Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 May 7:19:30.
doi: 10.1186/s12991-020-00281-8. eCollection 2020.

The prevalence of depression among patients with tuberculosis: a systematic review and meta-analysis

Bereket Duko  1   2 , Asres Bedaso  1 , Getinet Ayano  2   3
Affiliations
Review

The prevalence of depression among patients with tuberculosis: a systematic review and meta-analysis

Bereket Duko et al. Ann Gen Psychiatry. .

Abstract

Background: Evidence has shown that the prevalence of depression is much higher among patients with tuberculosis (TB) and this, in turn, may adversely impact compliance with anti-TB medications. Therefore, this systematic review and meta-analysis aimed to quantitatively summarize epidemiologic evidence on the prevalence of depression among patients with TB and formulate a recommendation for future clinical practice as well as research.

Methods: We followed the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines to conduct this review. We searched PubMed, EMBASE, SCOPUS and Psych INFO to identify relevant studies that investigated the prevalence of depression among TB patients. We also supplemented our electronic search with manual searching to include all pertinent studies in the analysis. We used a Comprehensive Meta-Analysis software version 3.0 (CMA 3.0) to conduct a meta-analysis. We conducted a subgroup and sensitivity analysis and Cochran's Q- and the I 2-statistics were used to assess heterogeneity. The evidence for the presence of publication bias was checked by using Egger's test and visual inspection of the symmetry in funnel plots.

Results: We identified a total of 25 studies that included 4903 participants across seven countries. In our analysis, the pooled estimated prevalence of depression among TB patients was found to be 45.19% (95% CI 38.04-52.55). The prevalence was higher in MDR-TB 52.34% (95% CI 38.09-66.22) than non-MDR-TB 43.47% (95% CI 35.88-51.37) patients. We also found that the pooled prevalence of depression was higher among females 51.54% (95% CI 40.34-62.60) when compared to males 45.25% (95% CI 35.19-55.71). The pooled prevalence of depression was 45.45% as measured by HRDS, and it was 55.62%, 45.52%, and 38.36% as measured by BDI, HADS and PHQ-9, respectively.

Conclusion: Our finding suggested that the pooled estimated prevalence of depression among tuberculosis patients was relatively high. Screening and management of depression among TB patients were warranted to alleviate suffering. Moreover, the integration of tuberculosis program with regular psychiatry services may substantially reduce the burden.

Keywords: Depression; Meta-analysis; Prevalence; Systematic review; TB.

PubMed Disclaimer

Conflict of interest statement

Competing interestsThe authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flowchart of review search
Fig. 2
Fig. 2
Forest plot of the prevalence of depression among TB patients: a meta-analysis
Fig. 3
Fig. 3
Funnel plot of standard error by logit event rate (publication bias)
See this image and copyright information in PMC

References

    1. Global tuberculosis report 2018. Geneva: World Health Organization; 2018. Licence: CCBY-NC-SA3.0IGO. https://apps.who.int/iris/handle/10665/274453. Accessed 28 Feb 2019.
    1. World Health Organization, Global tuberculosis report 2019. https://www.who.int/tb/global-report-2019. Accessed 28 Feb 2019.
    1. Ugarte-Gil C, Ruiz P, Zamudio C, Canaza L, Otero L, Kruger H, et al. Association of major depressive episode with negative outcomes of tuberculosis treatment. PLoS ONE. 2013;8:e69514. doi: 10.1371/journal.pone.0069514. - DOI - PMC - PubMed
    1. Munro SA, Lewin SA, Smith HJ, Engel ME, Fretheim A, Volmink J. Patient adherence to tuberculosis treatment: a systematic review of qualitative research. PLoS Med. 2007;4:e238. doi: 10.1371/journal.pmed.0040238. - DOI - PMC - PubMed
    1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed. (DSM-5). Washington, DC: American Psychiatric Publishing; 2013. https://psycnet.apa.org/record/2013-14907-000. Accessed 28 Feb 2019.

LinkOut - more resources