Community Knowledge about Tuberculosis and Perception about Tuberculosis Associated Stigma in Pakistan

Tuberculosis (TB) associated stigma is well-documented phenomenon that may contribute to sub-optimal TB care in Pakistan. The objective of study was to assess TB related knowledge and perceived stigma among community members. This was cross-sectional survey using convenience sample of 183 individuals recruited between October and December 2017. A validated stigma measurement tool developed by Van Rie et al. was adapted. Data was analyzed using SPSS version 20.0. 183 individuals (73% males; n = 134) participated in survey.  Eighty-seven percent were aware that TB is curable disease (n = 159) and 91% thought that it could be transmitted by coughing (n = 167). However, respondents also thought that TB was spread through contaminated food (73%; n = 134), sharing meals (55%; n = 100), sharing utensils (53%; n = 96) and by having sexual intercourse with a TB patient (51%; n = 93). Fifty-seven percent (n = 104) associated TB with high levels of stigma. Persons who had less than six years of education (crude OR  =  1.2; 95% CI: 0.89, 1.72) and lacked knowledge that TB is curable (crude OR  =  3.42; 95% CI: 1.20, 9.70) were more likely to associate TB with stigma.  In addition, females (crude OR = 1.33; 95% CI: 0.87, 2.04) and those who were unemployed (crude OR = 1.06; 95% CI: 0.65, 1.74) were also more likely to associate TB with stigma. We found an association between lack of knowledge about TB and perceived stigma. This highlights need for improved education and awareness about TB.