Sekandi Juliet N, Quach Trang, Olum Ronald, Nakkonde Damalie, Farist Leila, Obiekwe Rochelle, Zalwango Sarah, Buregyeya Esther
Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, GA, USA.
College of Public Health, Global Health Institute, University of Georgia, Athens, GA, USA.
Ther Adv Infect Dis. 2024 Dec 14;11:20499361241305517. doi: 10.1177/20499361241305517. eCollection 2024 Jan-Dec.
Tuberculosis (TB) is the leading cause of death from a single infectious agent globally. The stigma associated with TB, encompassing self, anticipated, and public stigma, has significant negative effects on treatment adherence. In Uganda, limited data exist on the prevalence of stigma and its relationship with sex among patients with TB.
We aimed to evaluate the prevalence of three types of stigma and their relationship with the sex of patients undergoing TB treatment.
Cross-sectional study.
This cross-sectional study was conducted among patients living with TB attending selected TB clinics in Kampala, Uganda, between July 2020 and March 2021. We collected data on sociodemographics and used 13 items to capture the self, anticipated, and public stigma from which we composed the dependent variables. We employed multivariable logistic regression analysis to evaluate the association between sex and the three stigma types. Additionally, we considered potential confounders such as age, HIV, and employment status. Statistical significance was defined as < 0.05.
In this study, we enrolled 144 participants with a mean age of 35.8 years (standard deviation = 12). Half of the participants were female, 44.4% had a secondary education, 37.5% were unemployed, and 32.6% were living with both HIV and TB. The prevalence of self-stigma was 71.1%, anticipated stigma was 75.7%, and public stigma was 41.7%. Significant factors associated with self-stigma were female sex (adjusted odds ratio (AOR): 2.35, 95% confidence interval (CI): 1.02-5.74) and unemployment (AOR: 2.95, 95% CI: 1.16-8.58). Living with HIV was significantly associated with anticipated stigma (AOR: 3.58, 95% CI: 1.38-11.23). However, none of the evaluated variables showed a significant association with public stigma.
Our study showed a relatively high prevalence of self, anticipated, and public stigma among TB patients. Notably, females and unemployed individuals were at a higher risk of self-stigma, while those with HIV/AIDS and TB were more likely to report anticipated stigma. To combat stigma effectively, interventions should be tailored to cater to sex-specific needs and persons living with HIV. Future research should delve further into determinants of TB-related stigma in high-burden settings.
结核病是全球单一感染源导致死亡的首要原因。与结核病相关的耻辱感，包括自我耻辱感、预期耻辱感和公众耻辱感，对治疗依从性有重大负面影响。在乌干达，关于结核病患者耻辱感的患病率及其与性别的关系的数据有限。
我们旨在评估三种耻辱感的患病率及其与接受结核病治疗患者性别的关系。
横断面研究。
这项横断面研究于2020年7月至2021年3月在乌干达坎帕拉选定的结核病诊所对结核病患者进行。我们收集了社会人口统计学数据，并使用13个项目来衡量自我耻辱感、预期耻辱感和公众耻辱感，这些构成了因变量。我们采用多变量逻辑回归分析来评估性别与三种耻辱感类型之间的关联。此外，我们还考虑了年龄、艾滋病毒感染状况和就业状况等潜在混杂因素。统计学显著性定义为P<0.05。
在本研究中，我们招募了144名参与者，平均年龄为35.8岁（标准差=12）。一半的参与者为女性，44.4%接受过中等教育，37.5%失业，32.6%同时感染艾滋病毒和结核病。自我耻辱感的患病率为71.1%，预期耻辱感为75.7%，公众耻辱感为41.7%。与自我耻辱感相关的显著因素为女性（调整后的优势比（AOR）：2.35，95%置信区间（CI）：1.02-5.74）和失业（AOR：2.95，95%CI：1.16-8.58）。感染艾滋病毒与预期耻辱感显著相关（AOR：3.58，95%CI：1.38-11.23）。然而，所评估的变量均未显示与公众耻辱感有显著关联。
我们的研究表明，结核病患者中自我耻辱感、预期耻辱感和公众耻辱感的患病率相对较高。值得注意的是，女性和失业者自我耻辱感的风险较高，而感染艾滋病毒/艾滋病和结核病的人更有可能报告预期耻辱感。为有效消除耻辱感，干预措施应根据性别特定需求和艾滋病毒感染者进行调整。未来的研究应进一步深入探究高负担环境中与结核病相关耻辱感的决定因素。
