Mycobacterium tuberculosis is a type of bacteria that typically affects the lungs. InSomalia, TB is a leading cause of death and illness burden. Stigma is a major
impediment to the global eradication of tuberculosis (TB). And one of the manyfactors hampering tuberculosis (TB) control, and treatment adherence. Self-stigmaremains an undesirable psychological behavior that has an impact on patients’ lives. So far self-stigma is often continued beyond the period of infection, treatment, andhindering complete recovery. At present, there is no self-stigma interventionreduction program in Somalia that is directed TB patients to improve medicationadherence. A Literature search on the effect of self-stigma intervention amongTBpatients is not available. However, the effect of Psychological counselingandeducational interventions on TB treatment adherence based on HBMrevealedastatistically significant difference between the intervention and control at theendpoint of the intervention. Objective: To develop, implement and evaluatetheeffectiveness of self-stigma intervention reduction to improve the psychological
status, basic TB knowledge, and TB treatment adherence based on HBMamongTBpatients in Hargeisa TB Hospital Somalia. Methods: A randomized controlledtrial
was conducted to determine the effectiveness of a recently developed self-stigmaintervention program on improving psychological status, basic TB knowledge, TBtreatment adherence, and reduced TB stigma. The intervention group receivedHBM-based stigma intervention program including stigma related to TB, basicTBknowledge, adherence to TB treatment, clarification of myths and misconceptionsas videos, ppt lectures, And the control group received standard TB treatment. Results: The study results showed significant change differences in the stigmaTBcommunity and stigma TB patients’ reduction, improved knowledge, and adherenceto treatment between the intervention and control group at baseline, two, andsixmonths follow-up. Basic TB knowledge between the intervention and control group[mean score = 3.467 (0.148) vs. 2 months, [ms = 13.980(0.148) vs 2.54 (0.149), and 6 months, ms = 13.980(0.148) vs 2.54 (0.149), F(1,305) = 1811.5, p<0.001. In adherence to TB medication in the intervention group as compared tothecontrol group, [mean score = 2.65 (0.98) vs. 2 months, [ms = 9.91(0.31) vs 2.54(0.77), and six months, ms = 9.92(0.33) vs 2.54 (0.77), F(1,305) =5052, p<0.001]. Community TB stigma and patients TB [Meanscore = 29.191(0.229) vs. 29.893(0.231)]. 2 months, [ms = 12.132(0.091) vs 29.893(0.092), and6, ms=12.132(0.084) vs 30.000, (0.085), F(1,305) = 7905, p<0.001]. as well as:
[Meanscore = 25.145(0.199), vs 25.940(0.201),)]. 2 monhs, [ms =13.105(0.109)vs 25.940(0.109) and 6, ms=11.230(0.350) vs 25.567(0.352), F(1, 305)=1930.7, p<0.001] respectively). Conclusion: The self-stigma reduction interventionprogram based on HBM, was effective in improving, knowledge, adherencetotreatment, and reduced stigma, among TB patients.
Keywords: Intervention, Tuberculosis, TB Stigma, Hargeisa-TB-Hospital, Somalia.