Tuberculosis in Southeast Asia

Stigma

Tuberculosis (TB) stigma is categorized into two types: internal stigma, where patients feel ashamed and struggle with self-management during treatment, and external stigma, which comes from societal judgment and can lead to delayed care and discrimination. In Southeast Asia, countries like Indonesia, Thailand, Cambodia, and Vietnam—classified as developing nations—have some of the highest TB case numbers globally, with stigma playing a significant role in this burden.

A recent literature review examined the causes and consequences of TB-related stigma across these four countries. Most studies focused on drug-sensitive TB, with some addressing multidrug-resistant TB (MDR-TB) and pediatric TB. The research designs were primarily qualitative and cross-sectional, with some using mixed methods or retrospective cohorts. Sample sizes ranged from 19 to 721 participants, mostly adults aged 51 to 91. Commonly used tools included validated questionnaires like the Van Rie TB Stigma Scale and Zung Anxiety Self-Assessment.

Findings revealed that stigma often leads to fear, social rejection, and family exclusion. These experiences can have serious consequences, such as patients discontinuing treatment or isolating themselves. TB stigma—both internal and external—remains a major barrier to effective TB control in the region, underscoring the urgent need for stigma-reduction strategies alongside medical interventions.

Source: Pradana, T.L.C., Putra, B.T.W. and Utami, W.S., 2025. Stigma Tuberkulosis Paru di Asia Tenggara: Systematic Literatur Review. MAHESA: Malahayati Health Student Journal, 5(6), pp.2501-2512.