Effectiveness of Community-Based Participatory Health Education in Reducing Stigma Towards Tuberculosis in South East Nigeria

Tuberculosis stigma remains a significant barrier to treatment-seeking and completion in Nigeria, contributing to delayed diagnosis and sustained community transmission. This study evaluated the effectiveness of a community-based participatory health education intervention in reducing stigma towards tuberculosis in South East Nigeria, covering Imo, Anambra, and Abia states. A quasi-experimental design with pre-test, post-test, and follow-up measurements was employed. Thirty communities were randomised into experimental and control arms, with experimental communities receiving a 12-week participatory health education programme engaging community leaders, patient advocates, and local media. The Tuberculosis Stigma Scale was administered at baseline, post-intervention, and three months post-intervention. Data from 280 participants were analysed using multilevel mixed-effects models. Results showed a statistically significant reduction in tuberculosis stigma scores in experimental communities at post-test (p less than 0.01) and follow-up (p less than 0.05), with no significant change in control communities. Community engagement depth and repeated participation were the strongest predictors of stigma reduction. The study recommends institutionalising participatory health education in Nigeria's national tuberculosis programme as a complementary stigma reduction strategy. Keywords: tuberculosis stigma, community-based participatory education, South East Nigeria, stigma reduction, health education intervention