Effects and modifiers of experienced stigma among people living with drug-resistant tuberculosis in Lagos, Nigeria

Abstract

Tuberculosis (TB) continues to be a disease of public health concern in Nigeria despite current efforts to increase notification rates in the country. In 2024, Nigeria recorded its highest TB notification and a treatment coverage rate of 79%. Despite these efforts, the country is yet to reach the global elimination targets due to several factors, including the effect of stigma on TB notification and treatment adherence. Previous studies have reported a high prevalence of TB-related stigma, mainly because of the close relationship between TB and HIV. People living with drug-resistant TB (PwDR-TB), however, experience more stigma compared to drug-sensitive TB patients because of the longer duration of DR-TB treatment. TB-related stigma is associated with decreased self esteem, poor quality of life, anxiety, feelings of guilt, isolation, loneliness, and depression. In addition, People with TB (PWTB) experience abuse, neglect, shame and social seclusion at home, work, community, or healthcare facilities. TB-related stigma undermines TB screening efforts and negatively impacts the disclosure of status, healthcare-seeking behaviours, care delivery, treatment adherence, and outcomes. Despite the importance of TB-related stigma on TB control and the quality of life among PwDR- TB in Nigeria, there is a paucity of literature on the subject. This study intends to contribute to the body of knowledge on TB-related stigma in Nigeria to understand the prevalence, effects, and modifiers of stigma among PwDR-TB in Nigeria