Mental Shadows of TB: Cross-Sectional Analysis of Stigma, Psychological Well-being, and Support Needs in Pulmonary Tuberculosis Patients
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Abstract
Background: Tuberculosis (TB), a leading infectious disease worldwide, often carries significant psychological and social burdens beyond its physical symptoms. Stigma, depression, anxiety, and insufficient psychosocial support can negatively impact patients' treatment adherence and overall well-being. Objective: To assess the prevalence of psychological distress, stigma-related experiences, and unmet support needs among pulmonary tuberculosis patients in the Gazipur district of Bangladesh. Methods: A cross-sectional study was carried out from April to September 2024, involving both primary and secondary data. Primary data were collected from 156 pulmonary tuberculosis (TB) patients residing across various upazilas of Gazipur District. Secondary data were sourced from three Upazila Health Complexes: Kaliganj, Kaliakair, and Kapasia. A structured questionnaire was employed to gather information on socio-demographic characteristics, psychological well-being (focusing on symptoms of depression and anxiety), perceived stigma, and support needs. Results: The majority of patients were male (56.4%), aged between 31–50 years (44.9%), and predominantly from low-income backgrounds (59.6%). Depression and anxiety were reported in 52.6% and 48.7% of participants, respectively. Stigma-related behaviors were widespread: 62.2% felt embarrassed to disclose their TB status, and 56.4% avoided social interactions. Statistical analysis revealed significant associations between psychological distress and stigma indicators (p<0.05). Emotional support (69.2%), mental health counseling (58.3%), and financial assistance (46.8%) were the most commonly expressed support needs. Suicidal ideation was reported by 7.1% of respondents. Conclusion: Pulmonary TB patients in Gazipur experience high levels of psychological distress and social stigma, with marked unmet support needs. These findings underscore the urgent need for integrating mental health services and stigma-reduction interventions into TB care strategies to improve patients’ overall well-being and treatment outcomes.
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