A systematic review and psychometric appraisal of instruments measuring tuberculosis stigma in Sub-Saharan Africa.
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Abstract
Tuberculosis (TB) stigma is one barrier to TB testing, treatment uptake, and treatment completion.
Therefore, stigma measurement must be approached through rigorous scientific methodology in order to
accurately and reliably estimate the impact of TB stigma on treatment outcomes. The aim of this
systematic review is to evaluate the methods and instruments used to measure TB stigma and interrogate
strategies used to culturally validate measures of TB stigma in global research. Two reviewers used the
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method to extract and
analyze the existing body of literature on TB stigma in Sub-Saharan Africa. A thorough search was
performed using three databases generating 2,302 independent studies. After the systematic screening,
this review includes 28 studies. Of those studies, 13 used a psychometrically validated instrument while
15 used informal questionnaires or proxy variables to measure stigma. The psychometric appraisal was
limited due to the number of studies that measured stigma using unvalidated questionnaires or proxy
variables. The Patient and Community Perceptions of TB scales validated by Van Rie et al. were the most
commonly used instruments to measure TB stigma; additionally, many instruments were not culturally or
linguistically validated in Sub-Saharan Africa. Our appraisal emphasizes the need for reliable and valid
instruments to measure TB stigma in low- and middle-income countries most affected by TB.
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Alanna Bergman, Katherine McNabb, Jason E. Farley. (2021-6-17). "A systematic review and psychometric appraisal of instruments measuring tuberculosis stigma in Sub-Saharan Africa.." Stigma and Health. 10.1037/sah0000328.