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1. Unit for Health Promotion Research, University of Southern Denmark (SDU), Esbjerg, Denmark.
2. Department of Infectious Diseases, Odense University Hospital, Odense, Denmark.
Address of correspondence:
Ahmed Suleiman MM 1
Unit for Health Promotion Research,
University of Southern Denmark (SDU),
Esbjerg, Denmark.
Tel. + 4565504241
Email msuleiman@health.sdu.dk
Address. Niels Bohrs Vej 9, 6700 Esbjerg, Denmark
Abstract
Background: Disease-related stigma and knowledge are believed to be associated with patients' willingness to seek treatment and adherence to treatment. Aim: This review aims to reflect on the tuberculosis (TB) stigma and discrimination worldwide. Methods: The studies published in English between January 1990 and October 2010 were included. The publications (n=40) were identified by searching the PubMed database, WHO publications, publications of the CDC, Social Science citation index, Arts and Humanities and Social Science Data base. Results: Most of them showed that poor TB knowledge was the major cause of TB stigmatization. Association between gender of the patient and stigma varied from one study to another. Stigma has serious consequences on health seeking behaviour and adherence to TB treatment. The key issue to treat TB stigma is to influence people’s attitudes through increasing awareness about TB. The perception of TB as a stigmatizing disease seemed to differ according to cultural context whereas the negative impact of TB stigma on the delayed health seeking behaviour and decreased adherence to TB treatment was very similar across studies and contexts. Conclusion: More studies are needed to clarify the relationship between TB stigma and ethnicity, religious orientation, DOTS,stigma in relation to HIV / AIDS and TB multidrug resistance as well as interventional studies to assess TB awareness raising.
Key words: Tuberculosis, stigma, perception, impact and adherence
Learning Objectives: Studies exist from different parts of the world on the issue related to TB stigma. However, since stigma might be specific to context, it is necessary to pull together the published studies to find out if there are common determinants in the TB stigma across cultures. The aim of this review is to reflect on the tuberculosis stigma worldwide.