Intersecting Burdens: A Comprehensive Assessment of Psychosocial Distress, Physical Health, and Social Stigma Among Female Tuberculosis Patients in Bangladesh
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Abstract
Background: Tuberculosis (TB) remains a significant public health challenge in Bangladesh, particularly among women, who face additional burdens due to social stigma, psychological distress, and physical side effects of treatment. Despite national efforts under the Directly Observed Treatment, Short-course (DOTS) strategy, these psychosocial dimensions are underexplored. Objective: This study aimed to assess the psychosocial distress, treatment-related physical symptoms, and experiences of social stigma among female TB patients in Bangladesh. Methods: A cross-sectional study was conducted from September 2024 to March 2025 across three districts—Khulna, Satkhira, and Magura. A total of 120 female pulmonary TB patients receiving treatment under the National TB Control Programme (NTP) were interviewed using a structured questionnaire. Psychological distress was measured using the Kessler Psychological Distress Scale (K10), and stigma was assessed using a modified TB stigma scale. Descriptive, bivariate, and multivariate analyses were performed using SPSS Version 26. Results: The majority of participants were rural, low-income, and engaged in domestic work. Over 76% experienced moderate to severe psychological distress. Drug-related side effects were reported by 65%, and 68.3% faced social stigma, predominantly from family and community. Multivariate logistic regression identified social stigma (AOR = 4.58; 95% CI: 2.01–10.45), drug side effects (AOR = 3.02; 95% CI: 1.42–6.45), higher pill burden (AOR = 2.67), and intensive treatment phase (AOR = 2.11) as significant predictors of distress. Conclusion: Female TB patients in Bangladesh experience a high burden of psychosocial distress, compounded by stigma and treatment-related challenges. Tailored, gender-sensitive psychosocial interventions are urgently needed to complement biomedical TB control strategies and align with WHO’s patient-centered care framework.
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