A Systematic Review of Tuberculosis Stigma Reduction Interventions

Area of Science:

• Public Health
• Social Science
• Medical Sociology

Background:

• Stigma associated with tuberculosis (TB) significantly impacts patient well-being, treatment adherence, and public health outcomes.
• A systematic review is crucial to understand current strategies for mitigating TB-related stigma.

Purpose of the Study:

• To systematically review and synthesize TB stigma reduction interventions published between 2015 and 2025.
• To identify trends and key components of effective stigma reduction strategies.

Main Methods:

• Adherence to PRISMA guidelines for a comprehensive literature search across major academic databases.
• Inclusion of qualitative, quantitative, and mixed-methods studies focusing on TB stigma interventions.
• Categorization of studies into intervention development, TB treatment with stigma outcomes, and stigma-specific interventions, with quality appraisal using MMAT.

Main Results:

• Fifteen studies met inclusion criteria, detailing diverse stigma reduction approaches.
• Interventions included co-developed strategies, TB treatment programs with incidental stigma reduction, and targeted stigma interventions (education, therapy, peer support).
• Strategies addressed internalized, enacted, anticipated, and intersectional stigma across individual, community, and policy levels.

Conclusions:

• TB stigma interventions have diversified, moving beyond education to include peer leadership, digital platforms, and socio-ecological frameworks.
• Recent interventions increasingly integrate multi-level and multicomponent approaches.
• Effective interventions require comprehensive, context-specific designs reflecting the experiences of individuals affected by TB.