Associations of depression, anxiety, and perceived stigma with treatment adherence among pulmonary tuberculosis patients at a provincial tuberculosis hospital in Southern Vietnam

Tuberculosis (TB) remains a major public health challenge in Vietnam. Although clinical treatment outcomes have improved, psychosocial factors such as mental health conditions and stigma continue to be associated with difficulties in recovery. This study examined the prevalence of depression and anxiety and explored the associations between perceived stigma, mental health, and treatment adherence among pulmonary TB patients in Southern Vietnam. A cross-sectional survey was conducted in 2024 among 195 adults with drug-susceptible pulmonary TB at Tra Vinh Tuberculosis and Lung Hospital. Data were collected through structured face-to-face interviews. Depression and anxiety were assessed using the DASS-21, medication adherence using the MMAS-8, and perceived stigma through self-report. Multivariable Firth’s penalized logistic regression was used to examine associated factors. The prevalence of anxiety and depression was 26.7% and 27.7%, respectively; 32.3% of patients had poor adherence, and 22.1% perceived TB-related stigma. Perceived stigma was strongly associated with higher odds of anxiety (aOR = 6.8) and non-adherence (aOR = 19.8). Support from family and healthcare workers was associated with lower odds of anxiety. Perceived stigma remains an important factor associated with mental health difficulties and treatment non-adherence among TB patients. Integrating mental health screening and anti-stigma support into TB care may help improve outcomes.