Kılıç Ayşenur, Zhou Xuanyu, Moon Zoe, Hamada Yohhei, Duong Trinh, Layton Charlotte, Jhuree Sobhash, Abubakar Ibrahim, Rangaka Molebogeng X, Horne Robert
School of Pharmacy, University College London, London, WC1H 9JP, UK.
Institute for Global Health, University College London, London, UK.
BMC Public Health. 2025 Feb 14;25(1):628. doi: 10.1186/s12889-024-20868-0.
Tuberculosis (TB) stigma may be a barrier to engagement in testing and treatment for TB infection (TBI). We systematically reviewed the available evidence on how TB stigma influences engagement with TBI testing and treatment.
Electronic databases (e.g., CINAHL, Central, OVID) were searched from 1963 to 1st August 2024. Quantitative, qualitative, and mixed-method studies reporting the effects of TB stigma on engagement with TBI testing and treatment were included in the review. Descriptive synthesis was applied to the quantitative studies, and thematic analysis was applied to qualitative studies. The risk of bias was assessed by using the mixed methods appraisal tool.
Seventeen studies were included in the review (12 qualitative, four quantitative and one mixed methods). TB stigma was complex and multifactorial with six overlapping domains: public, anticipated, self, experienced, secondary, and structural. Perceptions or experiences of stigma were associated with lower rates of engagement in testing and adherence to treatment in TBI.
Perceptions of TB stigma among people with TBI were related to the common social representation of TB disease such as its being contagious or disease of the poor. Negative perceptions of active TB appear to carry over to its infection, despite people being informed about the nature of TBI. Our findings could inform more effective communication to support TBI testing and treatment engagement.
结核病污名化可能是阻碍参与结核感染（TBI）检测和治疗的一个因素。我们系统回顾了关于结核病污名化如何影响TBI检测和治疗参与度的现有证据。
检索了1963年至2024年8月1日的电子数据库（如CINAHL、Central、OVID）。纳入综述的有报告结核病污名化对TBI检测和治疗参与度影响的定量、定性和混合方法研究。对定量研究采用描述性综合分析，对定性研究采用主题分析。使用混合方法评估工具评估偏倚风险。
综述纳入了17项研究（12项定性研究、4项定量研究和1项混合方法研究）。结核病污名化是复杂且多因素的，有六个重叠领域：公众、预期、自我、经历、次生和结构。污名化的认知或经历与TBI检测参与率较低和治疗依从性较低有关。
TBI患者对结核病污名化的认知与结核病的常见社会表征有关，如具有传染性或为穷人的疾病。尽管人们已了解TBI的性质，但对活动性结核病的负面认知似乎延续到了其感染方面。我们的研究结果可为更有效的沟通提供参考，以支持TBI检测和治疗参与度。
