A Comparative Study of Knowledge, Attitude, and Determinants of Tuberculosis-Associated Stigma in Rural and Urban Communities of Lagos State, Nigeria.

David A Oladele,Mobolanle R Balogun,Kofoworola Odeyemi,Babatunde L Salako,Alexander S Apt

doi:10.1155/2020/1964759

Abstract

Background Tuberculosis (TB) is an important public health concern in Nigeria. TB-associated stigma could lead to delayed diagnosis and care, treatment default, and multidrug resistance. Understanding of TB-associated stigma is therefore important for TB control. The study is aimed at determining and comparing the knowledge, attitude, and determinants of TB-associated stigma. Methodology. This was a comparative cross-sectional study among adults in urban and rural areas of Lagos State, Nigeria. Respondents were selected through a multistage sampling technique and interviewed using a semistructured questionnaire, which contained the Explanatory Model Interviewed Catalogue (EMIC) stigma scale. IBM SPSS Statistics Software package version 20 was used for analysis. Results A total of 790 respondents were interviewed. High proportions of respondents in rural and urban areas were aware of TB (97.5% and 99.2%, respectively). Respondents in the urban areas had overall better knowledge of TB compared to the rural areas (59.4% vs. 23%; p < 0.001), while respondents in the rural areas had a better attitude to TB (60.5% vs. 49.9%; p = 0.002). The majority of respondents in rural and urban areas had TB-associated stigma (93% and 95.7%, respectively). The mean stigma score was higher in the urban compared to rural areas (17.43 ± 6.012 and 16.54 ± 6.324, respectively, p = 0.046). Marital status and ethnicity were the predictors of TB-associated stigma in the rural communities (AOR-0.257; CI-0.086-0.761; p = 0.014 and AOR–3.09; CI-1.087-8.812; p = 0.034, respectively), while average monthly income and age of respondents were the predictors of TB-associated stigma in urban areas (AOR–0.274; CI–0.009-0.807; p = 0.019 and AOR-0.212; CI–0.057-0.788; p = 0.021, respectively). Conclusion TB-associated stigma is prevalent in both rural and urban areas in this study. There is therefore a need to disseminate health appropriate information through the involvement of the community. Also, innovative stigma reduction activities are urgently needed.

Highlights

Tuberculosis (TB) is a curable and preventable disease [1]
More than four-fifth 385 (97.5%) of respondents in the rural area had ever heard about TB compared to 392 (99.2%) of respondents in the urban area
Higher proportions of respondents in the urban areas got information about TB from radio, television, and healthcare workers when compared to rural areas (Table 2)

Summary

Introduction

Tuberculosis (TB) is a curable and preventable disease [1]. It is the ninth leading cause of death worldwide and the leading cause of death from a single infectious agent [2, 3]. In order to sustain the global fight to end TB, the WHO proposed a paradigm shift in TB control through the “End TB strategy” program [5] This Global Plan identifies eight fundamental changes that must be implemented as part of the paradigm shift needed to end TB [5]. This was a comparative cross-sectional study among adults in urban and rural areas of Lagos State, Nigeria. High proportions of respondents in rural and urban areas were aware of TB (97.5% and 99.2%, respectively). The majority of respondents in rural and urban areas had TB-associated stigma (93% and 95.7%, respectively). The mean stigma score was higher in the urban compared to rural areas (17:43 ± 6:012 and 16:54 ± 6:324, respectively, p = 0:046). TB-associated stigma is prevalent in both rural and urban areas in this study.

Methods

Results

Discussion

Conclusion