Common mental disorders in TB/HIV co-infected patients in Ethiopia

Abstract

Background-The relationship between TB/HIV co-infection and common mental disorders (CMD) has been scarcely investigated. In this study, we compared the occurrence of CMD in TB/HIV co-infected and non-co-infected HIV patients in Ethiopia.Methods-We conducted a cross sectional study in three hospitals in Ethiopia from February to April, 2009. The study population consisted of 155 TB/HIV co-infected and 465 non-co-infected HIV patients. CMD was assessed through face to face interviews by trained clinical nurses using the Kessler 10 scale. Several risk factors for CMD were assessed using a structured questionnaire.Results-TB/HIV co-infected patients had significantly (p = 0.001) greater risk of CMD (63.7%) than the non-co-infected patients (46.7%). When adjusted for the effect of potential confounding variables, the odds of having CMD for TB/HIV co-infected individuals was 1.7 times the odds for non-co-infected patients [OR = 1.7, (95%CI: 1.0, 2.9)]. Individuals who had no source of income [OR = 1.7, (95%CI: 1.1, 2.8)], and day labourers [OR = 2.4, 95%CI: 1.2, 5.1)] were more likely to have CMD as compared to individuals who had a source of income and government employees respectively. Patients who perceived stigma [OR = 2.2, 95%CI: 1.5, 3.2)] and who rate their general health as "poor" [OR = 10.0, 95%CI: 2.8, 35.1)] had significantly greater risk of CMD than individual who did not perceive stigma or who perceived their general health to be "good".Conclusion-TB/HIV control programs should develop guidelines to screen and treat CMD among TB/HIV co-infected patients. Screening programs should focus on individuals with no source of income, jobless people and day labourers.

Assessing Quality of Life and Depression Among People Living With HIV/AIDS and TB-HIV Coinfection in Kathmandu, Nepal

“…11 In other studies, it was reported that HIV patients had a lower QoL as compared to the general population 14 and that TB patients had a lower QoL as compared to their neighbors.…”

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“…Tuberculosis and HIV are two chronic infective medical diseases which have been found to be associated with psychiatric comorbidity [38,39] and this furthers affect the quality of life of the sufferers [40][41][42][43][44][45][46][47][48][49][50][51][52]. The greatest risk factor to the TB infection is known to be Human Immunodeficiency Virus (HIV) [27][28][29]46]. This is because the virus compromises the immune system.…”

“…A mere diagnosis of these chronic medical diseases can pose serious psychological trauma for the sufferer, giving rise to varied psychiatric symptoms and comorbidities [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26]. The situation has greatly worsened with the recent surge in co-infection of tuberculosis with HIV infection [27][28][29]. However, the introduction of chemotherapy has significantly reduced the morbidity and mortality [30][31][32][33][34][35][36][37].…”

“…People with co-infection with TB/HIV have HIV along with either latent or active TB infection [27,28,46,56]. If someone has both TB/HIV, each disease accelerates the development and progress of the other.…”

“…This constitutes an intolerable burden of human suffering, and an unacceptable barrier to socioeconomic and human development [29]. This is further worsened by co-infection with HIV [27][28][29]. Several studies have established comorbidity of TB and mental health disorders especially depression [32,[61][62][63][64][65].…”