Perceived stigma among hospitalized pulmonary tuberculosis patients in Hue Central Hospital: A 2024 mixed method study in Vietnam

Perceived tuberculosis related stigma remains a critical structural barrier to timely healthcare-seeking and a major driver of the global tuberculosis burden. This study aimed to estimate the prevalence of perceived stigma and identify its associated factors among hospitalized pulmonary tuberculosis inpatients in Hue Central Hospital - a national tertiary hospital in Vietnam - in 2024. A mixed-methods design was employed, incorporating both quantitative and qualitative components. The quantitative component utilized the validated Van Rie Tuberculosis Stigma Scale (VTSS) with 200 pulmonary tuberculosis inpatients from May to July 2024 to measure multiple dimensions of perceived stigma. Additionally, 13 in-depth interviews were conducted with inpatients and healthcare workers following the quantitative phase. Quantitative data were analyzed using multivariable regression while qualitative data were audio-recorded, transcribed, thematically coded, and used to enrich interpretation of quantitative findings. Overall, 43.5% of inpatients experienced perceived stigma, 90.5% intentionally kept physical distance from others, and 87.0% disclosed their disease status selectively to close family members. Perceived stigma was more prevalent among patients with higher socioeconomic status (aOR = 2.01; 95%CI: 1.01-3.99), and those who were unmarried or widowed (aOR = 2.93; 95%CI: 1.01-8.47). Qualitative results further highlighted how social isolation, fear of contagion, and persistent cultural misconceptions about tuberculosis - compounded by the visibility of a tertiary hospital - significantly shaped these perceived stigmatizing experiences. Perceived pulmonary tuberculosis related stigma among pulmonary tuberculosis inpatients remains high. These findings underscore the urgent need for integrating stigma-reduction strategies into routine tuberculosis programs, including community education, patient-centered counselling, and strengthened social support mechanisms to mitigate the psychological burden of the disease.