Tuberculosis-related knowledge, practices, perceived stigma and discrimination, and adherence to anti-TB medication among patients with tuberculosis: A cross-sectional study in Jordan (Preprint)

Abstract

Tuberculosis knowledge, practices, adherence to treatment among patients with tuberculosis are key factors for the management of the disease.

The objectives of the study were to assess knowledge, practices, perceived stigma and discrimination, perceived family and health workers support, perceived level of satisfaction with healthcare services, delay in diagnosis/treatment and reasons for delay, and adherence to tuberculosis medication among patients with tuberculosis in Jordan.

A cross-sectional study was conducted among patients who were under treatment for tuberculosis in Jordan in 2021. A structured questionnaire was developed, pilot tested and used for data collection.

This study included a total of 452 patients with tuberculosis. About 91.4% (413/452) of patients had low to moderate overall tuberculosis-related knowledge score and 8.6% had high knowledge score. Almost two-thirds of patients (67.5%, n = 305/452) had perceived a low level of stigma, 61 (13.5%) perceived a moderate level of stigma, and 86 (19.0%) perceived a high level of stigma. About 43.6% (197/ 452) of patients with tuberculosis felt stigmatized due to their tuberculosis status. Of those, almost 64.0% (126/197) reported that such feelings inhibited them from seeking healthcare services. A total of 156 out of 452 (34.5%) patients experienced a high level of discrimination, 33 (7.3%) experienced a moderate level of discrimination, and 263 (58.2%) experienced a low level of discrimination. The majority (84.5%, 382/452) of patients with tuberculosis thought that there was a delay in diagnosis and/or treatment of TB. Overall, 36.9% (167/452) of patients were not adherent to TB medication.

Our study showed gaps in tuberculosis knowledge and practices, high perceived stigma and discrimination, perceived delay in diagnosis and treatment initiation, non-adherence to anti- TB medications, and difficulties in accessing TB services during COVID-19 pandemic. Efforts within the national TB control program should be made to increase public awareness about the symptoms of tuberculosis and the importance of seeking early care.