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. 2020 Jan 15;9(1):4.
doi: 10.1186/s40249-019-0619-4.

Comorbidities between tuberculosis and common mental disorders: a scoping review of epidemiological patterns and person-centred care interventions from low-to-middle income and BRICS countries

André Janse Van Rensburg  1 , Audry Dube  2 , Robyn Curran  2 , Fentie Ambaw  3 , Jamie Murdoch  4 , Max Bachmann  4 , Inge Petersen  5 , Lara Fairall  2   6
Affiliations

Comorbidities between tuberculosis and common mental disorders: a scoping review of epidemiological patterns and person-centred care interventions from low-to-middle income and BRICS countries

André Janse Van Rensburg et al. Infect Dis Poverty. .

Abstract

Background: There is increasing evidence that the substantial global burden of disease for tuberculosis unfolds in concert with dimensions of common mental disorders. Person-centred care holds much promise to ameliorate these comorbidities in low-to-middle income countries (LMICs) and emerging economies. Towards this end, this paper aims to review 1) the nature and extent of tuberculosis and common mental disorder comorbidity and 2) person-centred tuberculosis care in low-to-middle income countries and emerging economies.

Main text: A scoping review of 100 articles was conducted of English-language studies published from 2000 to 2019 in peer-reviewed and grey literature, using established guidelines, for each of the study objectives. Four broad tuberculosis/mental disorder comorbidities were described in the literature, namely alcohol use and tuberculosis, depression and tuberculosis, anxiety and tuberculosis, and general mental health and tuberculosis. Rates of comorbidity varied widely across countries for depression, anxiety, alcohol use and general mental health. Alcohol use and tuberculosis were significantly related, especially in the context of poverty. The initial tuberculosis diagnostic episode had substantial socio-psychological effects on service users. While men tended to report higher rates of alcohol use and treatment default, women in general had worse mental health outcomes. Older age and a history of mental illness were also associated with pronounced tuberculosis and mental disorder comorbidity. Person-centred tuberculosis care interventions were almost absent, with only one study from Nepal identified.

Conclusions: There is an emerging body of evidence describing the nature and extent of tuberculosis and mental disorders comorbidity in low-to-middle income countries. Despite the potential of person-centred interventions, evidence is limited. This review highlights a pronounced need to address psychosocial comorbidities with tuberculosis in LMICs, where models of person-centred tuberculosis care in routine care platforms may yield promising outcomes.

Keywords: BRICS; Comorbidity; Low-to-middle income countries; Mental disorder; Person-centred care; Tuberculosis.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Search results for papers describing the nature and extent of tuberculosis and mental (anxiety, mood and substance use) disorder comorbidity in LMICs and BRICS (2000–2019)
Fig. 2
Fig. 2
Search results for papers describing person-centred care approaches to tuberculosis and mental disorder comorbidities in LMICs and BRICS (2000–2019)
See this image and copyright information in PMC

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