Which misconceptions matter? Tuberculosis knowledge and stigma towards students with tuberculosis among schoolteachers in Yogyakarta, Indonesia: an analytical cross-sectional study

Document Type : Original Article

Authors

1 Master’s Programme in Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada

2 Department of Pediatric and Maternity Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada

Abstract
Aims: This study examined whether schoolteachers’ stigma towards students with tuberculosis in Indonesia, which has the world’s second largest tuberculosis burden, is associated with their aggregate knowledge or with particular misconceptions.

Methods: In a 2023 cross-sectional survey, 300 teachers were randomly selected from staff lists of ten purposively chosen public schools in Yogyakarta City. Knowledge was measured with a 16-item index and stigma with an 11-item scale adapted from one validated in Indonesia. The primary analysis treated both scores as continuous; item-level associations with above-median stigma were explored by logistic regression with false discovery rate adjustment.

Findings: Knowledge and stigma were weakly and not significantly correlated (Spearman ρ −0.10, 95% confidence interval [CI] −0.21 to 0.02; adjusted slope −0.23, 95% CI −0.55 to 0.09). The belief that everyone in close contact with a person with tuberculosis will develop the disease was the strongest exploratory signal (adjusted odds ratio 2.52, 95% CI 1.45 to 4.38; univariable false discovery rate adjusted p = 0.022). The belief that tuberculosis can be cured with herbal medicine (adjusted odds ratio 1.99, 95% CI 1.21 to 3.27) did not meet the false discovery rate threshold (adjusted p = 0.072). The most prevalent misconception, continued infectiousness after treatment (62.7%), was not associated with stigma (odds ratio 1.02, 95% CI 0.64 to 1.63).

Conclusion: Stigma was only weakly related to total knowledge, and the clearest exploratory signal concerned a belief that infection after close contact is inevitable. These cross-sectional associations need replication before they inform school curricula.

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Articles in Press, Accepted Manuscript
Available Online from 22 October 2026