Analysing interventions designed to reduce tuberculosis-related stigma: A scoping review

Area of Science:

• Public Health
• Social Sciences
• Health Services Research

Background:

• Stigma remains a significant obstacle to tuberculosis (TB) care delivery.
• There is a scarcity of data on effective stigma reduction interventions for TB.
• Existing interventions require evaluation within a structured framework for better design and implementation.

Purpose of the Study:

• To systematically review and map existing literature on TB stigma reduction interventions.
• To analyze intervention implementation using the Health Stigma and Discrimination framework.
• To identify research gaps and inform future intervention design for TB stigma reduction.

Main Methods:

• Systematic literature search across PubMed, EMBASE, and Web of Science using TB and stigma-related terms.
• Screening of 1865 articles by two independent reviewers, followed by data extraction, quality assessment, and implementation analysis.
• Categorization of results by socio-ecological level and targeted stigma drivers or manifestations.

Main Results:

• Nine studies were included, categorized by socio-ecological level (individual, interpersonal, organizational, community).
• Individual/interpersonal interventions (TB clubs, support, counseling) effectively addressed internal/anticipated stigma.
• Organizational/community interventions (information, education campaigns) targeted enacted stigma, particularly among healthcare workers.

Conclusions:

• Internal and anticipated TB stigma can be managed with individual-focused interventions like counseling and support groups.
• Enacted TB stigma necessitates information-based interventions at organizational or community levels.
• Future research must address consistent stigma definitions, standardized measurement, and implementation outcomes, with a noted absence of policy-level interventions.