{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T04:29:43Z","timestamp":1786768183958,"version":"build-2736575974"},"reference-count":60,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001713","name":"European and Developing Countries Clinical Trials Partnership","doi-asserted-by":"crossref","award":["TMA.2017-GSF.1942-TB-DM"],"award-info":[{"award-number":["TMA.2017-GSF.1942-TB-DM"]}],"id":[{"id":"10.13039\/501100001713","id-type":"DOI","asserted-by":"crossref"}]},{"award":["TMA.2017-GSF.1942-TB-DM"],"award-info":[{"award-number":["TMA.2017-GSF.1942-TB-DM"]}],"id":[{"id":"https:\/\/ror.org\/031jv9v19","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int. J. Environ. Res. Public Health","IJERPH"],"abstract":"<jats:p>Introduction: Tuberculosis [TB] and diabetes mellitus (DM) remain major public health concerns worldwide. TB negatively affects an individual\u2019s glucose tolerance, increasing the risk of developing DM. Similarly, DM reduces the host\u2019s ability to fight TB infection and increases the likelihood of developing TB and poor response to TB medication. This study analysed stigma and health-seeking behaviour in a sub-district of Accra Metropolis. Methods: We used a mixed-methods research approach involving a cross-sectional survey and in-depth interviews to explore community knowledge, stigma, and health-seeking behaviour related to TB and DM. A total of 437 individuals were selected for a survey using a simple random sampling technique, while 22 participants, including three TB patients, four nurses, one medical doctor, four students from a nursing and midwifery school, five students from a school of hygiene, and five community members, were involved in the study. Healthcare providers and patients were purposively selected, while students and community members were recruited through convenience sampling. Descriptive and logistic regression analyses were performed on the quantitative data using STATA, while the qualitative data were thematically analysed using the MAXQDA software. Results: Participants\u2019 age, sex, and educational levels were significantly associated with their knowledge of TB and DM. Males were 0.600 times as likely as females to be knowledgeable about DM (95% CI: 0.386\u20130.934, p = 0.024). Social determinants of health, such as poverty, local beliefs, stigma, and negative attitudes from healthcare workers, may influence TB patients\u2019 preference for traditional remedies over biomedical treatment. Conclusion: Therefore, we observed that addressing cultural barriers, stigma, and financial costs related to TB and diabetes care will help increase patients\u2019 willingness for biomedical treatment.<\/jats:p>","DOI":"10.3390\/ijerph23081050","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T08:06:16Z","timestamp":1786608376000},"page":"1050","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Tuberculosis- and Diabetes Mellitus-Associated Knowledge, Stigma, and Health-Seeking Behaviour in Ghana"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-9185-9756","authenticated-orcid":false,"given":"Edmond Kwaku","family":"Ocloo","sequence":"first","affiliation":[{"name":"Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra P.O. Box LG 581, Ghana"},{"name":"Department of Sociology and Anthropology, University of Cape Coast, Cape Coast PM, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8929-193X","authenticated-orcid":false,"given":"Adwoa","family":"Asante-Poku","sequence":"additional","affiliation":[{"name":"Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra P.O. Box LG 581, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ishaque Mintah","family":"Siam","sequence":"additional","affiliation":[{"name":"Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra P.O. Box LG 581, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2980-4220","authenticated-orcid":false,"given":"Nii Arku","family":"Laryea","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra P.O. Box LG 581, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7778-6748","authenticated-orcid":false,"given":"Emmanuel Frimpong","family":"Gyekye","sequence":"additional","affiliation":[{"name":"Department of Virology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra P.O. Box LG 581, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel Afreh","family":"Kyei","sequence":"additional","affiliation":[{"name":"Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra P.O. Box LG 581, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2840-3568","authenticated-orcid":false,"given":"Stephen","family":"Osei-Wusu","sequence":"additional","affiliation":[{"name":"Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra P.O. Box LG 581, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1551-0394","authenticated-orcid":false,"given":"Michelle","family":"Yeboah-Manu","sequence":"additional","affiliation":[{"name":"University of Ghana Medical Centre, Legon, Accra P.O. Box LG 25, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9683-1444","authenticated-orcid":false,"given":"Eric","family":"Koka","sequence":"additional","affiliation":[{"name":"Department of Sociology and Anthropology, University of Cape Coast, Cape Coast PM, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard Adjei","family":"Akuffo","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra P.O. Box LG 581, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8848-8974","authenticated-orcid":false,"given":"Daniel","family":"Okyere","sequence":"additional","affiliation":[{"name":"Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra P.O. Box LG 581, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0673-5967","authenticated-orcid":false,"given":"Prince","family":"Asare","sequence":"additional","affiliation":[{"name":"Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra P.O. Box LG 581, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Augustine Asare","family":"Boadu","sequence":"additional","affiliation":[{"name":"Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra P.O. Box LG 581, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emelia Konadu","family":"Danso","sequence":"additional","affiliation":[{"name":"Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra P.O. Box LG 581, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phillip","family":"Tetteh","sequence":"additional","affiliation":[{"name":"Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra P.O. Box LG 581, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5451-7860","authenticated-orcid":false,"given":"Kenneth Mawuta","family":"Hayibor","sequence":"additional","affiliation":[{"name":"Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra P.O. Box LG 581, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theophilus","family":"Afum","sequence":"additional","affiliation":[{"name":"Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra P.O. Box LG 581, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac Darko","family":"Otchere","sequence":"additional","affiliation":[{"name":"Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra P.O. Box LG 581, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nelly","family":"Arthur","sequence":"additional","affiliation":[{"name":"Department of Chest Diseases, Korle-Bu Teaching Hospital, Accra P.O. Box 77, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvester Owusu","family":"Amoako","sequence":"additional","affiliation":[{"name":"Department of Chest Diseases, Korle-Bu Teaching Hospital, Accra P.O. Box 77, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaw","family":"Adusi-Poku","sequence":"additional","affiliation":[{"name":"National Tuberculosis Control Programme, Ghana Health Service, Accra P.O. Box KB 493, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte-Alberta","family":"Cato","sequence":"additional","affiliation":[{"name":"Mamprobi Hospital, Mamprobi P.O. Box MP 772, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abraham","family":"Adjei","sequence":"additional","affiliation":[{"name":"Department of Chest Diseases, Korle-Bu Teaching Hospital, Accra P.O. Box 77, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Afriyie-Mensah","sequence":"additional","affiliation":[{"name":"Department of Chest Diseases, Korle-Bu Teaching Hospital, Accra P.O. Box 77, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorothy","family":"Yeboah-Manu","sequence":"additional","affiliation":[{"name":"Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra P.O. Box LG 581, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,13]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2024). 2024 Global Tuberculosis (TB) Report, World Health Organization."},{"key":"ref_2","unstructured":"WHO (2025). Tuberculosis, World Health Organization."},{"key":"ref_3","unstructured":"WHO (2022). Global Tuberculosis Report [Internet], World Health Organisation."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"109119","DOI":"10.1016\/j.diabres.2021.109119","article-title":"IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045","volume":"183","author":"Sun","year":"2022","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_5","unstructured":"IDF (2025). 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