Effectiveness of Stigma-Reduction Interventions on Enhancing Basic Tuberculosis Knowledge and Treatment Adherence among TB Patients in Northwestern Region of Somalia: A Randomized Controlled Trial (RCT)

Abstract

Introduction: Mycobacterium tuberculosis is a type of bacteria that predominantly affects the lungs. In Somalia, TB ranks as a leading cause of death and imposes a significant illness burden. The country's history and culture with tuberculosis have intertwined to an extent where TB and the stigmatization surrounding it are virtually inseparable. This stigma remains a significant barrier to the global eradication of tuberculosis (TB) and hampers TB control and treatment adherence. Both TB knowledge and adherence to its treatment are critical factors when addressing tuberculosis and related issues.

Objectives: To develop, implement, and evaluate the effectiveness of a self-stigma intervention to enhance basic TB knowledge and treatment adherence among TB patients in the Northwest region of Somalia.

Methods: A randomized controlled trial (RCT) was conducted on chronologically selected TB patients treated at the Hargeisa Referral TB Hospital. Participants were split into two groups: intervention and control. The study spanned from February to July 2020. Data on basic TB knowledge and treatment adherence were collected using self-administered validated questionnaires. This data was analyzed using SPSS version 28 with repeated measures ANOVA. The intervention involved a video-based module aimed at reducing stigma, accompanied by lecture programs to bolster basic TB knowledge and treatment adherence. Adjustments were made based on feedback, with rapid follow-ups at two months and again at six months post-intervention. The control group, in contrast, only received standard tuberculosis treatment.

Results: There were significant changes in the improvement of basic TB knowledge and treatment adherence between the two groups. Notably, there was a marked increase in knowledge and adherence among the intervention group across all follow-up periods. Specific statistical details showcasing the differences in mean scores between the groups at various intervals have been provided.

Conclusions: Overall, interventions aimed at reducing stigma were effective in enhancing basic TB knowledge and treatment adherence among patients. This study underscores the importance and efficacy of such interventions in the broader effort to combat tuberculosis.

Keywords: Intervention, Tuberculosis, Basic-TB-knowledge, Treatment-adherence,  Northwestern-region-Somalia; Human and Health.