Stigma and Depression among Tuberculosis Patients in Kedah, Malaysia

Abstract

INTRODUCTION: Tuberculosis (TB) related stigma is one of the significant barriers in the global TB control programme and it may lead to depression. This study aims to assess the level of stigma among TB patients and its associated factors, as well as to ascertain the correlation between stigma and depression in Kedah, Malaysia. MATERIALS AND METHODS: This was a cross-sectional study using the proportionate sampling method. TB patients were recruited from respiratory clinics in three government hospitals in Kedah. Case report form, Malay version of TB stigma scale (TSS) and Beck Depression Inventory (BDI-Malay) were used for data collection. Data were then analyzed using the linear regression and correlation analysis. RESULTS: A total of 200 respondents were enrolled and the mean score of TB stigma from patient’s perspective was 13.3 (6.87). Younger patient, currently married, higher education, unemployment, and HIV co-infection were significantly associated with the stigma experienced. 27.5% (n=55) of the TB patients were found to be depressed, with the majority categorized into mild severity (20%, n=40), followed by moderate (5.5%, n = 11) and severe depression (2%; n = 4). There was a moderate, positive correlation between stigma and depression which was statistically significant (r = 0.345, p<0.001). CONCLUSION: Although the stigma score among TB patients was not as high as has been postulated, there was a moderate, positive correlation between stigma and depression. Thus, the intervention to reduce the stigma among TB patients may be helpful as it may reduce the depression level.