02394nas a2200289   4500000000100000008004100001653001100042653001700053653003300070653001900103653001500122100001700137700001400154700001900168700001300187700001400200700001800214700001200232700001000244700001000254245008500264856003200349300001000381490000700391520169200398022001402090       2017                            d10aStigma10aTuberculosis10aEvidence-based interventions10aDiscrimination10aEvaluation1 aSommerland N1 aWouters E1 aMitchell E M H1 aNgicho M1 aRedwood L1 aMasquillier C1 aHoorn R1 aHof S1 aRie A00aEvidence-based interventions to reduce tuberculosis stigma: a systematic review.  uhttp://tinyurl.com/ybd9k83f  a81-860 v213 a<p><strong>SETTING: </strong>While substantial progress is being made in tuberculosis (TB) control, the success of public health efforts is hampered by pervasive stigma.</p>

<p><strong>OBJECTIVE: </strong>To perform a systematic literature review to assess the effectiveness of interventions aimed at reducing TB stigma in patients, health care workers, care givers and the general community.</p>

<p><strong>DESIGN: </strong>Studies were eligible for inclusion if they evaluated interventions aimed at reducing TB stigma and were published between 1950 and 2015. We searched eight databases (PubMed, Cochrane Library, Ovid, Embase, PsycInfo, Sociological Abstracts, Cumulative Index to Nursing and Allied Health Literature, World Health Organization Latin American and Caribbean Health Sciences Literature), and complemented the searches by using the snowball strategy and by reviewing relevant grey literature.</p>

<p><strong>RESULTS: </strong>Only seven studies were identified as providing quantitative (n = 4) or qualitative (n = 3) evidence of effectiveness in reducing TB stigma. Quality assessment of the studies was poor. Knowledge-shaping and attitude-changing interventions aimed at the public, patients and their families were effective in reducing anticipated stigma. Home visits and support groups were effective in reducing both anticipated and internalised stigma.</p>

<p><strong>CONCLUSION: </strong>There is a dearth of reliable information on the effectiveness of TB stigma-reduction interventions. Knowledge-shaping, attitude-changing and patient-support interventions can be effective in reducing TB stigma, but more rigorous evaluations are needed.</p>
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