ArticleBMJ open2026
Association of community sociodemographic and tuberculosis-related factors with variability in community-level tuberculosis stigma in South Africa: an ecological analysis from the MISSED TB Outcomes study.
Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Multidimensional Poverty and Implementation Reach of Household Contact Tracing for Tuberculosis in South Africa: Analysis of a Randomized Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Trial
- Quality of life among people with tuberculosis in the Eastern Cape, South Africa: a qualitative study.BMC global and public health · 2026Article
- Assessing awareness of latent tuberculosis infection: the urgent need for clinical governance-driven education in rural Eastern Cape - insights from a community-based study.Frontiers in public health · 2025Article
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9 authors.
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Abstract
objectiveTuberculosis (TB) stigma is a critical barrier to timely diagnosis and treatment, yet few studies have quantified community-level TB stigma or its variability across geographic contexts. This study describes methods for capturing community-level TB stigma and examines stigma variability and correlations with community-level sociodemographic and TB-related factors across urban, periurban and rural communities.
designEcological study.
setting93 demarcated study communities in Buffalo City Metropolitan Health District, Eastern Cape, South Africa.
participants3869 heads of household, age ≥18 years, were surveyed in a geographically clustered random sample of households across the 93 study communities. PRIMARY OUTCOME MEASURES: Validated scales were used to measure perceived TB stigma. Community levels of TB stigma were generated by aggregating individual responses within each study community.
resultsMedian community TB stigma scores varied significantly by community location: compared with urban communities, rural communities had lower TB stigma scores (beta=-0.235; 95% CI -0.362 to -0.108) while periurban communities had higher scores (beta=0.136; 95% CI 0.017 to 0.254). Community TB stigma was positively associated with community HIV stigma, with the strongest associations in urban (beta=0.977 (95% CI 0.634 to 1.321) and rural (beta=0.816 (95% CI 0.186 to 1.446) communities. No associations were observed between TB stigma and TB prevalence, TB knowledge or household demographics after adjusting for community location.
conclusionsTB stigma varied meaningfully across communities and was associated with urbanicity and HIV stigma. Stigma is a complex social process and there may be many other factors shaping TB stigma at the community level. Future research and stigma-reduction interventions should consider local contexts and community-level determinants beyond individual demographics, TB knowledge or community TB burden.
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