TB-related stigma is widely prevalent among people with TB and carers in Mongolia

Abstract

Background: In Mongolia, estimated TB incidence is high, but treatment coverage is low. Stigma is a likely barrier to access but has not previously been evaluated.

Methods: We conducted a national TB stigma assessment in Mongolia in 2021-2022 to evaluate prevalence and impact of TB-related stigma. All survey participants had face-to-face interviews conducted by trained community staff members using semi-structured questionnaires tailored to study participants.

Results: Study participants included 460 people with TB, 90 family members, 83 community members and 115 healthcare workers (HCWs). Overall, 53% of participants reported experiencing stigma with HCWs reporting highest prevalence (72%). Stigma was most commonly experienced in healthcare settings, particularly during initial diagnosis and treatment initiation. Urban slum residence was associated with higher stigma among patients while older age was associated with lower scores. Female respondents reported stigma significantly more commonly overall. Family members and community members commonly reported secondary stigma with concerns about infection and social isolation being prevalent.

Conclusion: TB-related stigma is highly prevalent across Mongolia. There is an urgent need for comprehensive stigma-reduction strategies that extend beyond PWTB and their families to also include HCWs and broader community.

Keywords: healthcare workers; people with TB; self-reported stigma; tuberculosis.