Title : Impact of tuberculosis-related stigma on physical activity and social participation
Abstract:
Background: Tuberculosis (TB) remains highly stigmatised, with psychosocial consequences persisting despite successful treatment. Stigma is often linked to poverty, HIV co-infection, transmission risk, and mortality, this continues to hinder early diagnosis, recovery, and reintegration. It contributes to social exclusion, reduced self-efficacy, discrimination, and behavioural avoidance, which directly impairs physical activity and limits social participation, both critical components of functional rehabilitation and quality of life. Understanding TB-related stigma and implementing mitigation strategies is therefore essential for improving rehabilitation outcomes.
Methods: A cross-sectional analytical study was conducted among 28 individuals who had completed TB treatment within the past 6-12 months. Tuberculosis-related stigma was measured using the Van Rie Tuberculosis Stigma Scale, physical activity levels were assessed with the International Physical Activity Questionnaire (IPAQ-Short Form), and social participation evaluated using the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0). Pearson correlation and multiple linear regression analyses examined relationships between stigma, physical activity, and social participation.
Results: Results showed a mean stigma score of 2.9 ± 0.6, with 42.9% classified as high stigma, 35.7% moderate, and 21.4% low. Physical activity averaged 1,120 ± 480 MET-min/week, with 46.4% exhibiting low activity. Social participation scores indicated moderate-to-severe restriction in 75% of participants. High stigma strongly correlated with low physical activity (83.3%) and greater participation restriction (91.7%), while low stigma aligned with higher activity and milder participation limitations. Stigma was a significant independent predictor of both reduced physical activity and impaired social participation, even after adjusting for age, sex, and time since treatment.
Conclusion: These findings confirm that TB-related stigma substantially limits functional recovery. Integrating stigma-targeted psychosocial interventions alongside physiotherapy and community-based rehabilitation is critical to restore activity levels, enhance social participation, and achieve comprehensive recovery beyond microbiological cure.
