Prevalence of psychological distress and associated factors among adult tuberculosis patients attending public health institutions in Dire Dawa and Harar cities, Eastern Ethiopia

Abstract

BackgroundIn developing countries, the prevalence of psychological distress was higher among tuberculosis patients. Patients with tuberculosis infection were more prone to psychological distress than peoples without tuberculosis. However, little studies were conducted on psychological distress among tuberculosis patients in Ethiopia, particularly in the Eastern Ethiopian health institutions.MethodsInstitution-based cross-sectional study design was conducted. Based on the TB burden, four hospitals and six health centers were selected from Dire Dawa and Harar cities. Socio-demographic factors, psychological distress, TB related stigma experience, and alcohol use data were collected by face to face interview while TB and HIV related variables collected from TB registration book. All TB patients from the first month of TB treatment initiation through 6 were consecutively interviewed by trained data collectors from January to February 2018. The collected data were entered into Epi Data Version 3.1 software and exported into SPSS window version 20 for analysis. Bivariate and multivariate binary logistic regression was carried out. All variables with P-value ≤0.25 were taken into the multivariate model. Crude and adjusted odds ratios with a 95% confidence interval were estimated, and variables with P-value less than 0.05 in the final model were taken as significant predictors of psychological distress.ResultsThe prevalence of psychological distress among tuberculosis in this study population was 63.3% (95% CI: 58.1, 68.1). Being from rural residence (AOR: 1. 98; 95% CI: 1.01,3.86), co-infection TB- HIV (AOR: 2.15; 95% CI:1.02, 4.56), presence of at least one chronic disease (AOR:3.04; 95% CI:1.59,5.79), experience of stigma (AOR: 1.71; 95% CI:1.01, 2.90), Pulmonary and MDR-TB (AOR:2.53; 95% CI:1.50,4.28) and smoking cigarette (AOR:2.53; 95% CI:1.06,6.03) were associated with psychological distress.ConclusionsIn this study, almost two-thirds of the tuberculosis patients had psychological distress. Chronic disease morbidity, HIV-TB co-infection and experienced TB related stigma were associated with psychological distress. Attention should be given to chronic diseases including HIV/AIDS diagnosis and referring to chronic disease units to prevent the impact on mental health. Consideration should be given for psychological distress and linking moderate to severe form of the disease to the Psychiatric clinics to hinder its effects.

Prevalence and Associated Factors for Alcohol Use Disorder Among Tuberculosis Patients: A Systematic Review and Meta-analysis.

“…The average prevalence of alcohol use disorder in tuberculosis patients was higher in Asia and Europe;37% (14, 17, 25, 35-39, 42-45, 48, 53) than the prevalence in US ; 24% (36,39) and Africa ; 24% (11,15,33,34,40,41,46,47,(49)(50)(51)(52)54) (Figure 3). The average prevalence of AUD was 36% in studies that do not report the assessment tool for AUD (35,36,38,(41)(42)(43)(44)51) which is higher than the prevalence in studies that utilized AUDIT (26%) (14,15,17,25,34,39,(45)(46)(47)(48)(49)(50)(52)(53)(54) (Figure 4). Besides, studies which were case-control (15,40,42) provided higher prevalence of AUD (39%) than cross-sectional (11,14,17…”

“…A total of twenty-seven studies (11,14,15,17,25, that studied our outcome of interest; alcohol use disorder (AUD) in thirty thousand six hundred ftyfour (30654) tuberculosis patients on treatment with anti-tuberculosis medications were included in the present study. Considering the regional setting where the included studies were done; six (17,25,35,37,38,48), ve (41,46,47,49,50) and another ve studies were from Russia, South Africa (33,34,51,52,54) and Ethiopia (33,34,51,52,54) respectively. The remaining studies were from United States (US) (36,39), Estonia (42,43), India (14,44,53), Thailand (45), Nigeria (40), Botswana (15) and Zambia (11).…”

“…The remaining studies were from United States (US) (36,39), Estonia (42,43), India (14,44,53), Thailand (45), Nigeria (40), Botswana (15) and Zambia (11). Most of the studies in the present analysis were Cohort (25,35,38,41,45,47,49,(52)(53)(54) and cross-sectional (11,14,17,33,34,36,37,42,44,46,50,51).…”

“…One -third of the studies included (14,15,17,25,34,39,(45)(46)(47)(48)(49)(50)(52)(53)(54) used Alcohol use disorder identi cation test (AUDIT) to measure alcohol use disorder in tuberculosis patients. Besides two studies (11, 40) measured AUD with mini-international neuropsychiatric-interview(MINI), one (33) with alcohol, smoking, and substance involvement screening test(ASSIST)and another one used DSM-IV (37).…”

“…However, eight of the studies (35, 36, 38, 41-44, 51) did not report the assessment tool for the measurement of AUD. Regarding the setting of anti-tuberculosis treatment, seven (11,17,33,46,47,49,50), thirteen (14, 25, 35, 38-42, 44, 45, 48, 53) and another seven (34,36,43,51,52,54) of the included studies involved subjects with treatment setting at the primary health care setting (PHCU), hospital and both hospital and PHCU respectively. Also, twenty (14, 33, 35, 37-39, 44-47, 50, 52-54), four (17,25,43,48) and three (34,36,51) of the studies involved participant patients at the directly observed treatment(DOT), continuation and both phases of ant-tuberculosis treatment in the respective order (Table 1).…”