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Background
Tuberculosis (TB) stigma remains a barrier to early diagnosis and treatment completion.
Increased understanding of stigma is necessary for improved interventions to minimise TB
stigma and its effects. The purpose of this study is to quantitatively measure TB stigma and
to explore qualitatively its manifestation among TB patients in a rural Kenyan community.
Methods
This hospital based study using explanatory sequential mixed methods approach was con-
ducted in 2016. In the quantitative part of the study, a questionnaire containing socio-demo-
graphic characteristics and scales measuring perceived TB stigma and experienced TB
stigma, was administered to 208 adult pulmonary TB patients receiving treatment in West
Pokot County. Respondents with high stigma were purposively selected to take part in in-
depth interviews and focus group discussions. The qualitative data were collected through
15 in-depth interviews and 6 focus group discussions with TB patients. Descriptive and
bivariate analysis was done for the quantitative data while the thematic analysis was done
for qualitative data.
Results
The internal consistency reliability coefficients were satisfactory with Cronbach alphas of
0.87 and 0.86 for the 11-item and 12-item stigma measurement scale. The investigation
revealed that TB stigma was high. The key drivers of TB stigma were the association of TB
with HIV/AIDS and the fear of TB transmission. TB stigma was exemplified through patients
being isolated by others, self-isolation, fear to disclose TB diagnosis, association of TB with
human immunodeficiency virus (HIV) and lack of social support. Being a woman was significantly associated with high levels of both experienced stigma (p = 0.007) and per-
ceived stigma (p = 0.005) while age, marital status, occupation and the patient’s religion
were not.
Conclusion
There is a need to implement stigma reduction interventions in order to improve TB program
outcomes. |
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