Depression and delayed tuberculosis treatment initiation among newly diagnosed patients in Botswana

Molebatsi, Keneilwe; Wang, Qiao; Dima, Mbatshi; Ho-Foster, Ari; Modongo, Chawangwa; Zetola, Nicola M.; Shin, Sanghyuk S.

doi:10.1080/17441692.2020.1826049

Cited by 8 publications

(5 citation statements)

References 37 publications

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“…Previous studies have demonstrated that more than half of the patients with TB possibly suffer from depression and anxiety ( 3 ). TB with comorbidity of mental disorders is more prone to poor medication adherence and delayed treatment ( 4 ), resulting in higher drug resistance, risk of treatment failure, mortality, and transmission ( 5 , 6 ). Therefore, the mental health of TB patients should be emphasized.…”

Section: Introductionmentioning

confidence: 99%

Association between depression or anxiety symptoms and immune-inflammatory characteristics in in-patients with tuberculosis: A cross-sectional study

Liu

Bai²,

Ren³

et al. 2022

Front. Psychiatry

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BackgroundDepression and anxiety are major psychological issues among patients with tuberculosis (TB) owing to chronic and complex treatments, have been reported to be closely correlated with immune and inflammation. However, the association of peripheral immune-inflammatory characteristics with depression/anxiety symptoms in in-patients with TB has rarely been reported.MethodsA cross-sectional study of 338 in-patients with TB from 3 hospitals in China were enrolled to investigate their depression and anxiety status by using the nine-item Patient Health Questionnaire (PHQ-9) and seven-item Generalized Anxiety Disorder Scale (GAD-7). Participants were divided into groups based on their PHQ-9 and GAD-7 scores, and differences in demography and immune-inflammatory characteristics were studied. Logistic analysis was performed to explore factors related to depression and anxiety symptoms.ResultsDepression and anxiety prevalence among patients with TB was 47.9 and 42.6%, respectively. Furthermore, 38.5% of patients reported a comorbidity of depression and anxiety symptoms. The counts of CD3, CD4, CD8, and lymphocytes decreased, whereas those of neutrophils, platelets, and peripheral blood cells and their derived indices increased among TB patients with depression or anxiety in comparison with those without symptoms (p < 0.05). In addition, increasing age, lower income (monthly income ≤ 3,000 yuan), divorced or widowed, drug resistance, and higher systemic immune inflammation index (SII) were significantly associated with depression or anxiety symptoms (p < 0.05).ConclusionApproximately half of the patients with TB suffered from depression or/and anxiety symptoms. Patients with depression or anxiety present worse cell immune status and stronger inflammatory responses compared to those without symptoms. We emphasized the importance of paying attention to the dysfunction of immune-inflammation process of TB patients with depression or anxiety symptoms. Especially, SII has a potential application value in guiding the evaluation of TB-related depression or anxiety owing to its easily accessibility and being economical.

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Section: Introductionmentioning

confidence: 99%

Association between depression or anxiety symptoms and immune-inflammatory characteristics in in-patients with tuberculosis: A cross-sectional study

Liu

Bai²,

Ren³

et al. 2022

Front. Psychiatry

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“…Also, 10 articles were excluded as they had mentioned anxiety without TB and had not reported any quantitative data on prevalence. Finally, 29 articles were considered for the meta-analysis[ 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 ] [ ].…”

Section: Resultsmentioning

confidence: 99%

Anxiety, stress, and quality of life in patients with tuberculosis: A systematic review and meta-analysis

Sutar,

Majumdar,

Yadav

et al. 2024

Industrial Psychiatry Journal

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Anxiety symptoms when coexisting with tuberculosis (TB), can have deleterious effects on treatment continuation that could contribute to the development of treatment resistance in TB. It is essential to understand the prevalence of anxiety in TB to develop clinical recommendations for its management. The primary objective of our review was to estimate the pooled prevalence of anxiety in TB patients along with the estimation of stress and quality of life in such patients. The relevant literature search on observational studies published in the English language till the year 2020 was carried out. A total of 8086 participants from 29 studies were included, of which 24 were cross-sectional studies and the remaining were case–control, and cohort studies. The estimated pooled prevalence of anxiety, comorbid depression, stress, and poor quality of life in TB patients was 32.54% [24.95, 41.18], 32.87% [25.79, 40.82], 52.68% [48.60, 56.72], and 79.51% [45.67, 94.72] respectively. When comparing the prevalence of anxiety across World Health Organization (WHO) regions, there was a statistically significant difference, with the African Region (AFR) having the highest prevalence i.e. 37.87% [29.59, 46.92], and the Western Pacific Region (WPR) having the lowest prevalence i.e. 15.83 % [12.72, 19.53]. The higher prevalence of anxiety in TB in the AFR and South-East Asian Region (SEAR) suggests a strong correlation with the developing status of these regions which calls for efforts to identify and treat the risk factors common to both anxiety and TB.

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“…This study underlines the intersectionality of TB-stigma, depression and QoL. In addition to biological factors inducing depression among people with TB [ 60 ], TB-Stigma is among the psychosocial factors contributing to depression, which is the most common comorbid mental health disorder in people with TB [ 42 , 61 ]. Depression and TB-Stigma can occur from symptom onset, including relating to weight loss and changes in appearance and body habitus, and lead to delay in care seeking, diagnostic, and treatment initiation [ 61 ].…”

Section: Discussionmentioning

confidence: 99%

“…In addition to biological factors inducing depression among people with TB [ 60 ], TB-Stigma is among the psychosocial factors contributing to depression, which is the most common comorbid mental health disorder in people with TB [ 42 , 61 ]. Depression and TB-Stigma can occur from symptom onset, including relating to weight loss and changes in appearance and body habitus, and lead to delay in care seeking, diagnostic, and treatment initiation [ 61 ]. As suggested by our findings, TB-Stigma and depression experienced after TB treatment initiation may be associated with difficulties in adhering to TB treatment, LTFU, and impaired quality of life [ 20 , 41 , 62 ].…”

Section: Discussionmentioning

confidence: 99%

Stigma, depression, quality of life, and the need for psychosocial support among people with tuberculosis in Indonesia: A multi-site cross-sectional study

Fuady,

Arifin,

Yunita

et al. 2024

PLOS Glob Public Health

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Stigma towards people with tuberculosis (TB-Stigma) is associated with other psychosocial consequences of TB including mental illness and reduced quality of life (QoL). We evaluated TB-Stigma, depression, QoL, and the need for psychosocial support among adults with TB in Indonesia, a high TB burden country. In this primary health facility-based survey in seven provinces of Indonesia, from February to November 2022, we interviewed adults receiving (a) intensive phase treatment for drug-susceptible (DS) TB at public facilities, (b) treatment at private facilities, (c) those lost to follow up (LTFU) to treatment, and (d) those receiving TB retreatment. We used our previously validated Indonesian TB-Stigma Scale, Patient Health Questionnaire-9, and EQ-5D-5L to measure TB-Stigma, depression, and QoL. Additional questions assessed what psychosocial support was received or needed by participants. We recruited and interviewed 612 people, of whom 60.6% (96%CI 59.6–64.5%) experienced moderate TB-Stigma. The average TB-Stigma scores were 19.0 (SD 6.9; min-max 0–50; Form A-Patient Perspective) and 23.4 (SD 8.4, min-max 0–50; Form B-Community Perspective). The scores were higher among people receiving treatment at private facilities (adjusted B [aB] 2.48; 0.94–4.03), those LTFU (aB 2.86; 0.85–4.87), males (aB 1.73; 0.59–2.87), those losing or changing job due to TB (aB 2.09; 0.31–3.88) and those living in a rural area (aB 1.41; 0.19–2.63). Depression was identified in 41.5% (95% CI 37.7–45.3%) of participants. Experiencing TB-Stigma was associated with moderately severe to severe depression (adjusted odds ratio [aOR] 1.23; 1.15–1.32) and both stigma and depression were associated with lower QoL (aB -0.013; [-0.016]-[-0.010]). Informational (20.8%), emotional (25.9%) and instrumental (10.6%) support received from peers or peer-groups was limited, and unmet need for such support was high. There is a sizeable and intersecting burden of TB-Stigma and depression among adults with TB in Indonesia, which is associated with lower QoL. Participants reported a substantial unmet need for psychosocial support including peer-led mutual support groups. A community-based peer-led psychosocial support intervention is critical to defray the psychosocial impact of TB in Indonesia.

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Depression and delayed tuberculosis treatment initiation among newly diagnosed patients in Botswana

Cited by 8 publications

References 37 publications

Association between depression or anxiety symptoms and immune-inflammatory characteristics in in-patients with tuberculosis: A cross-sectional study

Association between depression or anxiety symptoms and immune-inflammatory characteristics in in-patients with tuberculosis: A cross-sectional study

Anxiety, stress, and quality of life in patients with tuberculosis: A systematic review and meta-analysis

Stigma, depression, quality of life, and the need for psychosocial support among people with tuberculosis in Indonesia: A multi-site cross-sectional study

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