“Who Will Marry a Diseased Girl?” Marriage, Gender, and Tuberculosis Stigma in Asia

Hatherall, Bethan; Newell, James; Emmel, Nick; Baral, Sushil; Khan, Muhammad Amir

doi:10.1177/1049732318812427

Cited by 31 publications

(36 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For example, in South Asia, young women with tuberculosis report diminished marriage prospects. 95 Qualitative and mixed methods research around the breadth of developmental issues that tuberculosis might affect -including schooling, work, relationships and mental health -would be of great value.…”

Section: Sequelae Post Tuberculosismentioning

confidence: 99%

Adolescent tuberculosis

Snow

Cruz

Seddon

et al. 2020

The Lancet Child & Adolescent Health

View full text Add to dashboard Cite

Adolescence is characterised by a dramatic increase in the incidence of tuberculosis, a fact that has been appreciated since the early 20 th century. The majority of the world's adolescents live in low and middle-income countries where tuberculosis remains common, and where they comprise one quarter of the population. Despite this, adolescents have not yet been addressed as a distinct population in tuberculosis policy or within tuberculosis treatment services, and emerging evidence suggests that current models of care do not meet their needs.This article reviews current knowledge about tuberculosis in adolescence with a focus on the management of infection and disease, including HIV co-infection and rifampicin-resistant tuberculosis. Recent progress in vaccine development is outlined and important directions for future research are highlighted. Search strategy and selection criteriaThis was a narrative review of the literature on adolescent tuberculosis, informed by expert opinion and clinical experience. We reviewed the English-and Spanish-language literature for studies on adolescent tuberculosis to identify case series documenting clinical presentation and treatment outcomes. We searched PubMed with the following string on 19August 2019: ('tuberculosis'[Title]) AND ('adolescent'[TIAB]). The search returned 210 results, of which 11 were eligible for inclusion (Table 1), and we identified three additional studies from reference lists, for a total of 14 studies. Studies reporting solely on prevalence or where data from adolescents was aggregated with those of younger children or adults were excluded. Data were extracted regarding major site(s) of disease, percent of adolescents with microbiologic confirmation, adverse drug reactions, and final treatment outcomes.

show abstract

Section: Sequelae Post Tuberculosismentioning

confidence: 99%

Adolescent tuberculosis

Snow

Cruz

Seddon

et al. 2020

The Lancet Child & Adolescent Health

View full text Add to dashboard Cite

show abstract

“…Females’ social expectations are mostly associated with family, and TB affects society’s expectations of females to be good mothers and their ability to fulfil the role of wife. This has a disproportionate impact on females, making them more likely to be associated with stigma than males [ 40 , 41 ]. The negative impact of TB on marriage prospects has been identified as one aspect of TB stigma, and the detrimental impact on a female’s marriage prospect is far greater than that of a male’s [ 41 , 42 ].…”

Section: Discussionmentioning

confidence: 99%

“…This has a disproportionate impact on females, making them more likely to be associated with stigma than males [ 40 , 41 ]. The negative impact of TB on marriage prospects has been identified as one aspect of TB stigma, and the detrimental impact on a female’s marriage prospect is far greater than that of a male’s [ 41 , 42 ]. In addition, female patients are generally less educated and have less TB-related knowledge, and lack of TB knowledge has been significantly associated with high TB-related stigma [ 16 , 29 ].…”

Section: Discussionmentioning

confidence: 99%

Tuberculosis-related stigma and its determinants in Dalian, Northeast China: a cross-sectional study

et al. 2021

BMC Public Health

View full text Add to dashboard Cite

Background The stigma of tuberculosis (TB) poses a significant challenge to TB control because it leads to delayed diagnosis and non-adherence. However, few studies on TB-related stigma have been completed in China. The aim of the current study was to explore the status of TB-related stigma and its associated predictive factors among TB patients in Dalian, Northeast China. Methods An institution-based, cross-sectional survey was conducted among outpatients at Dalian Tuberculosis Hospital in Liaoning Province, Northeast China. Data were collected by using a questionnaire that measured TB-related stigma, treatment status, anxiety, social support, doctor-patient communication and so on. A multiple linear regression model was used to determine the predictors of TB-related stigma. Results A total of 601 eligible participants were recruited. The mean score for TB-related stigma was 9.07, and the median score was 10. The average scores for anxiety, social support and doctor-patient communication were 4.03, 25.41 and 17.17, respectively. Multiple linear regression analysis revealed that patients who were female (β = 1.19, 95% CI: 0.38–2.01, P < 0.05), had self-assessed moderate or severe disease (β = 1.08, 95% CI: 0.12–2.03 and β = 1.36, 95% CI: 0.03–2.70, respectively, P < 0.05), and had anxiety (β = 0.38, 95% CI: 0.30–0.46, P < 0.001) were more likely to have a greater level of TB-related stigma than their counterparts. However, a significantly lower level of TB-related stigma was observed in patients with good social support (β = − 0.25, 95% CI: − 0.33--0.17, P < 0.001) and doctor-patient communication (β = − 0.14, 95% CI: − 0.29--0.00, P < 0.05). Conclusions This study showed that stigma among TB patients was high. Targeted attention should be paid to female patients and patients with moderate or severe disease in TB stigma-related interventions. Moreover, the important role of social support and doctor-patient communication in reducing TB-related stigma should also be emphasized.

show abstract

“…Both women and men may find the structure of DOTS inconvenient, as generally female TB patients struggle with managing daily child-care and household responsibilities [136,137], and male TB patients are concerned with retaining employment, being typically the primary earners [138,139]. Studies in South India and Maharashtra have also found that women face greater social consequences of having TB, such as marriageability, divorce, familial rejection and harassment [136], [137], [138], [139], [140], [141]; this may make confidentiality and stigma a greater concern amongst women. Further, predominantly more male TB patients are impacted by addiction to substances (primarily alcohol and tobacco) [64,65,93,141,142] which suggests additional counselling needs from providers.…”

Section: Discussionmentioning

confidence: 99%

User-experience and patient satisfaction with quality of tuberculosis care in India: A mixed-methods literature review

Bhatnagar

2019

Journal of Clinical Tuberculosis and Other Mycobacterial Diseas

View full text Add to dashboard Cite

BackgroundTuberculosis affected 2.7 million people in India in 2017. The Revised National TB Control Programme has achieved milestones in coverage, however quality of TB care remains highly variable and often poor, with significant gaps in provider knowledge, practices, and patients consistently lost to follow-up. These quality gaps are largely informed by studies on provider practices or objective chart abstractions and case data. Per the knowledge of the author, no review has been conducted on first-hand patient perspectives on the quality of TB care they receive. This mixed-methods literature review aims to synthesize evidence on user-experience and patient satisfaction with TB care in India and inform areas for service quality improvement.MethodsFive medical databases, including PubMed, EMBASE, Global Health (Ovid), Web of Science, and CINAHL were searched for empirical studies on patient perspectives on TB health services published between January 1st, 2000 to December 31st, 2017. Studies in English with adult patients with any form of TB in the public or private health system were included. Studies prior to entering the health system, on distance to health facilities and cost were excluded. Seven Indian journals were hand searched and a grey literature search was conducted in GoogleScholar. Studies were assessed for methodological quality and thematic analysis was conducted by categorizing data using NVivo 12.ResultsA total of 498 studies were screened, of which 23 met the inclusion criteria. 16 supplementary studies were identified from Indian journals and grey literature. Of the 39 total studies included most were quantitative (29; 74%), based in South India (17; 44%) and focused on drug-sensitive TB patients (19; 49%) within the public health system (25; 64%). Data collection methods were highly heterogenous which limited synthesis and comparisons across population demographics, health sectors, or regions. Overall quantitative patient satisfaction measured in seven studies was high. Two major themes identified were provider-related factors (n = 26 studies) and convenience (n = 25), and six minor themes were supplies and equipment availability (n = 12), confidence (n = 10), information and communication (n = 10), waiting time (n = 8), stigma (n = 4), and confidentiality (n = 4). Each reported positive and negative user-experiences. Most significantly, DOTS did not fit the daily needs and obligations of many patients, particularly due to conflicts with employment and frequency of visits; while positive provider support, information, and flexibility helped patients adhere to treatment.ConclusionAlthough quantitative patient satisfaction was found to be high, data were not collected using robust, validated tools. Qualitative and quantitative user-experiences in each theme were variable, making them both barriers and facilitators of good quality TB care. Poor user-experiences were often responsible for patients interrupting treatment or dropping out of TB care. Patient-centeredness, or user-friendliness of TB ...

show abstract

“Who Will Marry a Diseased Girl?” Marriage, Gender, and Tuberculosis Stigma in Asia

Cited by 31 publications

References 32 publications

Adolescent tuberculosis

Adolescent tuberculosis

Tuberculosis-related stigma and its determinants in Dalian, Northeast China: a cross-sectional study

User-experience and patient satisfaction with quality of tuberculosis care in India: A mixed-methods literature review

Contact Info

Product

Resources

About