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在蒙古国,与结核病相关的耻辱感在结核病患者及其护理人员中广泛存在。

TB-related stigma is widely prevalent among people with TB and carers in Mongolia.

作者信息

Tsogt B, Denholm J T, Dambaa N, Sambuu T, Tsegeen N, Munkhjargal G, Chuluunbaatar A, Dorj G, Sukhbaatar G, Adilaa O, Dalai D, Batmunkh O, Khukhkhuukhen Z, Ulziikhutag B, Jargalsaikhan Kh, Moyo N, Graham S M

机构信息

Mongolian Anti-Tuberculosis Coalition, Ulaanbaatar, Mongolia.

Victorian Tuberculosis Program, Melbourne Health, Melbourne, VIC, Australia.

出版信息

IJTLD Open. 2025 Jul 9;2(7):420-426. doi: 10.5588/ijtldopen.25.0174. eCollection 2025 Jul.

Abstract

BACKGROUND

In Mongolia, estimated TB incidence is high, but treatment coverage is low. Stigma is a likely barrier to access but has not previously been evaluated.

METHODS

We conducted a national TB stigma assessment in Mongolia in 2021-2022 to evaluate prevalence and impact of TB-related stigma. All survey participants had face-to-face interviews conducted by trained community staff members using semi-structured questionnaires tailored to study participants.

RESULTS

Study participants included 460 people with TB, 90 family members, 83 community members and 115 healthcare workers (HCWs). Overall, 53% of participants reported experiencing stigma with HCWs reporting highest prevalence (72%). Stigma was most commonly experienced in healthcare settings, particularly during initial diagnosis and treatment initiation. Urban slum residence was associated with higher stigma among patients while older age was associated with lower scores. Female respondents reported stigma significantly more commonly overall. Family members and community members commonly reported secondary stigma with concerns about infection and social isolation being prevalent.

CONCLUSION

TB-related stigma is highly prevalent across Mongolia. There is an urgent need for comprehensive stigma-reduction strategies that extend beyond PWTB and their families to also include HCWs and broader community.

摘要

背景

在蒙古国,结核病估计发病率很高,但治疗覆盖率很低。耻辱感可能是获得治疗的一个障碍,但此前尚未进行评估。

方法

我们于2021年至2022年在蒙古国开展了一项全国性的结核病耻辱感评估,以评估与结核病相关的耻辱感的患病率及其影响。所有调查参与者均由经过培训的社区工作人员使用为研究参与者量身定制的半结构化问卷进行面对面访谈。

结果

研究参与者包括460名结核病患者、90名家庭成员、83名社区成员和115名医护人员。总体而言,53%的参与者报告曾经历过耻辱感,医护人员报告的患病率最高(72%)。耻辱感最常出现在医疗环境中,尤其是在初次诊断和开始治疗期间。城市贫民窟居民在患者中耻辱感较高,而年龄较大者耻辱感得分较低。总体而言,女性受访者报告耻辱感的情况明显更为常见。家庭成员和社区成员普遍报告存在继发性耻辱感,对感染和社会隔离的担忧很普遍。

结论

与结核病相关的耻辱感在蒙古国非常普遍。迫切需要采取全面的减少耻辱感策略,这些策略不仅要涵盖肺结核患者及其家人,还要包括医护人员和更广泛的社区。

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