Perceived Discrimination among Tuberculosis Patients in an Urban Area of Kolkata City, India.

ABSTRACT

CONTEXT AND AIMS: Tuberculosis (TB) in India is a leading public health problem plagued by social determinants such as stigma and discrimination, which may affect treatment seeking, adherence, and possibly treatment outcome. This study was conducted to elicit the perceived discrimination, its determinants, as well as to determine whether perceived discrimination is predicting treatment outcome among TB patients registered in an Urban Health District, Kolkata City, India. SETTINGS AND DESIGN: An institutionbased follow-up study was conducted where all the TB patients registered within the 1st 4 months of data collection were followed up for their current course of treatment. SUBJECTS AND METHODS: Perceived discrimination was assessed at treatment initiation, after intensive period and after continuation phase using a predesigned and pretested questionnaire. STATISTICAL ANALYSIS USED Multivariable logistic regression analyses were performed to identify the determinants of perceived discrimination as well as the treatment outcome. RESULTS: Perceived discrimination by family members, neighbors, and colleagues was reported by 9.4%, 36.5%, and 34.2% participants, respectively, overall discrimination being 37.9%. Multivariable analysis revealed that discrimination was significantly more among patients with older age group, females, and from joint families. Perceived discriminated was found to be significantly predicting unfavorable treatment outcome even after adjustment with background and treatment-related variables. CONCLUSIONS: Sensitization programs should incorporate measures to address stigma and discrimination and more emphasis needs to be placed on women and elderly patients.