A study to assess the stigma related to tuberculosis among directly observed treatment short-course (DOTS) providers and patients on DOTS therapy attending DOTS centres of Mandya

Nishita Padmanabhan; Poornima S.

doi:10.18203/2394-6040.ijcmph20163367

Authors

Nishita Padmanabhan House surgeon, Mandya Institute of Medical Sciences, Mandya, Karnataka, India
Poornima S. Department of Community Medicine, Mandya Institute of Medical Sciences, Mandya, Karnataka

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20163367

Keywords:

Stigma, EMIC, Tuberculosis, DOTS patients, DOTS providers

Abstract

Background: Stigma is defined as a "powerful and tainting social label that radically changes the way individuals view themselves and are viewed by others". Tuberculosis is the second leading cause of death from an infectious disease. In India, social stigma attached to tuberculosis hinders patients from seeking adequate treatment interventions thus adding to the burden of disease.

Methods: All the patients receiving DOTS therapy for pulmonary and or extra pulmonary tuberculosis at DOTS Centres at Mandya Institute of Medical Sciences (MIMS), primary health care centres (PHCs) Guthalu and Kyathamgere were interviewed using Explanatory Model Interview Catalogue (EMIC) stigma scale. During the study period there were 33, 17 and 11 patients receiving DOTS therapy at MIMS, PHC Guthalu and PHC Kyathamgere respectively. A total of 18 DOT providers were interviewed using Social Distance Scale (SDS).

Results: 21(34.43%) of the 61 DOTS patients were found to be stigmatised and 40(65.57%) were not stigmatised. 10 (47.62%) females and 11 (27.5%) males were found to be stigmatised. 43 (70.49%) patients preferred to keep other people from knowing that they were suffering from tuberculosis. 27(44.26%) patients had decided to stay away from work/social groups and 26(42.62%) felt that others give them less respect.

14(77.78%) of the 18 DOT providers were definitely unwilling to have someone with tuberculosis as a caretaker of their children for a couple of hours.

Conclusions: One-third of the patients on DOTS therapy were stigmatised and three-fourth of the DOT providers reported stigma.

Metrics

Metrics Loading ...

References

Raviglione MC, O’Brien RJ. Tuberculosis. Chapter 165 in Fauci AS, Braunwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL, et al. Harrison’s Principles Of Internal Medicine. 18thed. New York: McGraw Hill; 2012; p 1340-58.

World Health Organisation. Global Tuberculosis Report 2014. Geneva. Available on http://www.who.int/tb/publications/global_report/en/accessed on January 14, 2015.

TBC India. Available on http://www.tbcindia. nic.in/RNTCP. Html accessed on January 21, 2015.

Jaggarrajamma K, Ramchandran R, Charles N, Chandrasekaran V, Muniuandi M, Ganapathy S. Psycho- social dysfunction: Perceived and enacted stigma among tuberculosis patients registered under RNTCP. Indian J Tuberc. 2008;55:179-87.

International Federation of Anti-Leprosy Association (ILEP). Guidelines to reduce stigma. London. Available on http://www.ilep.org.uk/ library-resources/ infolep-information-services/ subjectguides/leprosy-related-stigma/accessed on January 12, 2015.

Alonzo AA, Reynolds NR. Stigma, HIV and AIDS: an exploration and elaboration of a stigma trajectory. Soc Sci Med. 1995;41(3):303-15.

Dhingra VK, Khan S. A Sociological Study On Stigma Among Tb Patients In Delhi. Indian J Tuberc. 2010;57:12-8.

Aryal S, Badhu A, Pandey S, Bhandari A, Khatiwoda P, Khatiwada P, et al. Stigma related to Tuberculosis among patients attending DOTS clinics of Dharan Municipality. Kathmandu Univ Med J. 2012;37(1)48-52.

Somma D, Thomas BE, Karim F, Kemp J, N. Arias N, Auer C, et al. Gender and socio-cultural determinants of TB-related stigmain Bangladesh, India, Malawi and Colombia. Int J Tuberc Lung Dis. 2008;12(7):856-66.

Balasubramanian R, Garg R, Santha T, P. G. Gopi PG, Subramani R, Chandrasekaran V, et al. Gender disparities in tuberculosis: report from a rural DOTS programme in south India. Int J Tuberc Lung Dis. 2004;8(3):323-32.

Van Rie A, Sengupta S, Pungrassami P, Balthip Q, Choonuan S, Kasetjaroen Y, et al. Measuring stigma associated with tuberculosis and HIV⁄AIDS in southern Thailand: exploratory and confirmatory factor analyses of two new scales. Tropical Med and Int Health. 2008;13(1):21-30.

Coreil J, Lauzardo M, Heurtelou M. Anticipated tuberculosis Stigma among Health Professionals and Haitian Patients in South Florida. J Health Care Poor Underserved. 2012; 23(2): 636-50.

Dodor EA. Health Professionals Expose Tb Patients To Stigmatization In Society: Insights From Communities In An Urban District In Ghana. Ghana Med J. 2008;42(4):144-8.