Stigma associated with tuberculosis  An Indian perspective

Background: Social stigma has been identified as an important barrier that delays initiation and adherence to treatment thereby adding to the disease burden and prolong transmission in community. Stigma may limit social participation and lead to social exclusion which may result in an economic burden for the household and thus aggravate poverty. Aims and Objectives: The present study was carried out to estimate the level of perceived and enacted stigma experienced by tuberculosis (TB) patients and also their care providers. This study was planned with the following objectives: (i) To assess the prevalence of stigma among TB patients; and (ii) to assess the different factors associated with stigma. Materials and Methods: This was a prospective, observational, multi-centric study, undertaken on TB patients attending to directly observed treatment short (DOTS) course centers. Patients were interviewed about stigma associated with TB using questionnaire – Explanatory Model Interview Catalogue. Personal interview of the patients and the DOTS providers by a trained person to assess the stigma using pre-tested questionnaires after taking informed consent was arranged. Results: Around half (50.57%) of the patients perceived the social stigma. The present study has found that level of education and socioeconomic class of the patients are statistically significantly associated perception of stigma by patients but not for other socio-demographic characteristics such as age, gender, and marital status of the patients. Conclusion: Stigma associated with TB is significantly associated with patients with the lower level of education and with lower socio-economic status, which is certainly grave area of concerns as often these population are at higher risk for health disparities.