{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T22:50:06Z","timestamp":1792277406804,"version":"4.4.0"},"reference-count":39,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T00:00:00Z","timestamp":1737676800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Tuberculosis (TB) stigma remains a significant barrier to TB control efforts globally, especially in countries with a high TB burden. Studies about TB stigma done in Uganda so far have been limited in scope and focused on data collected health facilities. In this study we report TB related stigma at community level for the period 2021\/2022. We used the 2021\/22 Lot Quality Assurance Sampling (LQAS) data from a sample of 33,349 participants across 77 districts, to measure TB stigma determine factors associated. We included demographic characteristics, knowledge and participant perspectives as our study variables. Univariable and multivariate logistic regression analyses were performed to identify factors associated with TB stigma. TB stigma was assessed as a categorical variable (below or above the median) due to the skewness of the data when fitting the scores. The data set had equal proportions of males and females. The largest age group was 20\u201329 years old (38.47%). Most participants were married (62.94%) and had primary level education (65.80%). The TB stigma scores were assigned on a scale from 0 to 30, with an average score of 21.67 (\u00b18.22) and a median score of 24 (19\u201328). Overall, 45.48% of participants had TB stigma scores above the median. Variations in TB stigma levels were observed across different districts. Factors associated with higher TB stigma included older age, higher education levels, urban residence, and TB knowledge. To reduce TB stigma and misinformation that can make an impact on TB response, community interventions should balance increasing awareness with minimizing fear. These interventions should be well-rounded and context-specific to address disparities within communities and bolster TB control efforts in the country.<\/jats:p>","DOI":"10.1371\/journal.pone.0313750","type":"journal-article","created":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T13:33:44Z","timestamp":1737725624000},"page":"e0313750","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":17,"title":["Level of tuberculosis-related stigma and associated factors in Ugandan communities"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5302-7077","authenticated-orcid":true,"given":"Derrick","family":"Kimuli","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florence","family":"Nakaggwa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norah","family":"Namuwenge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Kamara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mabel","family":"Nakawooya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geofrey","family":"Amanya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Tumwesigye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Mwehire","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deus","family":"Lukoye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Murungi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seyoum","family":"Dejene","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaffer","family":"Byawaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norbert","family":"Mubiru","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stavia","family":"Turyahabwe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Amuron","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daraus","family":"Bukenya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,1,24]]},"reference":[{"key":"pone.0313750.ref001","unstructured":"World Health Organization; Global tuberculosis report 2023. Geneva; 2023."},{"key":"pone.0313750.ref002","doi-asserted-by":"crossref","first-page":"168","DOI":"10.5588\/ijtld.13.0181","article-title":"A systematic review of global cultural variations in knowledge, attitudes and health responses to tuberculosis stigma","volume":"18","author":"S-H Chang","year":"2014","journal-title":"The International Journal of Tuberculosis and Lung Disease"},{"key":"pone.0313750.ref003","doi-asserted-by":"crossref","first-page":"1640","DOI":"10.4314\/ahs.v21i4.18","article-title":"Stigma among tuberculosis patients and associated factors in urban slum populations in Uganda","volume":"21","author":"C Ashaba","year":"2021","journal-title":"Afr Health Sci"},{"key":"pone.0313750.ref004","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1177\/00333549101250S407","article-title":"Tuberculosis and Stigmatization: Pathways and Interventions","volume":"125","author":"A Courtwright","year":"2010","journal-title":"Public Health Rep"},{"key":"pone.0313750.ref005","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1016\/S1473-3099(24)00136-1","article-title":"Post-tuberculosis lung disease: is there a light at the end of tunnel?","volume":"24","author":"J Chakaya","year":"2024","journal-title":"The Lancet Infectious Diseases"},{"key":"pone.0313750.ref006","doi-asserted-by":"crossref","first-page":"S41","DOI":"10.1016\/j.ijid.2020.02.032","article-title":"Post tuberculosis treatment infectious complications","volume":"92","author":"D Hsu","year":"2020","journal-title":"International Journal of Infectious Diseases"},{"key":"pone.0313750.ref007","doi-asserted-by":"crossref","first-page":"e0244451","DOI":"10.1371\/journal.pone.0244451","article-title":"Addressing the drug-resistant tuberculosis challenge through implementing a mixed model of care in Uganda","volume":"15","author":"S Kasozi","year":"2020","journal-title":"PLOS ONE"},{"key":"pone.0313750.ref008","unstructured":"TB SMEAR. Ministry of Health National TB & Leprosy Control Division Performance Review Meeting. M&E beyond Numbers \u201cWhat is your Story?\u201d; 2024 Apr."},{"key":"pone.0313750.ref009","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1186\/s12890-019-0853-3","article-title":"A four-year trend in pulmonary bacteriologically confirmed tuberculosis case detection in Kampala-Uganda","volume":"19","author":"NS Kirirabwa","year":"2019","journal-title":"BMC Pulm Med"},{"key":"pone.0313750.ref010","doi-asserted-by":"crossref","first-page":"e0208390","DOI":"10.1371\/journal.pone.0208390","article-title":"Response to anti-tuberculosis treatment by people over age 60 in Kampala, Uganda","volume":"13","author":"NS Kirirabwa","year":"2018","journal-title":"PLOS ONE"},{"key":"pone.0313750.ref011","article-title":"Stigma and Associated Sex Disparities Among Patients with Tuberculosis in Uganda: A Cross-Sectional Study","author":"JN Sekandi","year":"2024","journal-title":"Res Sq"},{"key":"pone.0313750.ref012","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/j.healthpol.2005.01.003","article-title":"An exploration of the social stigma of tuberculosis in five \u201cmunicipios\u201d of Nicaragua to reflect on local interventions","volume":"74","author":"J Macq","year":"2005","journal-title":"Health Policy"},{"key":"pone.0313750.ref013","first-page":"856","article-title":"Gender and socio-cultural determinants of TB-related stigma in Bangladesh, India, Malawi and Colombia","volume":"12","author":"D Somma","year":"2008","journal-title":"Int J Tuberc Lung Dis"},{"key":"pone.0313750.ref014","doi-asserted-by":"crossref","first-page":"940","DOI":"10.1080\/09540121.2014.882488","article-title":"Tuberculosis and human immunodeficiency virus: exploring stigma in a community in western Uganda","volume":"26","author":"A Wynne","year":"2014","journal-title":"AIDS Care"},{"key":"pone.0313750.ref015","doi-asserted-by":"crossref","first-page":"1756","DOI":"10.1111\/tmi.12605","article-title":"Comparing two survey methods of measuring health-related indicators: Lot Quality Assurance Sampling and Demographic Health Surveys","volume":"20","author":"SC Anoke","year":"2015","journal-title":"Trop Med Int Health"},{"key":"pone.0313750.ref016","doi-asserted-by":"crossref","first-page":"781","DOI":"10.3126\/nje.v9i3.24507","article-title":"Review of Lot Quality Assurance Sampling, Methodology and its Application in Public Health","volume":"9","author":"RS Rath","year":"2019","journal-title":"Nepal J Epidemiol"},{"key":"pone.0313750.ref017","unstructured":"Kintu P, Elizabeth E, Denis B, Samson K. UPHOLD LQAS Survey Report 2006: Household and Facility Survey on HIV\/AIDS, Health and Education Interventions in 34 Ugandan Districts. 2006. Available: http:\/\/library.health.go.ug\/sites\/default\/files\/resources\/LQAS%20Survey%20Report%202006.pdf."},{"key":"pone.0313750.ref018","unstructured":"MoLG & SSS M of LG and S& SS (SSS). Community Surveys based on LQAS Methodology in Uganda. Uganda and Silver Spring, Maryland, US: USAID\/SITES Project; 2020."},{"key":"pone.0313750.ref019","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1186\/s40834-023-00243-x","article-title":"Postpartum family planning uptake in Uganda: findings from the lot quality assurance sampling survey","volume":"8","author":"F Nakaggwa","year":"2023","journal-title":"Contraception and Reproductive Medicine"},{"key":"pone.0313750.ref020","doi-asserted-by":"crossref","first-page":"e0293041","DOI":"10.1371\/journal.pone.0293041","article-title":"Level of minimum acceptable diet and its associated factors among children aged 12\u201323 months in Ugandan districts","volume":"18","author":"D Kimuli","year":"2023","journal-title":"PLoS ONE"},{"key":"pone.0313750.ref021","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1186\/s13006-023-00604-x","article-title":"Sociodemographic and health-related factors associated with exclusive breastfeeding in 77 districts of Uganda","volume":"18","author":"D Kimuli","year":"2023","journal-title":"International Breastfeeding Journal"},{"key":"pone.0313750.ref022","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12889-024-19028-1","article-title":"Prevalence, patterns, and determinants of breastfeeding cessation among mothers of children under 24 months in Uganda","volume":"24","author":"F Nakaggwa","year":"2024","journal-title":"BMC Public Health"},{"key":"pone.0313750.ref023","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1186\/s40795-024-00858-6","article-title":"Prevalence and determinants of minimum dietary diversity for women of reproductive age in Uganda","volume":"10","author":"D Kimuli","year":"2024","journal-title":"BMC Nutrition"},{"key":"pone.0313750.ref024","unstructured":"StataCorp CS TX: Stata Press. Stata 15 Base Reference Manual. 2017 [cited 8 Dec 2020]. Available: https:\/\/www.stata.com\/support\/faqs\/resources\/citing-software-documentation-faqs\/."},{"key":"pone.0313750.ref025","unstructured":"QGIS (v3.32.1-Lima). QGIS Geographic Information System. 2023. Available: https:\/\/www.qgis.org\/en\/site\/."},{"key":"pone.0313750.ref026","unstructured":"Regional Health Integration to Enhance Services-North, Lango. LQAS Survey Report. 2020 Jul. Available: https:\/\/pdf.usaid.gov\/pdf_docs\/Pnadi228.pdf."},{"key":"pone.0313750.ref027","doi-asserted-by":"crossref","first-page":"1495","DOI":"10.1016\/j.ijsu.2014.07.013","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for reporting observational studies","volume":"12","author":"E von Elm","year":"2014","journal-title":"International Journal of Surgery"},{"key":"pone.0313750.ref028","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1046\/j.1365-3156.1997.d01-380.x","article-title":"From their own perspective. A Kenyan community\u2019s perception of tuberculosis","volume":"2","author":"R Liefooghe","year":"1997","journal-title":"Tropical Medicine & International Health"},{"key":"pone.0313750.ref029","doi-asserted-by":"crossref","DOI":"10.5040\/9798400636028","volume-title":"Culture and Customs of Uganda","author":"KM Otiso","year":"2006","edition":"1"},{"key":"pone.0313750.ref030","first-page":"848","article-title":"Gender and socio-cultural determinants of delay to diagnosis of TB in Bangladesh, India and Malawi","volume":"12","author":"GD Gosoniu","year":"2008","journal-title":"Int J Tuberc Lung Dis"},{"key":"pone.0313750.ref031","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1111\/tmi.13017","article-title":"Status of tuberculosis\u2010related stigma and associated factors: a cross\u2010sectional study in central China","volume":"23","author":"X Yin","year":"2018","journal-title":"Tropical Med Int Health"},{"key":"pone.0313750.ref032","doi-asserted-by":"crossref","first-page":"14998","DOI":"10.3390\/ijerph192214998","article-title":"Perceptions, Attitudes, Experiences and Opinions of Tuberculosis Associated Stigma: A Qualitative Study of the Perspectives among the Bolgatanga Municipality People of Ghana","volume":"19","author":"E Huq","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"pone.0313750.ref033","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/j.inhe.2011.12.002","article-title":"A qualitative study exploring delayed diagnosis and stigmatisation of tuberculosis amongst women in Uganda","volume":"4","author":"L Macfarlane","year":"2012","journal-title":"Int Health"},{"key":"pone.0313750.ref034","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1046\/j.1365-3156.1998.00202.x","article-title":"Pulmonary tuberculosis and health-seeking behaviour: how to get a delayed diagnosis in Cali, Colombia","volume":"3","author":"E. Jaramillo","year":"1998","journal-title":"Tropical Medicine & International Health"},{"key":"pone.0313750.ref035","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1186\/s12913-016-1655-4","article-title":"Can local staff reliably assess their own programs? A confirmatory test-retest study of Lot Quality Assurance Sampling data collectors in Uganda","volume":"16","author":"CA Beckworth","year":"2016","journal-title":"BMC Health Serv Res"},{"key":"pone.0313750.ref036","first-page":"40","article-title":"Faking It: Social Desirability Response Bias in Self-report Research","volume":"25","author":"F van de M Thea","year":"2012","journal-title":"The Australian Journal of Advanced Nursing"},{"key":"pone.0313750.ref037","doi-asserted-by":"crossref","first-page":"S65","DOI":"10.1016\/j.chest.2020.03.012","article-title":"Cross-Sectional Studies: Strengths, Weaknesses, and Recommendations","volume":"158","author":"X Wang","year":"2020","journal-title":"Chest"},{"key":"pone.0313750.ref038","first-page":"371","article-title":"Secondary analysis of existing data: opportunities and implementation","volume":"26","author":"HG Cheng","year":"2014","journal-title":"Shanghai Arch Psychiatry"},{"key":"pone.0313750.ref039","unstructured":"TB stigma assessment tool | Stop TB Partnership. [cited 14 Oct 2024]. Available: https:\/\/www.stoptb.org\/tb-stigma\/tb-stigma-assessment-tool."}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0313750","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T13:34:00Z","timestamp":1737725640000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0313750"}},"subtitle":[],"editor":[{"given":"Stephen Michael","family":"Graham","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,1,24]]},"references-count":39,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,24]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0313750","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,24]]}}}