Social determinants of tuberculosis in Addis Ababa, Ethiopia: a qualitative study

Abstract Tuberculosis (TB) is a complex health problem that requires an integrated approach that considers economic, environmental, and social factors to reduce the global burden of TB. To develop a comprehensive strategy for TB eradication, addressing the social determinants of TB is crucial. This...

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Main Authors: Yeshewas Abaynew, Ahmed Ali, Girma Taye
Format: Article
Language:English
Published: Nature Portfolio 2025-05-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-01059-2
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author Yeshewas Abaynew
Ahmed Ali
Girma Taye
author_facet Yeshewas Abaynew
Ahmed Ali
Girma Taye
author_sort Yeshewas Abaynew
collection DOAJ
description Abstract Tuberculosis (TB) is a complex health problem that requires an integrated approach that considers economic, environmental, and social factors to reduce the global burden of TB. To develop a comprehensive strategy for TB eradication, addressing the social determinants of TB is crucial. This study aimed to explore the experiences of healthcare workers and patients regarding the social determinants of health in the context of TB in Addis Ababa, Ethiopia. Purposive sampling was employed to select 20 healthcare workers and 24 individuals with TB. Key informant interviews were conducted with healthcare workers managing TB patients and individuals with TB who presented at selected health centers. A semi-structured interview guide was used to collect the data. The guide included questions to capture participants’ experiences of economic barriers, TB-related stigma, family and community support, food access, and housing conditions. Data were analyzed thematically and direct quotes were included. Forty-four participants were included, including 20 healthcare workers (16 men and four women) and twenty-four TB patients (nine men and 15 women). Key themes emerged, including economic barriers, with participants stating that financial constraints delayed TB care-seeking; stigma associated with TB, leading to fear of disclosure and social isolation; social support, with family and community networks playing a central role in facilitating care; food insecurity, with participants reporting the profound impact of food insecurity on TB vulnerability; exposure to smoke, with participants citing exposure to cigarette smoke as a potential risk factor for developing TB; and housing conditions, with participants stating that overcrowded living environments facilitate TB transmission. Economic barriers, TB-related stigma, a lack of social support, food insecurity, and exposure to cigarette smoke are key social determinants of TB. These findings underscore the need to address social determinants of TB through targeted interventions, such as stigma reduction campaigns, financial assistance, and community support programs, to reduce the TB burden in Addis Ababa.
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spelling doaj-art-3241b95c18a54df086ebc991ded9cc292025-08-20T03:53:12ZengNature PortfolioScientific Reports2045-23222025-05-011511610.1038/s41598-025-01059-2Social determinants of tuberculosis in Addis Ababa, Ethiopia: a qualitative studyYeshewas Abaynew0Ahmed Ali1Girma Taye2School of Public Health, College of Medicine and Health Sciences, Wollo UniversityDepartment of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa UniversityDepartment of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa UniversityAbstract Tuberculosis (TB) is a complex health problem that requires an integrated approach that considers economic, environmental, and social factors to reduce the global burden of TB. To develop a comprehensive strategy for TB eradication, addressing the social determinants of TB is crucial. This study aimed to explore the experiences of healthcare workers and patients regarding the social determinants of health in the context of TB in Addis Ababa, Ethiopia. Purposive sampling was employed to select 20 healthcare workers and 24 individuals with TB. Key informant interviews were conducted with healthcare workers managing TB patients and individuals with TB who presented at selected health centers. A semi-structured interview guide was used to collect the data. The guide included questions to capture participants’ experiences of economic barriers, TB-related stigma, family and community support, food access, and housing conditions. Data were analyzed thematically and direct quotes were included. Forty-four participants were included, including 20 healthcare workers (16 men and four women) and twenty-four TB patients (nine men and 15 women). Key themes emerged, including economic barriers, with participants stating that financial constraints delayed TB care-seeking; stigma associated with TB, leading to fear of disclosure and social isolation; social support, with family and community networks playing a central role in facilitating care; food insecurity, with participants reporting the profound impact of food insecurity on TB vulnerability; exposure to smoke, with participants citing exposure to cigarette smoke as a potential risk factor for developing TB; and housing conditions, with participants stating that overcrowded living environments facilitate TB transmission. Economic barriers, TB-related stigma, a lack of social support, food insecurity, and exposure to cigarette smoke are key social determinants of TB. These findings underscore the need to address social determinants of TB through targeted interventions, such as stigma reduction campaigns, financial assistance, and community support programs, to reduce the TB burden in Addis Ababa.https://doi.org/10.1038/s41598-025-01059-2Social determinantsTuberculosisFood insecurityQualitative study
spellingShingle Yeshewas Abaynew
Ahmed Ali
Girma Taye
Social determinants of tuberculosis in Addis Ababa, Ethiopia: a qualitative study
Scientific Reports
Social determinants
Tuberculosis
Food insecurity
Qualitative study
title Social determinants of tuberculosis in Addis Ababa, Ethiopia: a qualitative study
title_full Social determinants of tuberculosis in Addis Ababa, Ethiopia: a qualitative study
title_fullStr Social determinants of tuberculosis in Addis Ababa, Ethiopia: a qualitative study
title_full_unstemmed Social determinants of tuberculosis in Addis Ababa, Ethiopia: a qualitative study
title_short Social determinants of tuberculosis in Addis Ababa, Ethiopia: a qualitative study
title_sort social determinants of tuberculosis in addis ababa ethiopia a qualitative study
topic Social determinants
Tuberculosis
Food insecurity
Qualitative study
url https://doi.org/10.1038/s41598-025-01059-2
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