ArticlePLOS global public health2026
Community-based, peer-led psychosocial support to address stigma and reduce depression among adults with tuberculosis in Indonesia: A prospective interventional cohort study.
Article in PLOS global public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
We co-developed and evaluated a community-based, peer-led psychosocial support intervention consisting of individual and peer-led group counselling, online group messaging, and community-based "TB-Talks" to address tuberculosis (TB)-Stigma and reduce depression among adults with TB in Indonesia. A non-randomized, single-arm prospective interventional cohort study was conducted in five primary healthcare centres and two public hospitals in Depok and Padang cities from June 2024 to January 2025. All newly-diagnosed individuals with either drug-sensitive (DS-) or drug-resistant (DR-) TB, aged 15 years and above, were consecutively recruited and offered individual counselling at baseline, then monthly peer-led group counselling and online group messaging and TB Talks during six months of treatment. Participants were assessed at baseline, end of intensive phase (Month-2), and continuation phase (Month-6) for TB-stigma, depression, and quality of life (QoL), using locally-adapted and validated tools including the Van Rie TB-Stigma scale, PHQ-9, and EQ5D5L, respectively. In addition, we collated quantitative acceptability, appropriateness and feasibility feedback from participants and stakeholders. A total of 129 people with TB (Depok = 85, Padang = 44) participated, including 55 (43%) women. Most participants had new DS-TB (62%), 19 (15%) recurrent DS-TB, and 30 (23%) DR-TB. At baseline, most participants had moderate-to-severe TB-Stigma (74%; 95%CI = 65-82%) and depression symptoms (57%; 35-72%). Among 112 participants who completed all assessments, moderate-to-severe TB-Stigma decreased to 43% (34-53%) and 21% (13-28%) and depression symptom prevalence decreased to 32% (20-47%) and 15% (6-23%) at Month-2 and Month-6, respectively. Participants' QoL increased from median 0.84 (0.63-1.00, at baseline) to 0.92 (0.83-1.00, Month-2) and 1.00 (0.91-1.00, Month-6). Both study participants and stakeholders perceived that activities in this study were feasible, acceptable, and locally-appropriate. Community-based, peer-led psychosocial support, combining individual and monthly group counselling, has potential to mitigate TB-Stigma and depression while improving QoL among adults with TB in Indonesia.
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