Review
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Tuberculosis related stigma

Year 2021, Early Pub Special Issue: 4, 1 - 6, 30.05.2021
https://doi.org/10.5472/marumj.854373

Abstract

While tuberculosis is a preventable and curable disease, it still remains to be a major cause of morbidity and mortality across the
world. Research reveals that stigma impacts tuberculosis control negatively through delaying diagnosis and impairing treatment
compliance. It also causes enormous suffering since, it results with isolation of patients and their families from social life. In this
review; the magnitude, origins, correlates and consequences of tuberculosis related stigma are discussed and some examples of public
health interventions to combat stigma are presented.

References

  • Organization WHO. Global Tuberculosis Report 2017. 2017.
  • Chakrabartty A, Basu P, Ali KM, Sarkar AK, Ghosh D. Tuberculosis related stigma and its effect on the delay for sputum examination under the Revised National Tuberculosis Control Program in India. Indian J Tuberc 2018;65:145-51.
  • Courtwright A, Turner AN. Tuberculosis and stigmatization: pathways and interventions. Public Health Rep (Washington, DC : 1974). 2010;125 Suppl 4:34-42. doi: 10.1177/003.335.49101250S407.
  • de Vries SG, Cremers AL, Heuvelings CC, et al. Barriers and facilitators to the uptake of tuberculosis diagnostic and treatment services by hard-to-reach populations in countries of low and medium tuberculosis incidence: a systematic review of qualitative literature. Lancet Infect Dis 2017;17:e128-e43. doi: 10.1016/S1473-3099(16)30531-X.
  • Demissie M, Getahun H, Lindtjorn B. Community tuberculosis care through “TB clubs” in rural North Ethiopia. Soc Sci Med 2003;56:2009-18. doi: 10.1016/s0277-9536(02)00182-x.
  • Gebreweld FH, Kifle MM, Gebremicheal FE, et al. Factors influencing adherence to tuberculosis treatment in Asmara, Eritrea: a qualitative study. J Health Popul Nutr 2018;37(1):1. doi: 10.1186/s41043.017.0132-y.
  • Sabawoon W, Sato H, Kobayashi Y. Delay in the treatment of pulmonary tuberculosis: a report from Afghanistan. Environ Health Prev Med 2012;17:53-61. doi: 10.1007/ s12199.011.0219-9.
  • Saqib SE, Ahmad MM, Amezcua-Prieto C, Virginia MR. Treatment delay among pulmonary tuberculosis patients within the Pakistan National Tuberculosis Control Program. Am J Trop Med Hyg 2018;99:143-9. doi: 10.4269/ ajtmh.18-0001.
  • Yan S, Zhang S, Tong Y, Yin X, Lu Z, Gong Y. Nonadherence to antituberculosis medications: The impact of stigma and depressive symptoms. Am J Trop Med Hygi 2018;98:262-5. doi: 10.4269/ajtmh.17-0383.
  • Faccini M, Cantoni S, Ciconali G, et al. Tuberculosis-related stigma leading to an incomplete contact investigation in a low-incidence country. Epidem Infect 2015;143:2841-8. doi: 10.1017/S095.026.881400394X.
  • Jaramillo E, Sahu S, Van Weezenbeek C. Ending TBrelated stigma and discrimination. Int J Tuberc Lung Dis 2017;21(11):2-3. doi: 10.5588/ijtld.17.0229.
  • Goffman E. Stigma: Notes on the management of spoiled identity. NJ:Prentice Hall Englewood Cliffs , 1963.
  • Link BG, Phelan PJ. Conceptualizing stigma. Annu Rev Sociol 2001;27:363-85.
  • Link BG, Phelan JC. Stigma and its public health implications. Lancet 2006;367(9509):528-9.
  • Scambler G HA. Being epileptic: coming to terms with stigma. Sociology of Health and Illness 1986;8:26-43.
  • Macq J, Solis A, Martinez G, Martiny P. Tackling tuberculosis patients’ internalized social stigma through patient centred care: an intervention study in rural Nicaragua. BMC Public Health 2008;8:154.
  • Mitchell EMH, Daftary A. TB stigma: clearing the fog. Int J Tuberc Lung Dis 2017;21:1. doi: 10.5588/ijtld.17.0651
  • Aryal S, Badhu A, Pandey S, Bhandari A, et al. Stigma related to tuberculosis among patients attending DOTS clinics of Dharan municipality. Kathmandu Univ Med J 2012;10:48-52. doi: 10.3126/kumj.v10i1.6914.
  • Burtscher D, Van den Bergh R, Toktosunov U, Angmo N, Samieva N, Rocillo Arechaga EP. “My Favourite Day Is Sunday”: Community perceptions of (Drug-Resistant) tuberculosis and ambulatory tuberculosis care in Kara Suu District, Osh Province, Kyrgyzstan. PloS One. 2016;11:e0152283. doi: 10.1371/journal.pone.0152283.
  • EM/TDR/009/E/10.06/1000 WHOROftEM. Diagnostic and treatment delay in tuberculosis. Cairo, Egypt: WHO EMRO; 2006.
  • Rood EJJ, Mergenthaler C, Bakker MI, Redwood L, Mitchell EMH. Using 15 DHS surveys to study epidemiological correlates of TB courtesy stigma and health-seeking behaviour. Int J Tuberc Lung Dis 2017;21:60-8. doi: 10.5588/ijtld.16.0909.
  • Shivapujimath R, Rao AP, Nilima AR, Shilpa DM. A cross-sectional study ro assess the stigma associated with tuberculosis among tuberculosis patients in Udupi district in Karnataka. Indian Journal of Tuberculosis 2017;64:323-6. doi. org/10.1016/j.ijtb.2016.10.002
  • Şimşek H ÖD, Çetinkaya AÇ. Evaluation internalized stigma of tuberculosis patients. Int j Nursing Res 2016;7:156-73.
  • Yiğit Açıkel G ÇPS. Akciğer tüberkülozlu hastalarda damgalamanın değerlendirilmesi. FN Hem Derg 2015;23:136- 45.
  • Yin X, Yan S, Tong Y, Peng X, Yang T, Lu Z, et al. Status of tuberculosis-related stigma and associated factors: a crosssectional study in central China. Trop Med Int Health 2018;23:199-205. doi: 10.1111/tmi.13017.
  • Sagili KD, Satyanarayana S, Chadha SS. Is knowledge regarding tuberculosis associated with stigmatising and discriminating attitudes of general population towards tuberculosis patients? Findings from a community based survey in 30 districts of India. PloS one 2016;11(2):e0147274. doi: 10.1371/journal. pone.0147274.
  • Baral SC, Karki DK, Newell JN. Causes of stigma and discrimination associated with tuberculosis in Nepal: a qualitative study. BMC Public Health 2007;7:211. doi: 10.1186/1471-2458-7-211.
  • Pardeshi GS, Kadam D, Chandanwale A, Bollinger R, Deluca A. Resident doctors’ attitudes toward tuberculosis patients. Indian J Tuberc 2017;64(2):89-92. doi: 10.1016/j. ijtb.2016.11.001
  • Macintyre K, Bakker MI, Bergson S, et al. Defining the research agenda to measure and reduce tuberculosis stigmas. The international journal of tuberculosis and lung disease. Int J Tuberc Lung Dis 2017;21(11):87-96. doi: 10.5588/ ijtld.17.0151.
  • Coreil J, Mayard G, Simpson KM, Lauzardo M, Zhu Y, Weiss M. Structural forces and the production of TB-related stigma among Haitians in two contexts. Soc Sci Med 2010;71:1409- 17. doi: 10.1016/j.socscimed.2010.07.017.
  • Murray EJ, Bond VA, Marais BJ, Godfrey-Faussett P, Ayles HM, Beyers N. High levels of vulnerability and anticipated stigma reduce the impetus for tuberculosis diagnosis in Cape Town, South Africa. Health Policy Plan 2013;28:410-8. doi: 10.1093/heapol/czs072.
  • Juniarti N, Evans D. A qualitative review: the stigma of tuberculosis. J Clin Nurs 2011;20:1961-70. doi: 10.1111/j.1365- 2702.2010.03516.x.
  • Miller C, Huston J, Samu L, Mfinanga S, Hopewell P, Fair E. ‘It makes the patient’s spirit weaker’: tuberculosis stigma and gender interaction in Dar es Salaam, Tanzania. Int J Tuberc Lung Dis 2017;21:42-8. doi: 10.5588/ijtld.16.0914.
  • Skinner D, Claassens M. It’s complicated: why do tuberculosis patients not initiate or stay adherent to treatment? A qualitative study from South Africa. BMC Infect Dis 2016;16:712. doi. org/10.1186/s12879.016.2054-5
  • Kipp AM, Pungrassami P, Nilmanat K, et al. Sociodemographic and AIDS-related factors associated with tuberculosis stigma in southern Thailand: a quantitative, crosssectional study of stigma among patients with TB and healthy community members. BMC Public Health 2011;11:675. doi. org/10.1186/1471-2458-11-675
  • Daftary A. HIV and tuberculosis: the construction and management of double stigma. Soc Sci Med (1982). 2012;74:1512-9. doi: 10.1016/j.socscimed.2012.01.027.
  • Gerrish K, Naisby A, Ismail M. The meaning and consequences of tuberculosis among Somali people in the United Kingdom. J Adv Nurs 2012;68:2654-63. doi: 10.1111/j.1365- 2648.2012.05964.x.
  • Munro SA, Lewin SA, Smith HJ, Engel ME, Fretheim A, Volmink J. Patient adherence to tuberculosis treatment: a systematic review of qualitative research. PLoS Med 2007;4:e238. doi: 10.1371/journal.pmed.0040238.
  • Gerrish K, Naisby A, Ismail M. Experiences of the diagnosis and management of tuberculosis: a focused ethnography of Somali patients and healthcare professionals in the UK. J Adv Nurs 2013;69:2285-94. doi: 10.1111/jan.12112.
  • Senanayake MGB, Wickramasinghe SI, Samaraweera S, De Silva P, Edirippulige S. Examining the social status, risk factors and lifestyle changes of tuberculosis patients in Sri Lanka during the treatment period: a cross-sectional study. Multidiscip Respir Med 2018;13:9. doi: 10.1186/ s40248.018.0121-z.
  • Zuniga JA, Munoz SE, Johnson MZ, Garcia A. Tuberculosis treatment for Mexican Americans living on the U.S.-Mexico border. J Nurs Scholarsh 2014;46:253-62. doi: 10.1111/ jnu.12071.
  • Xu M, Markstrom U, Lyu J, Xu L. Survey on Tuberculosis patients in rural areas in China: tracing the role of stigma in psychological distress. Int J Enviro Res Public Health 2017;14:1171. doi:10.3390/ijerph14101171
  • Sommerland N, Wouters E, Mitchell EMH, et al. Evidencebased interventions to reduce tuberculosis stigma: a systematic review. Int J Tuberc Lung Dis 2017;21(11):81-6. doi: 10.5588/ ijtld.16.0788.
  • Chang SH, Cataldo JK. A systematic review of global cultural variations in knowledge, attitudes and health responses to tuberculosis stigma. lung disease. Int J Tuberc Lung Dis 2014;18:168-73, i-iv. doi: 10.5588/ijtld.13.0181.
  • Daftary A, Frick M, Venkatesan N, Pai M. Fighting TB stigma: we need to apply lessons learnt from HIV activism. BMJ Glob Health 2017;2:e000515. doi: 10.1136/bmjgh-2017-000515.
Year 2021, Early Pub Special Issue: 4, 1 - 6, 30.05.2021
https://doi.org/10.5472/marumj.854373

Abstract

References

  • Organization WHO. Global Tuberculosis Report 2017. 2017.
  • Chakrabartty A, Basu P, Ali KM, Sarkar AK, Ghosh D. Tuberculosis related stigma and its effect on the delay for sputum examination under the Revised National Tuberculosis Control Program in India. Indian J Tuberc 2018;65:145-51.
  • Courtwright A, Turner AN. Tuberculosis and stigmatization: pathways and interventions. Public Health Rep (Washington, DC : 1974). 2010;125 Suppl 4:34-42. doi: 10.1177/003.335.49101250S407.
  • de Vries SG, Cremers AL, Heuvelings CC, et al. Barriers and facilitators to the uptake of tuberculosis diagnostic and treatment services by hard-to-reach populations in countries of low and medium tuberculosis incidence: a systematic review of qualitative literature. Lancet Infect Dis 2017;17:e128-e43. doi: 10.1016/S1473-3099(16)30531-X.
  • Demissie M, Getahun H, Lindtjorn B. Community tuberculosis care through “TB clubs” in rural North Ethiopia. Soc Sci Med 2003;56:2009-18. doi: 10.1016/s0277-9536(02)00182-x.
  • Gebreweld FH, Kifle MM, Gebremicheal FE, et al. Factors influencing adherence to tuberculosis treatment in Asmara, Eritrea: a qualitative study. J Health Popul Nutr 2018;37(1):1. doi: 10.1186/s41043.017.0132-y.
  • Sabawoon W, Sato H, Kobayashi Y. Delay in the treatment of pulmonary tuberculosis: a report from Afghanistan. Environ Health Prev Med 2012;17:53-61. doi: 10.1007/ s12199.011.0219-9.
  • Saqib SE, Ahmad MM, Amezcua-Prieto C, Virginia MR. Treatment delay among pulmonary tuberculosis patients within the Pakistan National Tuberculosis Control Program. Am J Trop Med Hyg 2018;99:143-9. doi: 10.4269/ ajtmh.18-0001.
  • Yan S, Zhang S, Tong Y, Yin X, Lu Z, Gong Y. Nonadherence to antituberculosis medications: The impact of stigma and depressive symptoms. Am J Trop Med Hygi 2018;98:262-5. doi: 10.4269/ajtmh.17-0383.
  • Faccini M, Cantoni S, Ciconali G, et al. Tuberculosis-related stigma leading to an incomplete contact investigation in a low-incidence country. Epidem Infect 2015;143:2841-8. doi: 10.1017/S095.026.881400394X.
  • Jaramillo E, Sahu S, Van Weezenbeek C. Ending TBrelated stigma and discrimination. Int J Tuberc Lung Dis 2017;21(11):2-3. doi: 10.5588/ijtld.17.0229.
  • Goffman E. Stigma: Notes on the management of spoiled identity. NJ:Prentice Hall Englewood Cliffs , 1963.
  • Link BG, Phelan PJ. Conceptualizing stigma. Annu Rev Sociol 2001;27:363-85.
  • Link BG, Phelan JC. Stigma and its public health implications. Lancet 2006;367(9509):528-9.
  • Scambler G HA. Being epileptic: coming to terms with stigma. Sociology of Health and Illness 1986;8:26-43.
  • Macq J, Solis A, Martinez G, Martiny P. Tackling tuberculosis patients’ internalized social stigma through patient centred care: an intervention study in rural Nicaragua. BMC Public Health 2008;8:154.
  • Mitchell EMH, Daftary A. TB stigma: clearing the fog. Int J Tuberc Lung Dis 2017;21:1. doi: 10.5588/ijtld.17.0651
  • Aryal S, Badhu A, Pandey S, Bhandari A, et al. Stigma related to tuberculosis among patients attending DOTS clinics of Dharan municipality. Kathmandu Univ Med J 2012;10:48-52. doi: 10.3126/kumj.v10i1.6914.
  • Burtscher D, Van den Bergh R, Toktosunov U, Angmo N, Samieva N, Rocillo Arechaga EP. “My Favourite Day Is Sunday”: Community perceptions of (Drug-Resistant) tuberculosis and ambulatory tuberculosis care in Kara Suu District, Osh Province, Kyrgyzstan. PloS One. 2016;11:e0152283. doi: 10.1371/journal.pone.0152283.
  • EM/TDR/009/E/10.06/1000 WHOROftEM. Diagnostic and treatment delay in tuberculosis. Cairo, Egypt: WHO EMRO; 2006.
  • Rood EJJ, Mergenthaler C, Bakker MI, Redwood L, Mitchell EMH. Using 15 DHS surveys to study epidemiological correlates of TB courtesy stigma and health-seeking behaviour. Int J Tuberc Lung Dis 2017;21:60-8. doi: 10.5588/ijtld.16.0909.
  • Shivapujimath R, Rao AP, Nilima AR, Shilpa DM. A cross-sectional study ro assess the stigma associated with tuberculosis among tuberculosis patients in Udupi district in Karnataka. Indian Journal of Tuberculosis 2017;64:323-6. doi. org/10.1016/j.ijtb.2016.10.002
  • Şimşek H ÖD, Çetinkaya AÇ. Evaluation internalized stigma of tuberculosis patients. Int j Nursing Res 2016;7:156-73.
  • Yiğit Açıkel G ÇPS. Akciğer tüberkülozlu hastalarda damgalamanın değerlendirilmesi. FN Hem Derg 2015;23:136- 45.
  • Yin X, Yan S, Tong Y, Peng X, Yang T, Lu Z, et al. Status of tuberculosis-related stigma and associated factors: a crosssectional study in central China. Trop Med Int Health 2018;23:199-205. doi: 10.1111/tmi.13017.
  • Sagili KD, Satyanarayana S, Chadha SS. Is knowledge regarding tuberculosis associated with stigmatising and discriminating attitudes of general population towards tuberculosis patients? Findings from a community based survey in 30 districts of India. PloS one 2016;11(2):e0147274. doi: 10.1371/journal. pone.0147274.
  • Baral SC, Karki DK, Newell JN. Causes of stigma and discrimination associated with tuberculosis in Nepal: a qualitative study. BMC Public Health 2007;7:211. doi: 10.1186/1471-2458-7-211.
  • Pardeshi GS, Kadam D, Chandanwale A, Bollinger R, Deluca A. Resident doctors’ attitudes toward tuberculosis patients. Indian J Tuberc 2017;64(2):89-92. doi: 10.1016/j. ijtb.2016.11.001
  • Macintyre K, Bakker MI, Bergson S, et al. Defining the research agenda to measure and reduce tuberculosis stigmas. The international journal of tuberculosis and lung disease. Int J Tuberc Lung Dis 2017;21(11):87-96. doi: 10.5588/ ijtld.17.0151.
  • Coreil J, Mayard G, Simpson KM, Lauzardo M, Zhu Y, Weiss M. Structural forces and the production of TB-related stigma among Haitians in two contexts. Soc Sci Med 2010;71:1409- 17. doi: 10.1016/j.socscimed.2010.07.017.
  • Murray EJ, Bond VA, Marais BJ, Godfrey-Faussett P, Ayles HM, Beyers N. High levels of vulnerability and anticipated stigma reduce the impetus for tuberculosis diagnosis in Cape Town, South Africa. Health Policy Plan 2013;28:410-8. doi: 10.1093/heapol/czs072.
  • Juniarti N, Evans D. A qualitative review: the stigma of tuberculosis. J Clin Nurs 2011;20:1961-70. doi: 10.1111/j.1365- 2702.2010.03516.x.
  • Miller C, Huston J, Samu L, Mfinanga S, Hopewell P, Fair E. ‘It makes the patient’s spirit weaker’: tuberculosis stigma and gender interaction in Dar es Salaam, Tanzania. Int J Tuberc Lung Dis 2017;21:42-8. doi: 10.5588/ijtld.16.0914.
  • Skinner D, Claassens M. It’s complicated: why do tuberculosis patients not initiate or stay adherent to treatment? A qualitative study from South Africa. BMC Infect Dis 2016;16:712. doi. org/10.1186/s12879.016.2054-5
  • Kipp AM, Pungrassami P, Nilmanat K, et al. Sociodemographic and AIDS-related factors associated with tuberculosis stigma in southern Thailand: a quantitative, crosssectional study of stigma among patients with TB and healthy community members. BMC Public Health 2011;11:675. doi. org/10.1186/1471-2458-11-675
  • Daftary A. HIV and tuberculosis: the construction and management of double stigma. Soc Sci Med (1982). 2012;74:1512-9. doi: 10.1016/j.socscimed.2012.01.027.
  • Gerrish K, Naisby A, Ismail M. The meaning and consequences of tuberculosis among Somali people in the United Kingdom. J Adv Nurs 2012;68:2654-63. doi: 10.1111/j.1365- 2648.2012.05964.x.
  • Munro SA, Lewin SA, Smith HJ, Engel ME, Fretheim A, Volmink J. Patient adherence to tuberculosis treatment: a systematic review of qualitative research. PLoS Med 2007;4:e238. doi: 10.1371/journal.pmed.0040238.
  • Gerrish K, Naisby A, Ismail M. Experiences of the diagnosis and management of tuberculosis: a focused ethnography of Somali patients and healthcare professionals in the UK. J Adv Nurs 2013;69:2285-94. doi: 10.1111/jan.12112.
  • Senanayake MGB, Wickramasinghe SI, Samaraweera S, De Silva P, Edirippulige S. Examining the social status, risk factors and lifestyle changes of tuberculosis patients in Sri Lanka during the treatment period: a cross-sectional study. Multidiscip Respir Med 2018;13:9. doi: 10.1186/ s40248.018.0121-z.
  • Zuniga JA, Munoz SE, Johnson MZ, Garcia A. Tuberculosis treatment for Mexican Americans living on the U.S.-Mexico border. J Nurs Scholarsh 2014;46:253-62. doi: 10.1111/ jnu.12071.
  • Xu M, Markstrom U, Lyu J, Xu L. Survey on Tuberculosis patients in rural areas in China: tracing the role of stigma in psychological distress. Int J Enviro Res Public Health 2017;14:1171. doi:10.3390/ijerph14101171
  • Sommerland N, Wouters E, Mitchell EMH, et al. Evidencebased interventions to reduce tuberculosis stigma: a systematic review. Int J Tuberc Lung Dis 2017;21(11):81-6. doi: 10.5588/ ijtld.16.0788.
  • Chang SH, Cataldo JK. A systematic review of global cultural variations in knowledge, attitudes and health responses to tuberculosis stigma. lung disease. Int J Tuberc Lung Dis 2014;18:168-73, i-iv. doi: 10.5588/ijtld.13.0181.
  • Daftary A, Frick M, Venkatesan N, Pai M. Fighting TB stigma: we need to apply lessons learnt from HIV activism. BMJ Glob Health 2017;2:e000515. doi: 10.1136/bmjgh-2017-000515.
There are 45 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Review Article
Authors

Pinar Ay This is me

Seyhan Hıdıroglu This is me

Publication Date May 30, 2021
Published in Issue Year 2021 Early Pub Special Issue: 4

Cite

APA Ay, P., & Hıdıroglu, S. (n.d.). Tuberculosis related stigma. Marmara Medical Journal, 34(2), 1-6. https://doi.org/10.5472/marumj.854373
AMA Ay P, Hıdıroglu S. Tuberculosis related stigma. Marmara Med J. 34(2):1-6. doi:10.5472/marumj.854373
Chicago Ay, Pinar, and Seyhan Hıdıroglu. “Tuberculosis Related Stigma”. Marmara Medical Journal 34, no. 2 n.d.: 1-6. https://doi.org/10.5472/marumj.854373.
EndNote Ay P, Hıdıroglu S Tuberculosis related stigma. Marmara Medical Journal 34 2 1–6.
IEEE P. Ay and S. Hıdıroglu, “Tuberculosis related stigma”, Marmara Med J, vol. 34, no. 2, pp. 1–6, doi: 10.5472/marumj.854373.
ISNAD Ay, Pinar - Hıdıroglu, Seyhan. “Tuberculosis Related Stigma”. Marmara Medical Journal 34/2 (n.d.), 1-6. https://doi.org/10.5472/marumj.854373.
JAMA Ay P, Hıdıroglu S. Tuberculosis related stigma. Marmara Med J.;34:1–6.
MLA Ay, Pinar and Seyhan Hıdıroglu. “Tuberculosis Related Stigma”. Marmara Medical Journal, vol. 34, no. 2, pp. 1-6, doi:10.5472/marumj.854373.
Vancouver Ay P, Hıdıroglu S. Tuberculosis related stigma. Marmara Med J. 34(2):1-6.