Kimuli Derrick, Nakaggwa Florence, Namuwenge Norah, Kamara Vincent, Nakawooya Mabel, Amanya Geofrey, Tumwesigye Philip, Mwehire Daniel, Lukoye Deus, Murungi Miriam, Dejene Seyoum, Byawaka Jaffer, Mubiru Norbert, Turyahabwe Stavia, Amuron Barbara, Bukenya Daraus
Social & Scientific Systems, Inc., a DLH Holdings Company / United States Agency for International Development Strategic Information Technical Support Activity, Kampala, Uganda.
Institute of Public Health and Management, Clarke International University, Kampala, Uganda.
PLoS One. 2025 Jan 24;20(1):e0313750. doi: 10.1371/journal.pone.0313750. eCollection 2025.
Tuberculosis (TB) stigma remains a significant barrier to TB control efforts globally, especially in countries with a high TB burden. Studies about TB stigma done in Uganda so far have been limited in scope and focused on data collected health facilities. In this study we report TB related stigma at community level for the period 2021/2022. We used the 2021/22 Lot Quality Assurance Sampling (LQAS) data from a sample of 33,349 participants across 77 districts, to measure TB stigma determine factors associated. We included demographic characteristics, knowledge and participant perspectives as our study variables. Univariable and multivariate logistic regression analyses were performed to identify factors associated with TB stigma. TB stigma was assessed as a categorical variable (below or above the median) due to the skewness of the data when fitting the scores. The data set had equal proportions of males and females. The largest age group was 20-29 years old (38.47%). Most participants were married (62.94%) and had primary level education (65.80%). The TB stigma scores were assigned on a scale from 0 to 30, with an average score of 21.67 (±8.22) and a median score of 24 (19-28). Overall, 45.48% of participants had TB stigma scores above the median. Variations in TB stigma levels were observed across different districts. Factors associated with higher TB stigma included older age, higher education levels, urban residence, and TB knowledge. To reduce TB stigma and misinformation that can make an impact on TB response, community interventions should balance increasing awareness with minimizing fear. These interventions should be well-rounded and context-specific to address disparities within communities and bolster TB control efforts in the country.
结核病污名化仍然是全球结核病控制工作的重大障碍，尤其是在结核病负担较重的国家。迄今为止，在乌干达开展的关于结核病污名化的研究范围有限，且集中于从卫生机构收集的数据。在本研究中，我们报告了2021/2022年期间社区层面与结核病相关的污名化情况。我们使用了来自77个地区的33349名参与者样本的2021/22批次质量保证抽样（LQAS）数据，以衡量结核病污名化并确定相关因素。我们将人口统计学特征、知识和参与者观点作为研究变量。进行了单变量和多变量逻辑回归分析，以确定与结核病污名化相关的因素。由于拟合分数时数据存在偏态，结核病污名化被评估为一个分类变量（中位数以下或以上）。该数据集男女比例相等。最大的年龄组是20 - 29岁（38.47%）。大多数参与者已婚（62.94%），接受过小学教育（65.80%）。结核病污名化分数的评定范围为0至30分，平均分数为21.67（±8.22），中位数分数为24（19 - 28）。总体而言，45.48%的参与者结核病污名化分数高于中位数。不同地区的结核病污名化水平存在差异。与较高结核病污名化相关的因素包括年龄较大、教育水平较高、居住在城市以及了解结核病知识。为减少可能影响结核病应对的结核病污名化和错误信息，社区干预应在提高认识与减少恐惧之间取得平衡。这些干预措施应全面且因地制宜，以解决社区内部的差异并加强该国的结核病控制工作。
