Prevalence and factors associated with stigma among adults diagnosed with severe vision impairment in rural Mozambique.

BACKGROUND: There is limited evidence about the prevalence of and factors associated with stigmatizing attitudes in the context of severe visual impairment in sub-Saharan Africa. We assessed baseline prevalence and factors associated with stigma among adults undergoing eligibility screening for cataract surgery in northern Mozambique. METHODS: This was an analysis of baseline data from an ongoing cohort study. Participants were adult patients diagnosed with operable cataracts between April and December 2023 at eight district hospitals in Nampula province. Prior to final assessment for surgery by an eye care professional, participants were assessed for experiences of stigma and discrimination using an adapted existing scale measuring internalized and experienced stigma in the context of vision impairment. We used multivariate logistic regression to assess correlates of stigmatizing attitudes and behaviours. RESULTS: Of 927 participants, 59% (546/927) reported at least one stigmatizing attitude: internalized stigma (54%) and experienced stigma from others in the community (37%). Adjusting for all factors examined, patients with poor self-rated general health were more likely to report both internalised stigma (odds ratio (OR] 3.34 (95% confidence interval {CI} 1.90 to 5.88], p<0.001) and experienced stigma (OR 2.52 [95% CI 1.45 to 4.38], p<0.01). Several other health-related factors, including self-rated general health, perceived difficulty in seeing, objective visual acuity and vision-related quality of life were strongly associated with both internalised and experienced stigma. CONCLUSIONS: Stigma experiences were common among persons diagnosed with severe vision impairment in rural Mozambique and were associated with poor self-rated general health. These findings may help inform the development of tailored behavioural change interventions and support to visually impaired people about dealing with stigma.