Ending TB-related stigma and discrimination

Jaramillo, Ernesto; Sahu, Santosh Kumar; Weezenbeek, Catharina Van

doi:10.5588/ijtld.17.0229

Cited by 10 publications

(9 citation statements)

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“…Improved supervision of MDR-TB care should be performed with the continuation of its implementation. The findings from our study contributed to current efforts to understand the nature of stigma among health staff in conducting MDR-TB care that is argued as an initial step to address and tacking the implementation issue of DOT for MDR-TB patients [27]. The way forward to patient-centered MDR-TB care would be jeopardized unless stigma among health staff is diminished.…”

Section: Discussionmentioning

confidence: 88%

Being safe, feeling safe, and stigmatizing attitude among primary health care staff in providing multidrug-resistant tuberculosis care in Bantul District, Yogyakarta Province, Indonesia

et al. 2019

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Introduction Patient-centered care approach in multidrug-resistant tuberculosis care requires health worker safety that covers both being safe and feeling safe to conduct the services. Stigma has been argued as a barrier to patient-centered care. However, there has been relatively little research addressing the issues of safety and stigma among health staff. This paper explored the issue of being safe, feeling safe, and stigmatizing attitude among health staff working with multidrug-resistant tuberculosis cases in primary health care facilities in Indonesia. Methods Using a mixed methods research design, data was collected with structured questionnaires among 123 staff, observations of infection control in 17 primary health care facilities, and in-depth interviews among 22 staff. Results The findings showed suboptimal infection control infrastructures for the primary health care facilities. The knowledge and motivation to follow multidrug-resistant tuberculosis care protocols are suboptimal. Feeling unsafe is related to stigmatizing attitude in providing multidrug-resistant tuberculosis care. Conclusion Being safe, feeling unsafe, and stigmatizing attitude are challenges in providing patient-centered multidrug-resistant tuberculosis care in primary health care facilities in Indonesia. Serious efforts are needed on all levels to ensure safety and prevent irrational stigma.

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Section: Discussionmentioning

confidence: 88%

Being safe, feeling safe, and stigmatizing attitude among primary health care staff in providing multidrug-resistant tuberculosis care in Bantul District, Yogyakarta Province, Indonesia

et al. 2019

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“…Stigma against TB is one of the barriers to global TB elimination. 22 Stigma leads to delay in health-seeking behaviour for TB diagnosis, 23 and non-adherence to anti-tuberculosis treatment 24 and hinders contact investigation. This study shows that both types of stigma exist, i.e., enacted stigma (actual discrimination) and felt stigma (fearing to be discriminated).…”

Section: Public Health Actionmentioning

confidence: 99%

Stigma against tuberculosis may hinder non-household contact investigation: a qualitative study in Thailand

Ngamvithayapong-Yanai¹,

Luangjina²,

Thawthong³

et al. 2019

public health action

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“…Tuberculosis (TB), with 380 new cases per 1000 in 2016, is the leading cause of death in South Africa [ 11 ], and can be marginalizing, with numerous social and health consequences. Individuals with TB are often stigmatized [ 12 ] by peers (e.g., rejected by partners), within households (e.g., expulsion from homes) and at work (e.g., loss of employment). TB-stigma hampers health-seeking behavior [ 13 ], treatment initiation [ 14 ], and adherence to care [ 15 ], with potential consequences for the emergence of highly resistant strains to the standard antimicrobial isoniazid/rifampicin treatments.…”

Section: Introductionmentioning

confidence: 99%

Major depression and household food insecurity among individuals with multidrug-resistant tuberculosis (MDR-TB) in South Africa

Tomita

Ramlall

Naidu

et al. 2019

Soc Psychiatry Psychiatr Epidemiol

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Purpose Household food insecurity in South Africa is a pervasive public health challenge. Although its link to chronic health conditions is well established, its relationship to mental illness, particularly major depression, is not well-understood. Despite KwaZulu-Natal Province being the epicenter of the drug-resistant tuberculosis (MDR-TB) epidemic, and having the largest share of poverty in South Africa, this relationship remains unexamined. This study investigated the association between major depressive episode (MDE) and household food insecurity among individuals with MDR-TB. Methods We enrolled and interviewed 141 newly admitted microbiologically confirmed MDR-TB inpatients at a specialized TB hospital in KwaZulu-Natal Province, South Africa. Logistic regression models were fitted to assess the relationship between MDE and household food insecurity, while accounting for socio-demographic status (e.g., age, gender, education, marital status, social grant status, income, and preference for living in one’s community). Results The prevalence of MDE and household food insecurity was 11.35% and 21.01%, respectively. MDE was significantly associated with household food insecurity (aOR 4.63, 95% CI 1.17–18.38). Individuals who are female (aOR 6.29, 95% CI 1.13–35.03), young (aOR 8.86, 95% CI 1.69–46.34), have low educational attainment (aOR 6.19, 95% CI 1.70–22.59) and receive social grants (aOR 7.60, 95% CI 2.36–24.48) were most at risk of household food insecurity. Conclusions MDE in individuals with MDR-TB was significantly associated with household food insecurity, independent of socio-economic status. Although MDR-TB is not exclusively a disease of the poor, individuals from socio-economically disadvantaged backgrounds (e.g., female, young adults, low education, and social grant recipients) were more likely to experience household food insecurity. Our study underscores the need to address the co-occurring cycles of food insecurity and untreated MDE in South Africa.

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Ending TB-related stigma and discrimination

Cited by 10 publications

References 0 publications

Being safe, feeling safe, and stigmatizing attitude among primary health care staff in providing multidrug-resistant tuberculosis care in Bantul District, Yogyakarta Province, Indonesia

Being safe, feeling safe, and stigmatizing attitude among primary health care staff in providing multidrug-resistant tuberculosis care in Bantul District, Yogyakarta Province, Indonesia

Stigma against tuberculosis may hinder non-household contact investigation: a qualitative study in Thailand

Major depression and household food insecurity among individuals with multidrug-resistant tuberculosis (MDR-TB) in South Africa

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