Prevalence and correlates of depression and anxiety among patients with tuberculosis at WolaitaSodo University Hospital and Sodo Health Center, WolaitaSodo, South Ethiopia, Cross sectional study

Abstract

BackgroundAnxiety and depression are frequently and highly occurring mental disorders in patients with tuberculosis. When depression and anxiety co-morbid with tuberculosis, it leads to poor adherence to anti TB medication, which is important barrier to global control of tuberculosis & increases the risk of morbidity and mortality due to TB. Cross sectional study was conducted to assess prevalence and correlates of depression and anxiety among patients with TB at WolaitaSodo University Hospital and Sodo Health Center, WolaitaSodo, Ethiopia.MethodsInstitution based cross-sectional study was conducted in 2014.A total of 417 TB patients, who had regular follow up at WolaitaSodo University Hospital and Sodo Health Center, WolaitaSodo, South Ethiopia, were recruited to assess depression and anxiety and its associated correlates. Depression and anxiety were assessed through face to face interviews by trained psychiatry nurses using the hospital anxiety and depression scale (HADS). Correlates for depression and anxiety were assessed using a structured questionnaire, Oslo social support scale and TB stigma Scale.ResultsThe prevalence of depression and anxiety among patients with TB were 43.4 % (181) and 41.5 % (173) respectively. When we adjusted for the effect of potential confounding variables, patients who had co-morbid HIV infection [AOR = 5.90,(95 % CI: 2.34,15.93)], poor social support [AOR = 18.06, (95 % CI:11.21,25.45)] & perceived TB stigma [AOR = 10.86, (95 % CI:10.26,23.47)] were more likely to have depression as compared to individuals who had no co-morbid HIV infection, good social support and no perceived TB stigma respectively. Patients who had co-morbid HIV infection [AOR = 9.61,(95 % CI:3.56,25.96)], poor social support [AOR = 8.93,(95 % CI: 5.01,15.94)], perceived TB stigma [AOR = 3.11,(95 % CI:1.78,5.42)], being female [AOR = 1.72 (95 % CI: 1.06, 2.95)], current substance use[AOR = 4.88, (95 % CI: 1.79, 13.28)] and being on intensive phase of TB treatment [AOR = 1.91, (95 % CI: 1.08, 3.39)] were more likely to have anxiety as compared to individuals who had no co-morbid HIV infection, good social support, no perceived TB stigma, being male and being on continuous phase of TB treatment respectively.ConclusionDeveloping guidelines and training of health workers in TB clinics is useful to screen and treat depression and anxiety among TB patients.

Depression and its Associated Factors with Multidrug-Resistant Tuberculosis at Baseline

“…Our findings are consistent with other studies where women had higher level of depression than men, also observed by a study conducted in Pakistan [8]. The gender difference is likely to be due to a complex interaction between biological, psychological and socio-cultural vulnerabilities [28]. Female patients with MDR-TB in developing countries become lonely, underestimated and socially stigmatized with consequent depression [29].…”

Depressive symptoms and hazardous/harmful alcohol use are prevalent and correlate with stigma among TB-HIV patients in Lesotho

“…We found a high prevalence of both, a result that is consistent with the limited literature on mental health among individuals with HIV and TB in sub-Saharan Africa. 11,25–27 Depressive symptoms and hazardous/harmful alcohol use appeared to primarily affect distinct groups. Due to the small sample size, we did not formally explore correlates, but individuals who reported both were predominantly men who endorsed higher external stigma about HIV.…”

More than eight in every nineteen inmates were living with depression at prisons of Northwest Amhara Regional State, Ethiopia, a cross sectional study design

“…Many studies on the different population showed that depression was high among individuals who had poor social support. The possible reasons stated were lack of (poor) social support which may lead to increased psychological distress; on the other hand, good social support is vital for the prevention of anxiety, both of which have relation with depression [45]. Other studies added that loneliness has adverse consequences for mental health including depression [40, 46–49].…”