Tuberculosis literacy and stigma: female activists in five areas with the lowest treatment success rate in Semarang, Indonesia

Abstract

Background: The Case Detection Rate of Tuberculosis (TB) in Semarang city increased from 2014 to 2018, while the Treatment Success Rate declined. Low literacy can trigger stigma in society, especially among women, resulting in low awareness of suspect TB for treatment.
 Objectives: The aims are to analyze the correlation between TB literacy and stigma expressed among female health and social activists.
 Methods: Cross-sectional research was conducted in five public health centers with the lowest Treatment Success Rate (TSR). A valid and reliable self-administered online questionnaire collected data that involved 391 respondents predominantly in the urban areas. Rank Spearman test was used to analyze the data with a confidence interval of 95%.
 Results: The respondents were mostly elderly (>45 years; 61.6%), health activists with high school graduation, didn't have a family with a health background and did not work. Most of them showed low TB literacy (Me:60; SD±6.62) and high stigma (Me: 76; SD±10.36). They were also difficult to access, understand, assess, and apply information about TB. Age (p.0.03; r.-0.110), being health activist (p.0.081; r.-0.088), and TB literacy (p.0.001; r.0.165) correlated significantly with stigma.
 Conclusions: Public Health Center's officers require inserting literacy education materials related to stigma to form a comfortable support system for persons with TB.