Exploring the Impact of Stigma on Self-Esteem in Patients with Multidrug-Resistant Tuberculosis: Challenges and Coping Strategies
Keywords:
Multidrug-resistant Tuberculosis, Stigma, Self-Esteem, Public HealthAbstract
Background: Multidrug-resistant tuberculosis (MDR-TB) remains a significant global health challenge, not only due to its medical complexity but also because of its profound psychosocial impact. Among MDR-TB patients, stigma is a major concern, affecting self-esteem and overall well-being. Objective: To know the prevalence of stigma and its relationship with self-esteem among MDR-TB patients. Methodology: A cross-sectional study was conducted at Lady Reading Hospital, Peshawar. A total of 120 MDR-TB patients receiving treatment at the Programmatic Management of Drug-Resistant TB (PMDT) unit, were enrolled in this study. For study, data were collected using standardized tools, including the Berger Stigma Scale for Tuberculosis and the Rosenberg Self-Esteem Scale. Statistical analyses, including correlation and regression tests, were performed using SPSS version 23. Results: Results showed that the mean stigma score was 42.8 (±10.5), with societal stigma (57.9%) being the most prevalent, followed by self-stigma (46.1%) and institutional stigma (28.8%). The mean self-esteem score was 21.7 (±6.8). A significant negative correlation (r = -0.52, p < 0.01) was observed between stigma and self-esteem, indicating that higher stigma levels were associated with lower self-esteem. Conclusion: The study concluded that the substantial stigma faced by MDR-TB patients and its detrimental impact on self-esteem. Addressing stigma through public awareness campaigns, mental health support, and stigma-free healthcare environments is crucial for improving patients' psychological well-being and treatment adherence. Integrating psychosocial interventions into MDR-TB management can enhance patient outcomes and overall quality of life.References
Khan MA, Mehreen S, Basit A, Khan RA, Jan F, Ullah I, et al. Characteristics and treatment outcomes of patients with multi-drug resistant tuberculosis at a tertiary care hospital in Peshawar, Pakistan. Saudi Med J. 2015;36(12):1463.
Khan MA, Mehreen S, Basit A, Khan RA, Javaid A. Predictors of poor outcomes among patients treated for multidrug-resistant tuberculosis at tertiary care hospital in Pakistan. Am Eurasian J Toxicol Sci. 2015;7(3):162-72.
Mehreen S, Khan MA, Basit A, Khan A, Ashiq N, Javaid A. Frequency of depression in multidrug-resistant tuberculosis patients: an experience from a tertiary care hospital. Pak J Chest Med. 2015;21(4):149-54.
Redwood L, Mitchell EM, Viney K, Snow K, Nguyen TA, Dung LA, et al. Depression, stigma and quality of life in people with drug-susceptible TB and drug-resistant TB in Vietnam. Int J Tuberc Lung Dis. 2021;25(6):461-7.
Thomas BE, Shanmugam P, Malaisamy M, Ovung S, Suresh C, Subbaraman R, et al. Psycho-socio-economic issues challenging multidrug resistant tuberculosis patients: a systematic review. PLoS One. 2016;11(1):e0147397.
Wang XB, Li XL, Zhang Q, Zhang J, Chen HY, Xu WY, et al. A survey of anxiety and depressive symptoms in pulmonary tuberculosis patients with and without tracheobronchial tuberculosis. Front Psychiatry. 2018;9:308. DOI: 10.3389/fpsyt.2018.00308
Powell I. The effects of stigma against HIV and tuberculosis on patient mental health and healthcare-seeking behavior in Dharamshala. Independent Study Project (ISP) Collection. 2020;3655. Available from: https://digitalcollections.sit.edu/isp_collection/3655
Abdisa E, Fekadu G, Girma S, Shibiru T, Tilahun T, Mohamed H, et al. Self-stigma and medication adherence among patients with mental illness treated at Jimma University Medical Center, Southwest Ethiopia. Int J Ment Health Syst. 2020;14:13.
Jaggarajamma K, Ramachandran R, Charles N, Chandrasekaran V, Muniyandi M, Ganapathy S. Psycho-social dysfunction: perceived and enacted stigma among tuberculosis patients registered under revised national tuberculosis control programme. Indian J Tuberc. 2008;55(4):179-87.
Liboon Aranas L, Alam K, Gyawali P, Alam RM. Drug-resistant tuberculosis stigma among healthcare workers toward the development of a stigma-reduction strategy: a scoping review. Inquiry. 2023;60:00469580231180754.
Thomas BE, Shanmugam P, Malaisamy M, Ovung S, Suresh C, Subbaraman R, et al. Psycho-socio-economic issues challenging multidrug resistant tuberculosis patients: a systematic review. PLoS One. 2016;11(1):e0147397.
Liu K, Zhang Y, Qu S, Yang W, Guo L, Zhang L. Prevalence and correlates of anxiety and depressive symptoms in patients with and without multi-drug resistant pulmonary tuberculosis in China. Front Psychiatry. 2021;12:674891.
Paul S, Afzal Aftab MR, Nazneen S, Azmi R, Hossain S. Subjective experiences of stigma related to Tuberculosis: A qualitative exploration at Peri-urban, Bangladesh. Am J Prev Med Public Health. 2019;4(2):27-36.
Thusi AB, Paken J. The lived experiences and psychosocial impact of hearing loss on the quality of life of adults with multidrug-resistant tuberculosis. S Afr J Commun Disord. 2022;69(1):823.
Redwood L, Mitchell EM, Viney K, Snow K, Nguyen TA, Dung LA, et al. Depression, stigma and quality of life in people with drug-susceptible TB and drug-resistant TB in Vietnam. Int J Tuberc Lung Dis. 2021;25(6):461-7.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Pakistan Journal of Chest Medicine
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
