Tuberculosis stigma in Gezira State, Sudan: a case-control study

Suleiman, Maria; Sahal, N.; Sodemann, Morten; Sony, Asma El; Aro, Arja R.

doi:10.5588/ijtld.12.0654

Cited by 19 publications

(32 citation statements)

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“…In Zambia and Sudan, observational studies of TB patients reported gender, age, education, geographical location, employment, and TB awareness to be associated with TB stigma [39,53]. Among TB patients in our study, knowing the correct causes of TB, knowledge of the role of TB in HIV, perceived HIV stigma and race/ ethnic group were associated with TB stigma.…”

Section: Discussionmentioning

confidence: 45%

Quantification and correlates of tuberculosis stigma along the tuberculosis testing and treatment cascades in South Africa: a cross-sectional study

2020

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Background South Africa has one of the world’s worst tuberculosis (TB) (520 per 100 000 population) and TB-human immunodeficiency virus (HIV) epidemics (~ 56% TB/HIV co-infected). While individual- and system-level factors influencing progression along the TB cascade have been identified, the impact of stigma is underexplored and underappreciated. We conducted an exploratory study to 1) describe differences in perceived community-level TB stigma among community members, TB presumptives, and TB patients, and 2) identify factors associated with TB stigma levels among these groups. Methods A cross sectional study was conducted in November 2017 at public health care facilities in Buffalo City Metro (BCM) and Zululand health districts, South Africa. Community members, TB presumptives, and TB patients were recruited. Data were collected on sociodemographic characteristics, TB knowledge, health and clinical history, social support, and both HIV and TB stigma. A validated scale assessing perceived community TB stigma was used. Univariate and multivariate linear regression models were used to describe differences in perceived community TB stigma by participant type and to identify factors associated with TB stigma. Results We enrolled 397 participants. On a scale of zero to 24, the mean stigma score for TB presumptives (14.7 ± 4.4) was statistically higher than community members (13.6 ± 4.8) and TB patients (13.3 ± 5.1). Community members from Zululand (β = 5.73; 95% CI 2.19, 9.72) had higher TB stigma compared to those from BCM. Previously having TB (β = − 2.19; 95% CI − 4.37, 0.0064) was associated with reduced TB stigma among community members. Understanding the relationship between HIV and TB disease (β = 2.48; 95% CI 0.020, 4.94), and having low social support (β = − 0.077; 95% CI − 0.14, 0.010) were associated with increased TB stigma among TB presumptives. Among TB Patients, identifying as Black African (β = − 2.90; 95% CI − 4.74, − 1.04) and knowing the correct causes of TB (β = − 2.93; 95% CI − 4.92, − 0.94) were associated with decreased TB stigma, while understanding the relationship between HIV and TB disease (β = 2.48; 95% CI 1.05, 3.90) and higher HIV stigma (β = 0.32; 95% CI 0.21, 0.42) were associated with increased TB stigma. Conclusions TB stigma interventions should be developed for TB presumptives, as stigma may increase initial-loss-to-follow up. Given that stigma may be driven by numerous factors throughout the TB cascade, adaptive stigma reduction interventions may be required.

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Section: Discussionmentioning

confidence: 45%

Quantification and correlates of tuberculosis stigma along the tuberculosis testing and treatment cascades in South Africa: a cross-sectional study

2020

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“…The finding that one third of the patients would not tell anybody about their illness, might suggest that fear of social exclusion still exists (Story et al 2006 ) and necessitates further research on stigma in TB (Ahmed Suleiman et al 2013 ).…”

Section: Discussionmentioning

confidence: 99%

Illness perception in tuberculosis by implementation of the Brief Illness Perception Questionnaire – a TBNET study

Pešut

Bursuc²,

Bulajić

et al. 2014

SpringerPlus

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How patients relate to the experience of their illness has a direct impact over their behavior. We aimed to assess illness perception in patients with pulmonary tuberculosis (TB) by means of the Brief Illness Perception Questionnaire (BIPQ) in correlation with patients’ demographic features and clinical TB score.Our observational questionnaire based study included series of consecutive TB patients enrolled in several countries from October 2008 to January 2011 with 167 valid questionnaires analyzed. Each BIPQ item assessed one dimension of illness perceptions like the consequences, timeline, personal control, treatment control, identity, coherence, emotional representation and concern. An open question referred to the main causes of TB in each patient’s opinion.The over-all BIPQ score (36.25 ± 11.054) was in concordance with the clinical TB score (p ≤ 0.001). TB patients believed in the treatment (the highest item-related score for treatment control) but were unsure about the illness identity. Illness understanding and the clinical TB score were negatively correlated (p < 0.01). Only 25% of the participants stated bacteria or TB contact as the first ranked cause of the illness.For routine clinical practice implementation of the BIPQ is convenient for obtaining fast and easy assessment of illness perception with potential utility in intervention design. This time saving effective personalized approach may improve communication with TB patients and contribute to better behavioral strategies in disease control.Electronic supplementary materialThe online version of this article (doi:10.1186/2193-1801-3-664) contains supplementary material, which is available to authorized users.

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“…2 , 3 Delays in TB case detection and treatment are associated with lack of TB knowledge, poor attitudes toward personal health, traditional beliefs and cultural factors, inability to access affordable healthcare services, and fear of stigmatization. 4 – 9 …”

Section: Introductionmentioning

confidence: 99%

Demographic and Socioeconomic Disparity in Knowledge About Tuberculosis in Inner Mongolia, China

Ren²,

Wang

et al. 2015

Journal of Epidemiology

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BackgroundThe aim of this study is to evaluate the awareness status, attitudes, and care-seeking behaviors concerning tuberculosis (TB) and associated factors among the public in Inner Mongolia, China.MethodsA five-stage sampling was conducted, in which counties as the primary survey units and towns, villages, and households as sub-survey units were selected progressively. A standardized questionnaire was used to collect TB information. Complex survey analysis methods, including the procedures of survey frequency and survey logistic regression, were applied for analysis of TB knowledge and associated factors. The sample was weighted by survey design, non-respondent, and post-stratification adjustment.ResultsAmong 10 581 respondents, awareness that TB is an infectious disease was 86.7%. Knowing that a cough lasting ≥3 weeks is suggestive of TB was 26.9%. Knowledge about TB dispensaries in county administrative areas was reported by 68.3% of respondents, and knowledge about the free TB detection/treatment policy was reported by 57.5% of respondents. About 52.5% of participants would stigmatize TB patients. Compared with the majority Han ethnic group, Mongolians and other minorities were 1.52–2.18 times more likely to know about TB curability, TB symptoms, the free detection/treatment policy, and TB dispensaries’ locations, but were less likely to know about the TB transmission mode (odds ratio, 0.74; 95% confidence interval, 0.65–0.84). The main sources of TB information were TV (65.6%) and other persons (47.2%). In the past year, 19.7% of TB knowledge was from acquaintances, and 16.1% was from TB institutes.ConclusionsImprovement in knowledge about TB risk (symptoms and transmission), the free treatment policy, and facilities is necessary and should be provided through effective multimedia for different target populations.

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Tuberculosis stigma in Gezira State, Sudan: a case-control study

Abstract: Although TB stigma among the Gezira population was found to be mild, it can affect treatment adherence. Empowering both TB patients and communities by increasing their knowledge through proper education programmes could effectively contribute to the effort of controlling TB in the state.

Cited by 19 publications

References 0 publications

Quantification and correlates of tuberculosis stigma along the tuberculosis testing and treatment cascades in South Africa: a cross-sectional study

Quantification and correlates of tuberculosis stigma along the tuberculosis testing and treatment cascades in South Africa: a cross-sectional study

Illness perception in tuberculosis by implementation of the Brief Illness Perception Questionnaire – a TBNET study

Demographic and Socioeconomic Disparity in Knowledge About Tuberculosis in Inner Mongolia, China

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