{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T22:33:39Z","timestamp":1781735619467,"version":"3.54.5"},"reference-count":72,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"unspecified","delay-in-days":20,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["5-AI150485-04"],"award-info":[{"award-number":["5-AI150485-04"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,4,28]]},"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Tuberculosis (TB) stigma is a critical barrier to timely diagnosis and treatment, yet few studies have quantified community-level TB stigma or its variability across geographic contexts. This study describes methods for capturing community-level TB stigma and examines stigma variability and correlations with community-level sociodemographic and TB-related factors across urban, periurban and rural communities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Ecological study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>93 demarcated study communities in Buffalo City Metropolitan Health District, Eastern Cape, South Africa.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>3869 heads of household, age \u226518 years, were surveyed in a geographically clustered random sample of households across the 93 study communities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary outcome measures<\/jats:title>\n                    <jats:p>Validated scales were used to measure perceived TB stigma. Community levels of TB stigma were generated by aggregating individual responses within each study community.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Median community TB stigma scores varied significantly by community location: compared with urban communities, rural communities had lower TB stigma scores (beta=\u22120.235; 95%\u2009CI \u22120.362 to \u22120.108) while periurban communities had higher scores (beta=0.136; 95%\u2009CI 0.017 to 0.254). Community TB stigma was positively associated with community HIV stigma, with the strongest associations in urban (beta=0.977 (95% CI 0.634 to 1.321) and rural (beta=0.816 (95% CI 0.186 to 1.446) communities. No associations were observed between TB stigma and TB prevalence, TB knowledge or household demographics after adjusting for community location.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>TB stigma varied meaningfully across communities and was associated with urbanicity and HIV stigma. Stigma is a complex social process and there may be many other factors shaping TB stigma at the community level. Future research and stigma-reduction interventions should consider local contexts and community-level determinants beyond individual demographics, TB knowledge or community TB burden.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-106835","type":"journal-article","created":{"date-parts":[[2026,5,24]],"date-time":"2026-05-24T15:15:39Z","timestamp":1779635739000},"page":"e106835","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Association of community sociodemographic and tuberculosis-related factors with variability in community-level tuberculosis stigma in South Africa: an ecological analysis from the MISSED TB Outcomes study"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2651-2445","authenticated-orcid":false,"given":"Aaron M","family":"Kipp","sequence":"first","affiliation":[{"name":"Department of Public Health, East Carolina University Brody School of Medicine, Greenville, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawie","family":"Olivier","sequence":"additional","affiliation":[{"name":"Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nelisiwe","family":"Skonje","sequence":"additional","affiliation":[{"name":"Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liyabuya","family":"Majiza","sequence":"additional","affiliation":[{"name":"Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilyn","family":"Free","sequence":"additional","affiliation":[{"name":"Department of Public Health, East Carolina University Brody School of Medicine, Greenville, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristopher J","family":"Preacher","sequence":"additional","affiliation":[{"name":"Department of Psychology & Human Development, Vanderbilt University, Nashville, Tennessee, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nondumiso","family":"Ngcelwane","sequence":"additional","affiliation":[{"name":"Department of Health, Buffalo City Metro Health District, East London, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2275-3540","authenticated-orcid":false,"given":"Amrita","family":"Daftary","sequence":"additional","affiliation":[{"name":"School of Global Health and Dahdaleh Institute of Global Health Research, York University, Toronto, Ontario, Canada"},{"name":"Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Medina-Marino","sequence":"additional","affiliation":[{"name":"Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa"},{"name":"Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,5,21]]},"reference":[{"key":"2026052111351616000_16.5.e106835.1","unstructured":"Global Tuberculosis Report 2024. World Health Organization, 2024."},{"key":"2026052111351616000_16.5.e106835.2","unstructured":"WHO country tuberculosis profile: South Africa. N.d Available: https:\/\/worldhealthorg.shinyapps.io\/tb_profiles\/"},{"key":"2026052111351616000_16.5.e106835.3","unstructured":"National TB recovery plan 3.0: April 2024 \u2013 March 2025. South Africa National Department of Health; 2024."},{"key":"2026052111351616000_16.5.e106835.4"},{"key":"2026052111351616000_16.5.e106835.5","doi-asserted-by":"crossref","unstructured":"Subbaraman R , Nathavitharana RR , Satyanarayana S , et al . The tuberculosis cascade of care in India\u2019s public sector: a systematic review and meta-analysis. PLoS Med 2016;13. doi:10.1371\/journal.pmed.1002149","DOI":"10.1371\/journal.pmed.1002149"},{"key":"2026052111351616000_16.5.e106835.6","doi-asserted-by":"crossref","unstructured":"Munro SA , Lewin SA , Smith HJ , et al . Patient adherence to tuberculosis treatment: a systematic review of qualitative research. PLoS Med 2007;4. doi:10.1371\/journal.pmed.0040238","DOI":"10.1371\/journal.pmed.0040238"},{"key":"2026052111351616000_16.5.e106835.7","doi-asserted-by":"crossref","unstructured":"Storla DG , Yimer S , Bjune GA . A systematic review of delay in the diagnosis and treatment of tuberculosis. BMC Public Health 2008;8. doi:10.1186\/1471-2458-8-15","DOI":"10.1186\/1471-2458-8-15"},{"key":"2026052111351616000_16.5.e106835.8","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1111\/j.1365-3156.2010.02718.x","article-title":"Factors associated with patient and health care system delay in diagnosis and treatment for TB in sub\u2010Saharan African countries with high burdens of TB and HIV","volume":"16","author":"Finnie","year":"2011","journal-title":"Tropical Med Int Health"},{"key":"2026052111351616000_16.5.e106835.9","doi-asserted-by":"crossref","first-page":"669","DOI":"10.2147\/PPA.S96241","article-title":"An ontology for factors affecting tuberculosis treatment adherence behavior in sub-Saharan Africa","volume":"10","author":"Ogundele","year":"2016","journal-title":"Patient Prefer Adherence"},{"key":"2026052111351616000_16.5.e106835.10","doi-asserted-by":"crossref","first-page":"87","DOI":"10.5588\/ijtld.17.0151","article-title":"Defining the research agenda to measure and reduce tuberculosis stigmas","volume":"21","author":"Macintyre","year":"2017","journal-title":"int j tuberc lung dis"},{"key":"2026052111351616000_16.5.e106835.11","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1186\/s44263-025-00166-6","article-title":"Social isolation, social exclusion, and access to mental and tangible resources: mapping the gendered impact of tuberculosis-related stigma among men and women living with tuberculosis in Eastern Cape Province, South Africa","volume":"3","author":"Medina-Marino","year":"2025","journal-title":"BMC Glob Public Health"},{"key":"2026052111351616000_16.5.e106835.12","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.soc.27.1.363"},{"key":"2026052111351616000_16.5.e106835.13","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1016\/S0140-6736(06)68189-0","article-title":"Stigma interventions and research for international health","volume":"367","author":"Weiss","year":"2006","journal-title":"The Lancet"},{"key":"2026052111351616000_16.5.e106835.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2012.01.027"},{"key":"2026052111351616000_16.5.e106835.15","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2012.672719"},{"key":"2026052111351616000_16.5.e106835.16","doi-asserted-by":"crossref","unstructured":"Skinner D , Claassens M . It\u2019s complicated: why do tuberculosis patients not initiate or stay adherent to treatment? A qualitative study from South Africa. BMC Infect Dis 2016;16. doi:10.1186\/s12879-016-2054-5","DOI":"10.1186\/s12879-016-2054-5"},{"key":"2026052111351616000_16.5.e106835.17","doi-asserted-by":"crossref","unstructured":"Makgopa S , Cele LP , Mokgatle MM . Pre-diagnosis health seeking behaviors and experiences post-diagnosis, among men diagnosed with tuberculosis in a district of Gauteng Metropolitan city, South Africa: in-depth interviews. Int J Environ Res Public Health 2022;19. doi:10.3390\/ijerph192013635","DOI":"10.3390\/ijerph192013635"},{"key":"2026052111351616000_16.5.e106835.18","doi-asserted-by":"crossref","unstructured":"Moodley N , Saimen A , Zakhura N , et al . \u201cThey are inconveniencing us\u201d - exploring how gaps in patient education and patient centred approaches interfere with TB treatment adherence: perspectives from patients and clinicians in the Free State Province, South Africa. BMC Public Health 2020;20. doi:10.1186\/s12889-020-08562-3","DOI":"10.1186\/s12889-020-08562-3"},{"key":"2026052111351616000_16.5.e106835.19","doi-asserted-by":"crossref","unstructured":"Tadesse S . Stigma against tuberculosis patients in Addis Ababa, Ethiopia. PLoS ONE 2016;11. doi:10.1371\/journal.pone.0152900","DOI":"10.1371\/journal.pone.0152900"},{"key":"2026052111351616000_16.5.e106835.20","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1016\/j.jiph.2016.11.018","article-title":"Factors contributing to non-adherence with treatment among TB patients in Sodo Woreda, Gurage Zone, Southern Ethiopia: a qualitative study","volume":"10","author":"Gugssa Boru","year":"2017","journal-title":"J Infect Public Health"},{"key":"2026052111351616000_16.5.e106835.21","doi-asserted-by":"crossref","unstructured":"Cremers AL , de Laat MM , Kapata N , et al . Assessing the consequences of stigma for tuberculosis patients in urban Zambia. PLoS One 2015;10. doi:10.1371\/journal.pone.0119861","DOI":"10.1371\/journal.pone.0119861"},{"key":"2026052111351616000_16.5.e106835.22","doi-asserted-by":"crossref","unstructured":"Chimbatata NBW , Zhou C-M , Chimbatata CM , et al . Post-2015, why delay to seek healthcare? Perceptions and field experiences from TB healthcare providers in Northern Malawi: a qualitative study. Infect Dis Poverty 2017;6. doi:10.1186\/s40249-017-0279-1","DOI":"10.1186\/s40249-017-0279-1"},{"key":"2026052111351616000_16.5.e106835.23","doi-asserted-by":"publisher","DOI":"10.1080\/13548500802199753"},{"key":"2026052111351616000_16.5.e106835.24","doi-asserted-by":"crossref","unstructured":"De Schacht C , Mutaquiha C , Faria F , et al . Barriers to access and adherence to tuberculosis services, as perceived by patients: a qualitative study in Mozambique. PLoS One 2019;14. doi:10.1371\/journal.pone.0219470","DOI":"10.1371\/journal.pone.0219470"},{"key":"2026052111351616000_16.5.e106835.25","first-page":"796","article-title":"Why do patients with a cough delay seeking care at Lusaka urban health centres? A health systems research approach","volume":"6","author":"Godfrey-Faussett","year":"2002","journal-title":"Int J Tuberc Lung Dis"},{"key":"2026052111351616000_16.5.e106835.26","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2007.07.014"},{"key":"2026052111351616000_16.5.e106835.27","first-page":"181","article-title":"Tuberculosis and AIDS stigma among patients who delay seeking care for tuberculosis symptoms","volume":"14","author":"Pungrassami","year":"2010","journal-title":"Int J Tuberc Lung Dis"},{"key":"2026052111351616000_16.5.e106835.28","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1007\/s12199-011-0219-9","article-title":"Delay in the treatment of pulmonary tuberculosis: a report from Afghanistan","volume":"17","author":"Sabawoon","year":"2012","journal-title":"Environ Health Prev Med"},{"key":"2026052111351616000_16.5.e106835.29","first-page":"5120841","article-title":"Factors associated with treatment delay among pulmonary tuberculosis patients in public and private health facilities in Addis Ababa, Ethiopia","volume":"2017","author":"Adenager","year":"2017","journal-title":"Tuberc Res Treat"},{"key":"2026052111351616000_16.5.e106835.30","doi-asserted-by":"crossref","unstructured":"Abebe G , Deribew A , Apers L , et al . Knowledge, health seeking behavior and perceived stigma towards tuberculosis among tuberculosis suspects in a rural community in SouthWest Ethiopia. PLoS One 2010;5. doi:10.1371\/journal.pone.0013339","DOI":"10.1371\/journal.pone.0013339"},{"key":"2026052111351616000_16.5.e106835.31","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1111\/j.1365-3156.2005.01393.x","article-title":"Rural poverty and delayed presentation to tuberculosis services in Ethiopia","volume":"10","author":"Cambanis","year":"2005","journal-title":"Tropical Med Int Health"},{"key":"2026052111351616000_16.5.e106835.32","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.1111\/j.1365-3156.2007.01925.x","article-title":"Duration and associated factors of patient delay during tuberculosis screening in rural Cameroon","volume":"12","author":"Cambanis","year":"2007","journal-title":"Tropical Med Int Health"},{"key":"2026052111351616000_16.5.e106835.33","doi-asserted-by":"crossref","unstructured":"Osei E , Akweongo P , Binka F . Factors associated with DELAY in diagnosis among tuberculosis patients in Hohoe Municipality, Ghana. BMC Public Health 2015;15. doi:10.1186\/s12889-015-1922-z","DOI":"10.1186\/s12889-015-1922-z"},{"key":"2026052111351616000_16.5.e106835.34","unstructured":"Diagnostic and treatment delay in tuberculosis . World Health Organization regional office for the Eastern mediterranean. 2006."},{"key":"2026052111351616000_16.5.e106835.35","doi-asserted-by":"crossref","unstructured":"Ambaw F , Mayston R , Hanlon C , et al . Is depression associated with pathways to care and diagnosis delay in people with tuberculosis in Ethiopia? Glob Ment Health (Camb) 2019;6. doi:10.1017\/gmh.2019.17","DOI":"10.1017\/gmh.2019.17"},{"key":"2026052111351616000_16.5.e106835.36","doi-asserted-by":"crossref","unstructured":"Christian C , Burger C , Claassens M , et al . Patient predictors of health-seeking behaviour for persons coughing for more than two weeks in high-burden tuberculosis communities: the case of the Western Cape, South Africa. BMC Health Serv Res 2019;19. doi:10.1186\/s12913-019-3992-6","DOI":"10.1186\/s12913-019-3992-6"},{"key":"2026052111351616000_16.5.e106835.37","doi-asserted-by":"publisher","DOI":"10.1177\/17571774231152720"},{"key":"2026052111351616000_16.5.e106835.38","doi-asserted-by":"crossref","unstructured":"Finlay A , Lancaster J , Holtz TH , et al . Patient- and provider-level risk factors associated with default from tuberculosis treatment, South Africa, 2002: a case-control study. BMC Public Health 2012;12. doi:10.1186\/1471-2458-12-56","DOI":"10.1186\/1471-2458-12-56"},{"key":"2026052111351616000_16.5.e106835.39","doi-asserted-by":"publisher","DOI":"10.1002\/hpm.675"},{"key":"2026052111351616000_16.5.e106835.40","doi-asserted-by":"publisher","DOI":"10.5588\/ijtld.10.0273"},{"key":"2026052111351616000_16.5.e106835.41","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.17-0383"},{"key":"2026052111351616000_16.5.e106835.42","first-page":"891","article-title":"Factors determining compliance with tuberculosis treatment in an urban environment, Tamatave, Madagascar","volume":"2","author":"Comolet","year":"1998","journal-title":"Int J Tuberc Lung Dis"},{"key":"2026052111351616000_16.5.e106835.43","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2016.31.2.254"},{"key":"2026052111351616000_16.5.e106835.44","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1111\/jphs.12012","article-title":"Factors affecting patients\u2019 compliance to anti-tuberculosis treatment in Yemen","volume":"4","author":"Anaam","year":"2013","journal-title":"J Pharm Health Serv Res"},{"key":"2026052111351616000_16.5.e106835.45","doi-asserted-by":"crossref","first-page":"9449070","DOI":"10.1155\/2022\/9449070","article-title":"Nonadherence predictors to tuberculosis medications among TB patients in Gambella region of Ethiopia","volume":"2022","author":"Kebede","year":"2022","journal-title":"Can J Infect Dis Med Microbiol"},{"key":"2026052111351616000_16.5.e106835.46","doi-asserted-by":"crossref","unstructured":"Suliman Q , Lim PY , Md Said S , et al . Risk factors for early TB treatment interruption among newly diagnosed patients in Malaysia. Sci Rep 2022;12. doi:10.1038\/s41598-021-04742-2","DOI":"10.1038\/s41598-021-04742-2"},{"key":"2026052111351616000_16.5.e106835.47","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1016\/j.jmii.2013.05.001","article-title":"Medication-adherence predictors among patients with tuberculosis or human immunodeficiency virus infection in Burkina Faso","volume":"47","author":"M\u00e9da","year":"2014","journal-title":"Journal of Microbiology, Immunology and Infection"},{"key":"2026052111351616000_16.5.e106835.48","doi-asserted-by":"crossref","first-page":"81","DOI":"10.5588\/ijtld.16.0788","article-title":"Evidence-based interventions to reduce tuberculosis stigma: a systematic review","volume":"21","author":"Sommerland","year":"2017","journal-title":"Int J Tuberc Lung Dis"},{"key":"2026052111351616000_16.5.e106835.49","doi-asserted-by":"crossref","unstructured":"Foster I , Galloway M , Human W , et al . Analysing interventions designed to reduce tuberculosis-related stigma: a scoping review. PLOS Glob Public Health 2022;2. doi:10.1371\/journal.pgph.0000989","DOI":"10.1371\/journal.pgph.0000989"},{"key":"2026052111351616000_16.5.e106835.50","doi-asserted-by":"crossref","unstructured":"Amo-Adjei J . Individual, household and community level factors associated with keeping tuberculosis status secret in Ghana. BMC Public Health 2016;16. doi:10.1186\/s12889-016-3842-y","DOI":"10.1186\/s12889-016-3842-y"},{"key":"2026052111351616000_16.5.e106835.51","doi-asserted-by":"crossref","first-page":"60","DOI":"10.5588\/ijtld.16.0909","article-title":"Using 15 DHS surveys to study epidemiological correlates of TB courtesy stigma and health-seeking behaviour","volume":"21","author":"Rood","year":"2017","journal-title":"Int J Tuberc Lung Dis"},{"key":"2026052111351616000_16.5.e106835.52","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-019-7915-6","article-title":"Stigma matters in ending tuberculosis: nationwide survey of stigma in Ethiopia","volume":"20","author":"Datiko","year":"2020","journal-title":"BMC Public Health"},{"key":"2026052111351616000_16.5.e106835.53","doi-asserted-by":"crossref","unstructured":"Bresenham D , Kipp AM , Medina-Marino A . Quantification and correlates of tuberculosis stigma along the tuberculosis testing and treatment cascades in South Africa: a cross-sectional study. Infect Dis Poverty 2020;9. doi:10.1186\/s40249-020-00762-8","DOI":"10.1186\/s40249-020-00762-8"},{"key":"2026052111351616000_16.5.e106835.54","doi-asserted-by":"crossref","unstructured":"Dormechele W , Bonsu EO , Boadi C , et al . Determinants of intention to conceal tuberculosis status among family members: an analysis of seven Sub-Saharan African countries. BMC Infect Dis 2024;24. doi:10.1186\/s12879-024-09064-y","DOI":"10.1186\/s12879-024-09064-y"},{"key":"2026052111351616000_16.5.e106835.55","unstructured":"Ndlovu N , Padarath A . District Health Barometer 2022\/23. Health Systems Trust 2024."},{"key":"2026052111351616000_16.5.e106835.56","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1186\/s12942-020-00230-4","article-title":"Gridded population survey sampling: a systematic scoping review of the field and strategic research agenda","volume":"19","author":"Thomson","year":"2020","journal-title":"Int J Health Geogr"},{"key":"2026052111351616000_16.5.e106835.57","doi-asserted-by":"crossref","first-page":"S239","DOI":"10.1093\/cid\/ciaa1310","article-title":"A cluster-based, spatial-sampling method for assessing household healthcare utilization patterns in resource-limited settings","volume":"71","author":"Yu","year":"2020","journal-title":"Clin Infect Dis"},{"key":"2026052111351616000_16.5.e106835.58","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208"},{"key":"2026052111351616000_16.5.e106835.59","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"2026052111351616000_16.5.e106835.60","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1111\/j.1365-3156.2007.01971.x","article-title":"Measuring stigma associated with tuberculosis and HIV\/AIDS in southern Thailand: exploratory and confirmatory factor analyses of two new scales","volume":"13","author":"Van Rie","year":"2008","journal-title":"Tropical Med Int Health"},{"key":"2026052111351616000_16.5.e106835.61","doi-asserted-by":"crossref","unstructured":"Kipp AM , Pungrassami P , Nilmanat K , et al . Socio-demographic and AIDS-related factors associated with tuberculosis stigma in southern Thailand: a quantitative, cross-sectional study of stigma among patients with TB and healthy community members. BMC Public Health 2011;11. doi:10.1186\/1471-2458-11-675","DOI":"10.1186\/1471-2458-11-675"},{"key":"2026052111351616000_16.5.e106835.62","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1037\/sah0000328","article-title":"A systematic review and psychometric appraisal of instruments measuring tuberculosis stigma in sub-Saharan Africa","volume":"9","author":"Bergman","year":"2024","journal-title":"Stigma Health"},{"key":"2026052111351616000_16.5.e106835.63","doi-asserted-by":"crossref","unstructured":"Huddart S , Bossuroy T , Pons V , et al . Knowledge about tuberculosis and infection prevention behavior: a nine city longitudinal study from India. PLoS One 2018;13. doi:10.1371\/journal.pone.0206245","DOI":"10.1371\/journal.pone.0206245"},{"key":"2026052111351616000_16.5.e106835.64","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-008-9363-7"},{"key":"2026052111351616000_16.5.e106835.65","doi-asserted-by":"publisher","DOI":"10.1521\/aeap.14.2.172.23902"},{"key":"2026052111351616000_16.5.e106835.66","doi-asserted-by":"crossref","unstructured":"Wagenaar BH , Sullivan PS , Stephenson R . HIV knowledge and associated factors among internet-using men who have sex with men (MSM) in South Africa and the United States. PLoS One 2012;7. doi:10.1371\/journal.pone.0032915","DOI":"10.1371\/annotation\/7910bc43-9371-4ad5-aa5d-900161daf089"},{"key":"2026052111351616000_16.5.e106835.67","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2015.1007116"},{"key":"2026052111351616000_16.5.e106835.68","doi-asserted-by":"crossref","first-page":"49","DOI":"10.5588\/ijtld.16.0920","article-title":"Secondary analysis of tuberculosis stigma data from a cluster randomised trial in Zambia and South Africa (ZAMSTAR)","volume":"21","author":"Bond","year":"2017","journal-title":"int j tuberc lung dis"},{"key":"2026052111351616000_16.5.e106835.69","doi-asserted-by":"publisher","DOI":"10.1111\/hsc.12637"},{"key":"2026052111351616000_16.5.e106835.70","doi-asserted-by":"crossref","unstructured":"Deribew A , HaileMichael Y , Tesfaye M , et al . The synergy between TB and HIV co-infection on perceived stigma in Ethiopia. BMC Res Notes 2010;3. doi:10.1186\/1756-0500-3-249","DOI":"10.1186\/1756-0500-3-249"},{"key":"2026052111351616000_16.5.e106835.71","first-page":"1964759","article-title":"A comparative study of knowledge, attitude, and determinants of tuberculosis-associated stigma in rural and urban communities of Lagos state, Nigeria","volume":"2020","author":"Oladele","year":"2020","journal-title":"Tuberc Res Treat"},{"key":"2026052111351616000_16.5.e106835.72","doi-asserted-by":"crossref","first-page":"115","DOI":"10.3961\/jpmph.18.170","article-title":"Knowledge, attitudes, and practices regarding tuberculosis in timor-leste: results from the demographic and health survey 2016","volume":"52","author":"Pengpid","year":"2019","journal-title":"J Prev Med Public Health"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2025-106835","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,24]],"date-time":"2026-05-24T15:15:45Z","timestamp":1779635745000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2025-106835"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":72,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5,21]]},"published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1136\/bmjopen-2025-106835"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2025-106835","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]}}}