Oxford Health Evaluations, Oxford, UK.
KIT Royal Tropical Institute, Amsterdam, The Netherlands.
Int J Tuberc Lung Dis. 2017 Nov 1;21(11):87-96. doi: 10.5588/ijtld.17.0151.
Crucial to finding and treating the 4 million tuberculosis (TB) patients currently missed by national TB programmes, TB stigma is receiving well-deserved and long-delayed attention at the global level. However, the ability to measure and evaluate the success of TB stigma-reduction efforts is limited by the need for additional tools. At a 2016 TB stigma-measurement meeting held in The Hague, The Netherlands, stigma experts discussed and proposed a research agenda around four themes: 1) drivers: what are the main drivers and domains of TB stigma(s)?; 2) consequences: how consequential are TB stigmas and how are negative impacts most felt?; 3) burden: what is the global prevalence and distribution of TB stigma(s) and what explains any variation? 4): intervention: what can be done to reduce the extent and impact of TB stigma(s)? Each theme was further subdivided into research topics to be addressed to move the agenda forward. These include greater clarity on what causes TB stigmas to emerge and thrive, the difficulty of measuring the complexity of stigma, and the improbability of a universal stigma 'cure'. Nevertheless, these challenges should not hinder investments in the measurement and reduction of TB stigma. We believe it is time to focus on how, and not whether, the global community should measure and reduce TB stigma.
要发现并治疗目前被国家结核病规划遗漏的 400 万结核病（TB）患者，结核病污名至关重要，这在全球层面上受到了当之无愧且姗姗来迟的关注。然而，衡量和评估减少结核病污名工作的成功与否受到了需要更多工具的限制。在 2016 年于荷兰海牙举行的结核病污名衡量会议上，污名专家讨论并提出了围绕以下四个主题的研究议程：1）驱动因素：结核病污名的主要驱动因素和领域是什么？2）后果：结核病污名的后果有多严重，负面影响最明显的地方在哪里？3）负担：全球结核病污名的流行程度和分布情况如何，哪些因素导致了这种差异？4）干预措施：可以采取哪些措施来减少结核病污名的程度和影响？每个主题都进一步细分为需要解决的研究课题，以推动议程向前发展。这些课题包括更清楚地了解是什么导致结核病污名的出现和盛行，衡量污名复杂性的困难，以及消除普遍污名的不可能性。然而，这些挑战不应阻碍对结核病污名的衡量和减少工作的投入。我们认为，现在是时候关注全球社会应该如何衡量和减少结核病污名，而不是是否应该这样做了。
