HIV, multidrug-resistant TB and depressive symptoms: when three conditions collide

Das, Mrinalini; Isaakidis, Petros; Bergh, Rafaël Van den; Kumar, Ajay; Nagaraja, Sharath Burugina; Valikayath, Asmaa; Jha, Santosh Kumar; Jadhav, Bindoo; Ladomirska, Joanna

doi:10.3402/gha.v7.24912

Cited by 28 publications

(45 citation statements)

References 9 publications

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“…Of these seven (16%) patients had depressive symptoms, while 38 did not have baseline depressive symptoms. 32 The results in the present study are on higher side and the percentage of normal patients is 4.62%. Adem A et al had done a study to assess the prevalence of depression in 222 tuberculosis patients and its relationship with regard to socio-demographic factors, disease characteristics, treatment factors and HIV infection.…”

Section: Resultssupporting

confidence: 54%

Prevalence of Depression Among Newly Diagnosed MDR Tuberculosis Patients at the Time of Registration- An Experience From Dots Plus Centre

Singh¹,

Verma²,

Kumar³

et al. 2018

jemds

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BACKGROUND MDR tuberculosis remains a leading chronic infection of lung and responsible for significant morbidity and mortality throughout the world and in India also. Depression is also a disorder of major public health importance in terms of its prevalence and the suffering, dysfunction, morbidity and economic burden. Depression and MDR tuberculosis co-exists, because of physical changes from the illness trigger the depression resulting in vicious cycle. So, it is very important to establish the prevalence of depression in MDR tuberculosis. To the best of our knowledge, very little is known about depression in MDR tuberculosis patients.The objective of this study is to find out the prevalence of depression among newly diagnosed MDR tuberculosis patients before the start of Category-IV treatments. MATERIALS AND METHODSThis was a cross-sectional study conducted in Department of Respiratory Diseases, GMC, Kannauj (India). A total of 130 MDR-TB patients were included in the study, which were enrolled for treatment in this unit from January 2017 till June 2017 and assessed at the time of registration for depression. Hamilton depression rating scale (HAM-D) was used to assess depression among MDR-TB patients. RESULTSOne hundred and thirty patients with MDR tuberculosis were enrolled during the study period. There were 93 males (71.5%) and 37 (28.4%) females. The mean age of study subject was 29.45 ± 14.49 years with a male-to-female ratio of 2.5: 1. Depression was not found in 6 (4.62%) patients, whereas 124 (95.3%) of the study participants were classified as depressive on the HAM-D scale. 65 patients (50%) had mild depression, 26 patients (20%) had moderate depression and 33 patients (25.3%) were diagnosed with severe depression. CONCLUSIONDepression is a very important negative factor to treatment adherence and it is important to diagnose and treat depression in time to get the desired results of TB treatment. Multi-drug resistant TB (MDR-TB) is defined as M. tuberculosis resistant to isoniazid and rifampicin with or without resistance to other drugs. Data from studies 'Financial or Other Competing Interest': None. Submission 14-11-2017, Peer Review 07-01-2018, Acceptance 12-01-2018, Published 22-01-2018. Corresponding Author: Dr. Vipul Singh, Associate Professor, Department of Psychiatry, Government Medical College, Kannauj, U. P. E-mail: drvipulsingh@yahoo.co.in DOI: 10.14260/jemds/2018 conducted by NIRT (erstwhile TRC) and NTI, have found MDR-TB levels of 1% to 3% in new cases and around 12% in re-treatment cases. 2-3 RNTCP has recently undertaken three community-based state level drug resistance surveillance (DRS) studies in Gujarat, Maharashtra and Andhra Pradesh. These surveys have been conducted as per a common generic protocol based on internationally accepted methodology and have estimated the prevalence of MDR-TB to be about 3% in new cases and 12% -17% in re-treatment cases. 4 Common mental disorders (CMDs) including depression, anxiety disorders and substance use disorders are a huge...

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Section: Resultssupporting

confidence: 54%

Prevalence of Depression Among Newly Diagnosed MDR Tuberculosis Patients at the Time of Registration- An Experience From Dots Plus Centre

Singh¹,

Verma²,

Kumar³

et al. 2018

jemds

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“…It was found that the mean of CD4 cell count progression among Another systemic review conducted in 2014 in sub-Saharan African countries found the pooled prevalence of major depressive disorder to be 14.5% (95% CI: 8.9-21.2) [6]. Among studies conducted in India, the prevalence was found to be 16% in Maharashtra, South-West Indian state [7]. Some Indian studies also report higher rates of depression, 49% to 67% [8][9][10][11].…”

Section: Discussionmentioning

confidence: 99%

“…WHO staging is a clinical staging of HIV/AIDS patients based on HIV-associated symptoms. It has four stages: asymptomatic, mild symptoms, advance symptoms, and severe symptoms represented by roman numbers I, II, III, and IV, Previous studies have documented a high prevalence of depression among people living with HIV/AIDS (PLHA), varying from 8.1% to 67.3%, quite higher than overall prevalence of depression [2][3][4][5][6][7][8][9][10][11]. Among many comorbidities associated with HIV/AIDS patients, depression ranks higher than most of the others.…”

Section: Study Instrumentsmentioning

confidence: 99%

Prevalence of depression among HIV-positive patients treated with antiretrovirals at different stage of infection

Alvi¹,

Khalique²,

Ahmad³

et al. 2018

HIV & AIDS Review

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Introduction: Depression in human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) is common and can have far-reaching implications in patients receiving antiretroviral therapy (ART). A high prevalence of depression has been reported in people living with HIV/AIDS (PLHA). With the improvement in the management of HIV/AIDS patients, depression is becoming a common medical problem and interferes with ART during HIV infection. This study was conducted with the objectives to determine the prevalence of depression and to study its relationship at different stages of infection (WHO staging) and disease progression.Material and methods: About 434 HIV-positive patients on ART from Anti-Retroviral Treatment Center in Aligarh, India were interviewed using pre-tested predefined questionnaire PHQ-9. The data was analyzed using SPSS20 and a p-value of less than 0.05 was considered statistically significant. Results:We found that 70/434 (16.1%) ART patients suffered from depression, with 13/434 (3%) suffering from moderate and moderately severe depression. In addition, depression was found to be greater among higher stage of the infection. About 9/70 (12.9%) patients with depression were found to be in WHO stage III or IV as compared to 23/364 (6.3%) of non-depressive patients in same WHO stage. Depression was also significantly related with worsening of disease progression, with the mean improvement in CD4 levels with treatment being only 88.54 ± 94.91 in patients suffering from moderate and moderately severe depression, as compared to 197.31 ± 169.84 in non-depressive patients. Conclusions:Depression has a significant relation with a higher stage of infection and disease progression of the HIV-infected respondents. Therefore, screening for depression is essential and should be incorporated in primary patient care.

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“…Further, in a rural Andhra Pradesh region of India, it was widely believed that TB is caused by natural and supernatural origins, witchcraft, evil, and imbalance in the quantity of consumption of hot and cold foods and people with TB are considered as those with ill fate (Venkatraju and Prasad, 2010). Severe depressive symptoms were evident in MDR-TB patients, which then improved substantially during the course of treatment (Das et al, 2014). Similarly, psychological impairment in the regions of the brain is associated with family, social and personal activities in TB patients of Delhi region (Bhatia et al, 2000).…”

Section: The Indian Scenariomentioning

confidence: 99%

Quality of Life, Psychological Interventions and Treatment Outcome in Tuberculosis Patients: The Indian Scenario

Peddireddy

2016

Front. Psychol.

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Objective: Psychological distress is being recognized in individuals affected with many diseases since it affects quality of life (QOF) and has gained importance in the clinical settings. Psychological interventions and their effect on the treatment outcome have yielded encouraging results in many diseased conditions. Tuberculosis (TB) ranks as a deadly disease resulting in millions of deaths worldwide. However, the effect of TB on the psychological status of patients and interventions to improve treatment outcome is neglected, especially in underdeveloped and developing countries.Methods: Systematic review of research papers that published on the QOF in TB and the effect of psychological interventions on treatment outcome were conducted.Results: Tuberculosis patients experience high levels of stress and decreased QOF. In the Indian scenario, TB patients undergo immense psychological stress similar to what is reported in other locations. Psychological interventions renewed hope on life and adherence to medication and treatment outcomes. Such psychological interventions are not practiced in Indian clinical settings.Conclusion: There is an urgent need for both governmental and non-governmental organizations to devise strategies to include psychological interventions mandatory during TB treatments. In the absence of such interventions, the fight against TB in India will remain incomplete.

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HIV, multidrug-resistant TB and depressive symptoms: when three conditions collide

Cited by 28 publications

References 9 publications

Prevalence of Depression Among Newly Diagnosed MDR Tuberculosis Patients at the Time of Registration- An Experience From Dots Plus Centre

Prevalence of Depression Among Newly Diagnosed MDR Tuberculosis Patients at the Time of Registration- An Experience From Dots Plus Centre

Prevalence of depression among HIV-positive patients treated with antiretrovirals at different stage of infection

Quality of Life, Psychological Interventions and Treatment Outcome in Tuberculosis Patients: The Indian Scenario

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