Table 1 Characteristics of the studies included in the meta-analysis.
Study | Country | Study design | Type of epidemics | Type of stigma | Total sample size | Effective sample size | Participants | Female (%) | Prevalence of stigma (%) | Measurement of stigma |
|---|---|---|---|---|---|---|---|---|---|---|
Abdelhafiz et al., 2020 [79] | Egypt | Cross sectional | COVID-19 | Enacted stigma | 559 | 559 | Community population | 62.3 | 22.7 | Items: Infection with the virus is associated with stigma |
Abdel Wahed et al., 2020 [78] | Egypt | Cross sectional | COVID-19 | Enacted stigma | 407 | 407 | Health care workers | 49.4 | 66.3 | Items: Those who get infection is the public stigmatizers |
Abuhammad et al., 2020 [80] | Jordan | Cross sectional | COVID-19 | Enacted stigma | 2000 | 1655 | Community population | 63.8 | 46.1* | Scale: A self-administered questionnaire |
Alzoubi et al., 2020 [74] | Jordan | Cross sectional | COVID-19 | Perceived stigma | 592 | 592 | Undergraduate students | 65.5 | 5.4 | Items: Infection is a stigma |
Aqeel et al., 2020 [81] | India | Cross sectional | COVID-19 | Enacted stigma | 1050 | 823 | Community population | 43.01 | 73.34 | Items: COVID-19 infection has become a social stigma; Therefore, the patients are reluctant to disclose their symptoms at the early stage |
Badi et al., 2021 [88] | Sudan | Cross sectional | COVID-19 | Enacted stigma | 657 | 657 | Community population | 60.4 | 5.2 | Items: Do you agree that the infection with the virus is associated with stigma |
Bai et al., 2004 [60] | China | Cross sectional | SARS | Enacted stigma | 338 | 338 | Hospital staff | 51.0 | 20.0* | Items: Stigmatization and rejection in the neighborhood because of hospital work |
Cassiani-Miranda et al., 2020 [82] | Colombia | Cross sectional | COVID-19 | Enacted stigma | 1687 | 1687 | Community population/ health care workers | 59.0 | 4.1* | Scale: Questionnaire on COVID-19 Stigma-Discrimination |
Chen et al., 2020 [83] | China | Cross sectional | COVID-19 | Perceived stigma | 5239 | 1902 | Community population | 43.89 | 44.34 | Items: Perceived discrimination |
Chong et al., 2004 [61] | China | Cross sectional | SARS | Perceived stigma | 1257 | 1007 | Health care workers | 81.1 | 59.6 | Items: People avoid my family because of my work |
De Roo et al., 1998 [14] | Congo | Cross sectional | Ebola | Perceived stigma | 34 | 34 | Ebola survivors | 76.0 | 35.0 | Items: They tried to escape from their family or immediate neighborhood during their illness because haemorrhagic fever was a very stigmatizing disease |
Elhadi et al., 2020 [84] | Libyan | Cross sectional | COVID-19 | Perceived stigma | 800 | 745 | Health care workers | 51.9 | 31.0 | Items: Feeling stigmatized |
Etard et al., 2017 [68] | Guinea | Cohort | Ebola | - | 802 | 786 | Ebola survivors | 55.0 | 26.0 | Items: Your situation is predominantly one of the stigma’s effects |
Etokidem et al., 2018 [72] | Nigeria | Cross sectional | Ebola | Enacted stigma | 177 | 177 | Nursing students | 94.4 | 22.0* | Item: (1) If your friend who had EVD has been certified cured of the disease, would you be willing to continue to be his/ her friend? (2) If a food vendor in the school cafeteria is known to have had EVD but is now certified cured, would you still eat the food she prepares? (3) If you know that your patient had EVD but has been certified cured, would you take part in his or her surgical operation as the theater nurse? (4) If you know that your patient who has come in labor had EVD but has been certified cured, would you deliver her of her baby? |
Goulia et al., 201067 | Greece | Cross sectional | A/H1N1 influenza | Perceived stigma | 469 | 469 | Health care workers | 68.4 | 3.8 | Items: I felt that family members and friends avoided them because of their hospital work |
Grace et al., 2005 [63] | Canada | Cross sectional | SARS | Perceived stigma | 193 | 193 | Health care workers | 32.1 | 35.8 | Items: Physicians felt that they had been treated differently because others knew they had potentially been exposed to a SARS patient (i.e., stigmatization) |
Greene et al., 2021 [89] | UK | Cross sectional | COVID-19 | Perceived stigma | 1194 | 1194 | Health care workers | 92.4 | 36.5 | Items: Feeling moderately to extremely stigmatized |
Gregorio et al., 2019 [22] | Philippines | Cross sectional | Zika | Perceived stigma | 609 | 609 | Teaching staffs | 68.5 | 42.2* | Items: (1) If a person gets Zika, he/she is discriminated or stigmatized because of it; (2) If a person gets Zika, his/ her family is discriminated or stigmatized because of it; (3) If somebody in my family were to get Zika, I would want it to remain private or a secret. |
Harjana et al., 2021 [90] | Indonesia | Cross sectional | COVID-19 | Perceived stigma | 335 | 335 | Community population | 19.4 | 53.43 | Items: Items about social support, social trust, perceived stigma, and experience on the COVID-19 test and quarantine were also adopted from previous studies |
Jalloh et al., 2017a [69] | Guinea | Cross sectional | Ebola | Enacted stigma | 5733 | 5029 | Community population | 49.0 | 20.8* | Items: Would not welcome survivor declared to be cured of Ebola back into the community |
Jalloh et al., 2017b [70] | Sierra Leone | Cross sectional | Ebola | Enacted stigma | 1413 | 1413 | Community population | 53.0 | 71.7* | Items: (1) Student who survived Ebola puts others in the class at risk of infection; (2) would not buy vegetables from a shopkeeper who survived Ebola; (3) would not welcome Ebola survivor into the community;(4) expressed at least one discriminatory attitude towards Ebola survivors. |
James et al., 2020 [75] | Sierra leone | Cross sectional | Ebola | Enacted stigma | 400 | 358 | Ebola survivors | 62.3 | 71.8* | Scale: Ebola-related stigma Questionnaire |
Jassim et al., 2021 [91] | Bahrain | Cross sectional | COVID-19 | Perceived stigma | 502 | 502 | Community population | 50.2 | 53.4 | Scale: The Stigma Scale (SS) 20 |
Kelly et al., 2019 [73] | Liberia | Cohort | Ebola | Perceived stigma | 859 | 859 | Ebola survivors | 56.0 | 16.2* | Scale: Seven-item EVD-related stigma index |
Kirk et al., 2021 [92] | Singapore | Cross sectional | COVID-19 | Perceived stigma | 430 | 430 | Health care workers | 85.8 | 23.3 | Items: Experiences stigma from the community: perceived avoidance by family members or their community owing to stigma and fear of contracting COVID-19 from them (e.g., avoidance from family members, friends, neighbors, and taxi drivers) |
Koh et al., 2005 [64] | Singapore | Cross sectional | SARS | Perceived stigma | 10511 | 10511 | Health care workers | 82.0 | 39.3* | Items: (1) I thought that “people avoid me because of my job”; (2) I felt that “people avoid my family members because of my job.” |
Lam et al., 2009 [93] | HongKong,China | Cross sectional | SARS | Perceived stigma | 124 | 124 | Community population | 62.8 | 32.3 | Items: The Stigma Scale (SS) 20 |
Lau et al., 2006 [66] | China | Cross sectional | SARS | Enacted stigma | 457 | 457 | Community population | 54.7 | 10.1 | Items: These items were mainly modified from some relevant studies investigating stigmatization towards PLWHA |
Lau et al., 2021 [94] | Singapore | Cross sectional | COVID-19 | Perceived stigma | 172 | 166 | Health care workers | 48 | 24.7 | Items: Felt that people would avoid their family members |
Lee et al., 2005 [65] | China | Cross sectional | SARS | Enacted stigma | 899 | 899 | Residents of the first outbreak community | 59.0 | 17.2 | Items: (1) SARS deeply affected their daily life; (2) Those employed perceived discriminating treatment by employers. |
Li et al., 2021 [95] | China | Cross sectional | COVID-19 | Enacted stigma | 2377 | 2377 | Community population | 51.4 | 62.3 | Items: Discrimination against Recovered COVID-19 Patients |
Misery et al., 2021 [96] | France | Cross sectional | COVID-19 | Perceived stigma | 800 | 800 | Health care workers | 80.2 | 24.9 | Items: Felt stigmatization |
Moideen et al., 2021 [97] | India | Cross sectional | COVID-19 | Perceived stigma | 56 | 56 | Patients | 58.9 | 7.1 | Scale: COVID-19 related stigma based on Berger-HIV stigma scale (12 items short version) |
Nickell et al., 2004 [62] | Canada | Cross sectional | SARS | Enacted stigma | 2001 | 1952 | Hospital staffs | 78.8 | 27.8 | Items: Being treated differently because of working in hospital |
Overholt et al., 2018 [59] | Liberia | Cohort | Ebola | - | 299 | 299 | Ebola survivors | 43.0 | 98.0 | Scale: The Ebola-related stigma questionnaire |
Poyraz et al., 2021 [98] | Turkey | Cross sectional | COVID-19 | Perceived stigma | 284 | 284 | Patients | 49.8 | 40.7 | Items: The patients rated how much they felt they were stigmatized and discriminated against, on a scale of 0 (never), 1 (very little), 2 (moderately), or 3 (considerably) |
Raab et al., 2020 [77] | Guinea | Cross sectional | Viral Haemorrhagic fevers | Enacted stigma | 102 | 102 | Health care workers | 52.0 | 2.9 | Items: Not welcome survivor in community |
Rahim et al., 2020 [99] | Iraq | Cross sectional | COVID-19 | Enacted stigma | 270 | 270 | Community population | 53.3 | 6.7 | Items: Infection with the virus is associated with stigma (1 item) |
Robinson et al., 2021 [100] | US | Cross sectional | COVID-19 | Perceived stigma | 7138 | 5549 | Community population | 51.2 | 4.8 | Items: Four items adapted from the Perceived Everyday Experiences with Discrimination Scale |
Secor et al., 2020 [24] | Liberia and Guinea | Cross sectional | Ebola | Perceived stigma | 744 | 744 | Patients | 53.1 | 30.4* | Items: (1) Refusal of service due to survivor status, (2) longer wait times for services than non-survivors, (3) receiving less care or attention than non-survivors, (4) providers gossiping about survivor status, (5) and providers being nervous to treat them due to their survivor status (6) if they had avoided or delayed seeking care due to fear of stigma. |
Secor et al., 2020 [24] | Sierra Leone | Cross sectional | Ebola | Perceived stigma | 751 | 751 | Patients | 49.8 | 19.5 | Scale: A modified questionnaire |
Singh et al., 2021 [101] | India | Cross sectional | COVID-19 | Enacted stigma | 485 | 485 | Community population | 48.9 | 39.2 | Items: COVID-19 generates stigma against specific people |
Taylor et al., 2020 [85] | United States and Canada | Cross sectional | COVID-19 | Enacted stigma | 3551 | 3551 | Community population | 42.0 | 33.2* | Scale: HCW Stigmatization Survey |
Tee et al., 2020 [86] | Philippines | Cross sectional | COVID-19 | Perceived stigma | 2700 | 1879 | Community population | 69.0 | 15.5 | Items: Feeling of being discriminated by other countries due to the outbreak of COVID-19. |
Tenkorang et al., 2017 [71] | Ghana | Cross sectional | Ebola | Enacted stigma | 800 | 800 | Community population | 57.7 | 32.4 | Items: (1) Would you welcome someone back into your family/community/neighborhood after the person has recovered from Ebola? (2) Would you socialize with someone who has recovered from Ebola? (3) Would you touch someone who has recovered from Ebola? |
Wang et al., 2021 [102] | China | Cross sectional | COVID-19 | Enacted stigma | 4191 | 4191 | Community population | 61.0 | 62.0 | Items: Public discrimination against COVID-19 cases |
Wei et al., 2020 [87] | China | cross sectional | COVID-19 | Perceived stigma | 1344 | 1344 | Community population | 60.1 | 57.4 | Items: Reporting makes me feel stigma |
Yohannes et al., 2020 [76] | Ethiopia | Cross sectional | COVID-19 | Enacted stigma | 247 | 247 | Community population | 23.5 | 83.8 | Items: I felt that COVID-19 was a stigmatized disease |
Yu et al., 2020 [103] | United States | Cross sectional | COVID-19 | Perceived stigma | 235 | 235 | Community population | 47.9 | 7.6* | Items: Experience of discrimination: adapted from the Everyday Discrimination Scale Responses were averaged to indicate the overall experiences of discrimination participants perceived: (1) you are treated with less courtesy or respect than other people; (2) people act as if they think you are dangerous |
Yu et al., 2021 [104] | China | Cross sectional | COVID-19 | Perceived stigma | 23863 | 23863 | Community population | 68.1 | 58.1 | Items: Perceived discrimination due to COVID-19 |
Yufika et al., 2021 [105] | Indonesia | Cross sectional | COVID-19 | Enacted stigma | 288 | 288 | Health care workers | 65.3 | 21.9 | Scale: A six-item questionnaire |
