3.63, for "should feel ashamed"; OR = 1•82, 95% CI: 1•15-2•89, for "deserve illness"). Adjusting for regional TB incidence did not affect this association. Conclusions: High proportions of this representative Brazilian population had knowledge of LTBI and were willing to seek treatment for it. However, such knowledge was associated with TB-specific stigma. Strategies to educate and implement treatment of latent tuberculosis must include efforts to decrease TB stigma.

show abstract

Section: Discussionsupporting

confidence: 73%

Knowledge and stigma of latent tuberculosis infection in Brazil: implications for tuberculosis prevention strategies

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Was imported to Open Code software and analyzed using thematic content analysis technique. Direct verbatim and results from the coding and categorization were used to develop the narrative, triangulated and synthesized with the quantitative results [ 39 , 40 ].…”

Section: Methodsmentioning

confidence: 99%

Patient and health system delay among TB patients in Ethiopia: Nationwide mixed method cross-sectional study

Datiko¹,

Jerene²,

Suarez

2020

BMC Public Health

Self Cite

View full text Add to dashboard Cite

Background: Effective tuberculosis (TB) control is the end result of improved health seeking by the community and timely provision of quality TB services by the health system. Rapid expansion of health services to the peripheries has improved access to the community. However, high cost of seeking care, stigma related TB, low index of suspicion by health care workers and lack of patient centered care in health facilities contribute to delays in access to timely care that result in delay in seeking care and hence increase TB transmission, morbidity and mortality. We aimed to measure patient and health system delay among TB patients in Ethiopia. Methods: This is mixed method cross-sectional study conducted in seven regions and two city administrations. We used multistage cluster sampling to randomly select 40 health centers and interviewed 21 TB patients per health center. We also conducted qualitative interviews to understand the reasons for delay. Results: Of the total 844 TB patients enrolled, 57.8% were men. The mean (SD) age was 34 (SD + 13.8) years. 46.9% of the TB patients were the heads of household, 51.4% were married, 24.1% were farmers and 34.7% were illiterate. The median (IQR) patient, diagnostic and treatment initiation delays were 21 (10-45), 4 (2-10) and 2 (1-3) days respectively. The median (IQR) of total delay was 33 (19-67) days; 72.3% (595) of the patients started treatment after 21 days of the onset of the first symptom. Poverty, cost of seeking care, protracted diagnostic and treatment initiation, inadequate community based TB care and lack of awareness were associated with delay. Community health workers reported that lack of awareness and the expectation that symptoms would resolve by themselves were the main reasons for delay. Conclusion: TB patients' delay in seeking care remains a challenge due to limited community interventions, cost of seeking care, prolonged diagnostics and treatment initiation. Therefore, targeted community awareness creation, cost reduction strategies and improving diagnostic capacity are vital to reduce delay in seeking TB care in Ethiopia.

show abstract

“…The questionnaire used in this survey was developed for this study (Additional le 1). Tools to measure stigma in this study were referred to a previous study published in the BMC Public Health [24]. Two online focus groups were conducted to discuss the questionnaire design, with six people with public health and medical backgrounds in each group.…”

Section: Study Design and Participantsmentioning

confidence: 99%

“…Questions on COVID-19-related stigma were adapted from previous studies [24,27]. Four questions, including stigma toward COVID-19 patients and residents of Wuhan at the individual and community levels were used, respectively.…”

Section: Stigmamentioning

confidence: 99%

COVID-19-related stigma and its' influencing factors: a rapid nationwide study in China

Jiang¹,

Zhou²,

Lin³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background：COVID-19 poses a signiﬁcant challenge to global public health. During the pandemic, COVID-19 patients and people in outbreak areas have suffered from stigma associated with the disease. This study aimed to evaluate the prevalence of COVID-19-related stigma toward COVID-19 patients and people from the city of Wuhan in China and assess the association of COVID-19-related stigma, health literacy, and sociodemographic characteristics.Methods：A cross-sectional survey covering 5,039 respondents was conducted in 31 provinces in China using a convenience sampling method. Binary logistic regressions were used to identify the factors associated with COVID-19-related stigma.Results：Among the participants, 122 (2.4%) reported themselves and 254 (5.0%) reported the communities they lived in held a stigmatizing attitude toward COVID-19 patients, respectively. Additionally, 114 (2.5%) and 475 (10.3%) reported that themselves and the communities they lived in, respectively, held a stigma against people from Wuhan, where was the most severely affected area in China. People aged over 40, lived in areas with severe epidemics (aOR=2.15, 95% CI [1.12-4.13]), and who felt it difficult to find and understand information about COVID-19 (aOR=1.91, 95% CI [1.08-3.27]; aOR=1.88, 95% CI [1.08-3.29]) were more likely to stigmatize COVID-19 patients. People who were male, aged 41 to 50, and had difficulty understanding information (aOR=2.08, 95% CI [1.17-3.69]) were more likely to stigmatize people from Wuhan.Conclusions：COVID-19 patients and Wuhan residents suffered stigma at both the individual and community levels, although proportion of those holding a stigma was not very high. Provinces close to Wuhan had relatively high stigma toward COVID-19 patients and people from Wuhan. There was a correlation between better health literacy and lower stigma during the COVID-19 outbreak. Tailored interventions were encouraged to improve health literacy and consequently to reduce stigma toward both COVID-19 patients and Wuhan people from individual and community levels, respectively.

show abstract

Stigma matters in ending tuberculosis: Nationwide survey of stigma in Ethiopia

Cited by 53 publications

References 26 publications

Knowledge and stigma of latent tuberculosis infection in Brazil: implications for tuberculosis prevention strategies

Knowledge and stigma of latent tuberculosis infection in Brazil: implications for tuberculosis prevention strategies

Patient and health system delay among TB patients in Ethiopia: Nationwide mixed method cross-sectional study

COVID-19-related stigma and its' influencing factors: a rapid nationwide study in China

Contact Info

Product

Resources

About