Perceived Stigma associated with Tuberculosis (TB) among patients and attitude of Caregivers towards affected person in selected areas of Surat district, Gujarat

Abstract

Introduction: Tuberculosis (TB), caused by Mycobacterium tuberculosis, primarily affects the lungs and is a leading cause
of global mortality, total of 1.25 million people died from tuberculosis (TB) in 2023 (including 161 000 people with HIV). The
disease disproportionately impacts low- and middle-income countries, with a significant burden among men. TB spreads
through airborne transmission, but most exposed individuals do not develop active disease. Stigma plays a crucial role in
shaping societal attitudes towards TB, affecting patients and their families through fear of discrimination and exclusion.
This study examines perceived TB stigma among patients and their household contacts.
Methodology: This cross-sectional study employed a quantitative approach to assess perceived stigma associated with
tuberculosis (TB) among patients and evaluate caregivers’ attitudes towards affected individuals in Bardoli taluka. Using
the Raosoft sample size calculator, 148 TB patients undergoing DOT therapy were recruited through non-probability
purposive sampling. Inclusion criteria were patients over 18 who understood Gujarati, Hindi, or English, while those with
deafness and dumbness and mentally challenged were excluded. Data collection involved socio-demographic and medical
information, as well as the Modified Explanatory Model Interview Catalogue (MEMIC) stigma scale for patients and the
Explanatory Model Interview Catalogue (EMIC) for caregivers. Data were collected via face-to-face interviews from May
28 to July 3, 2024, each lasting 15-20 minutes.
Result: The study finds that most TB patients are young, male (56.1%), married (77.0%), and Hindu (88.5%), with many
laborers earning Rs. 5001–10,000 (42.6%). Nearly all have pulmonary TB (98.6%) and high treatment compliance (89.2%).
Stigma is prevalent, with 35.8% hiding their condition, 46.6% feeling a loss of self-respect, and 38.5% experiencing shame.
Caregivers, mostly females (58.8%), share similar concerns. The mean stigma score is 20.76 (SD = 6.41), with a moderate
positive correlation (r = 0.587) between stigma and caregiver attitudes. While stigma is not linked to patient demographics,
caregiver attitudes significantly vary with income.
Conclusion: Based on the findings of the study, it was concluded that the stigma negatively impacts family dynamics and
employment. Stigma level linked to care giver’s perceptions of TB care.