A Systematic Review and Psychometric Appraisal of Instruments Measuring Tuberculosis Stigma in Sub-Saharan Africa

Alanna Bergman, Katherine McNabb, Jason E. Farley

Research output: Contribution to journalArticlepeer-review

Abstract

Tuberculosis (TB) stigma is one barrier to TB testing, treatment uptake, and treatment completion. Therefore, stigma measurement must be approached through rigorous scientific methodology in order to accurately and reliably estimate the impact of TB stigma on treatment outcomes. The aim of this systematic review is to evaluate the methods and instruments used to measure TB stigma and interrogate strategies used to culturally validate measures of TB stigma in global research. Two reviewers used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method to extract and analyze the existing body of literature on TB stigma in Sub-Saharan Africa. A thorough search was performed using three databases generating 2,302 independent studies. After the systematic screening, this review includes 28 studies. Of those studies, 13 used a psychometrically validated instrument while 15 used informal questionnaires or proxy variables to measure stigma. The psychometric appraisal was limited due to the number of studies that measured stigma using unvalidated questionnaires or proxy variables. The Patient and Community Perceptions of TB scales validated by Van Rie et al. were the most commonly used instruments to measure TB stigma; additionally, many instruments were not culturally or linguistically validated in Sub-Saharan Africa. Our appraisal emphasizes the need for reliable and valid instruments to measure TB stigma in low- and middle-income countries most affected by TB.

Original languageEnglish (US)
Pages (from-to)81-93
Number of pages13
JournalStigma and Health
Volume9
Issue number1
DOIs
StatePublished - Jun 17 2021

Keywords

  • measurement
  • psychometric
  • stigma
  • tuberculosis
  • validity

ASJC Scopus subject areas

  • Social Psychology
  • Clinical Psychology
  • Health Policy
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health

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