Assessment of Quality of Life, Adherence, and Stigmatization among People Receiving Anti-Tuberculosis Medications in Three Tertiary Hospitals in Sierra Leone: A Cross- Sectional Study

Background Tuberculosis (TB) remains a significant public health concern, particularly in resource-limited settings, where the burden of TB is compounded by socioeconomic challenges and stigmatization. This study assessed the quality of life, treatment adherence, and stigmatization among patients receiving anti-TB medications in three tertiary hospitals in Sierra Leone. Method A cross-sectional study of 384 patients at Connaught, Lakka, and Kenema government hospitals was conducted between May to July 2021. Data was collected using a structured pre-tested questionnaire, consisting of the Morisky adherence scale, WHO Quality of Life tool, and Stigma Scale for Chronic Illnesses to measure adherence, quality of life and stigma respectively. Data was analyzed using descriptive and inferential statistics using the Statistical Package for Social Sciences 16. Associations between independent variables and quality of life were determined using an independent sample T-test and ANOVA. Post hoc analysis was further conducted for variables that were significant using backward multivariate linear regression. Results More than half of the patients were male with a mean age of 33.92 years. The overall adherence rate among the patients in our study was 96.9%. The social relationship domain (64.65, SD = 15.6) recorded the highest Quality of Life score, while the environmental health domain (58.18, SD = 13.5) was the lowest. The result of the backward multivariate linear regression revealed patient age to be statistically significant with the physical Health (P-value = 0.000), psychological Health (P-value = 0.017) and environmental health domains (P-value = 0.005). Having kids, Marital status, religion, and family economic situation were also found to be statistically significant with various other individual quality of life domains. The stigma indicators in this study were low with 24 (6.3%) and 50 (13.0%) of the patients reporting rejection from spouse and other family members respectively. Conclusion Despite the study revealed an encouraging adherence rate, gaps in the psychological and environmental quality of life, along with stigma, require urgent public health action. Enhancing family support, reducing economic burdens, and combating stigma through public sensitization is crucial for better outcomes for TB patients.