Patients perceived stigma associated with community-based directly observed therapy of tuberculosis in Uganda

East Afr Med J. 2005 Jul;82(7):337-42.

Abstract

Objective: To assess whether linkage of tuberculosis (TB) and HIV/AIDS increases the perception of stigma among TB patients on Community-Based Directly Observed Therapy (CB-DOT) compared to similar TB patients on self-administered therapy (SAT).

Design: A Cross-sectional study.

Setting: Kiboga (CB-DOT) and Mubende (SAT) districts, Uganda in 2000.

Subjects: One hundred and five tuberculosis patients on CB-DOT and 202 patients on SAT. One hundred and twenty one (39%) of these patients agreed to be tested for HIV.

Results: Patients on CB-DOT and patients on SAT were similar on most of the domains used to assess stigma associated with a TB diagnosis, except for the domain of TB diagnosis and general belief that TB and HIV/AIDS are linked. Patients on CB-DOT were more likely to believe that neighbours knew they had TB compared to patients on SAT (91% vs. 62%, p < 0.001), but the groups did not differ in their perception that neighbours thought they have HIV because of TB (46% vs. 46%, p = 0.954). HIV prevalence was similar in both groups.

Conclusion: The study demonstrates that TB patients on CB-DOT did not differ from SAT patients in their perception of stigma as a result of TB. Therefore, HIV-related stigma may not limit wide implementation of CB-DOT in countries like Uganda.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Community Health Services / statistics & numerical data*
  • Cross-Sectional Studies
  • Directly Observed Therapy / psychology*
  • Directly Observed Therapy / statistics & numerical data*
  • Factor Analysis, Statistical
  • Female
  • HIV Infections / complications
  • HIV Infections / therapy
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Male
  • Prejudice*
  • Rural Population / statistics & numerical data
  • Self Administration / psychology
  • Social Perception*
  • Tuberculosis / etiology
  • Tuberculosis / therapy*
  • Uganda