Anand Tanu, Kumar D Arun, Sharma Nandini, Saha Renuka, Krishnamurthy Laxmi, Singh S V, Ingle G K
Indian J Tuberc. 2014 Jan;61(1):35-42.
In India, Tuberculosis (TB) continues to be a public health problem. One of the key reasons for it is the stigma associated with the disease which affects the treatment seeking behaviour and hence the outcome.
To assess the perceived and enacted stigma among TB patients and perceptions of other patients related to TB in Central Delhi.
A cross-sectional study conducted in urban field practice area of a medical college of Delhi, using a pre-designed questionnaire containing items for assessment of stigma being faced by a TB patient in family, social life and workplace. It also contained questions pertaining to reaction of patients from general OPD to a family member who develops TB.
A total of 100 patients on DOTS and 200 patients from general OPD were interviewed. There were 21 patients who reported to have delayed treatment seeking due to stigma. Nearly one third patients (n=34; 34%) noted negative changes in the behaviour of their family members towards them while 40% were isolated on being diagnosed with the disease. Out of the 36 employed TB patients, 65.5% (n=23) experienced negative change in the behaviour of their colleagues. In general OPD patients, significantly higher proportion of female patients said that they would not disclose the disease status of a family member suffering from TB to their neighbours (p<0.001).
Perception of stigmatizing effect of Tuberculosis was high both amongst TB and other patients. Behaviour Change Communication (BCC) strategies are needed to address the effects of stigma like delayed treatment seeking.
在印度，结核病仍然是一个公共卫生问题。其中一个关键原因是与该疾病相关的耻辱感，这会影响患者寻求治疗的行为，进而影响治疗结果。
评估德里中部结核病患者所感受到的和实际遭遇的耻辱感，以及其他患者对结核病的看法。
在德里一所医学院的城市实地实践区域进行了一项横断面研究，使用预先设计的问卷，其中包含评估结核病患者在家庭、社会生活和工作场所所面临耻辱感的项目。问卷还包含与普通门诊患者对患结核病家庭成员的反应相关的问题。
共采访了100名接受直接观察短程治疗（DOTS）的患者和200名普通门诊患者。有21名患者报告称由于耻辱感而延迟寻求治疗。近三分之一的患者（n = 34；34%）指出家庭成员对他们的行为发生了负面变化，而40%的患者在被诊断出患有该疾病后被孤立。在36名有工作的结核病患者中，65.5%（n = 23）的同事对他们的行为发生了负面变化。在普通门诊患者中，女性患者中表示不会向邻居透露患结核病家庭成员病情的比例显著更高（p < 0.001）。
结核病患者和其他患者对结核病耻辱化影响的认知都很高。需要采用行为改变沟通（BCC）策略来应对耻辱感带来的影响，如延迟寻求治疗。
