‘The way they treat us is worse than the disease’: A qualitative study of the experiences of people with drug-resistant tuberculosis at healthcare facilities in Lagos, Nigeria

Background: This study explored the stigma experiences of people with drug-resistant tuberculosis at health facilities in Lagos, Nigeria. Methods: Focus group discussions were conducted with individuals receiving treatment for drug-resistant tuberculosis at five treatment centers in Lagos. Thematic analysis was conducted. Results: The participants complained about the poor attitudes of healthcare workers, which they described as rude, hostile, and demeaning. These poor attitudes led some participants to consider abandoning treatment, whereasothers wished that they knew where to lodge complaints against healthcare workers. The participantsfelt humiliated, and some described the feeling as worse than the disease symptoms. The counselling by healthcare workers about the use of separate cutlery and self-isolation at home evoked feelings of loneliness at home, which was disapproved of by many participants. Conclusion: Reducing healthcare-associated stigma will require training healthcare workers on how to engage with people living with tuberculosis and their families, as well as providingnecessary infrastructural support that will make healthcare workers feel safe working among people living with tuberculosis. There is a need for stigma reduction intervention research in Nigeria, as well as learning from other settings that have achieved relative success.