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Open Access Depression and anxiety in patients with multidrug-resistant tuberculosis in Nepal: an observational study

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Setting: Multidrug-resistant tuberculosis (MDR-TB) patients in the national TB treatment programme of Nepal.

Objective: To estimate the prevalence of depression and anxiety in people receiving treatment for MDR-TB, identify potential risk factors for depression and anxiety and determine temporal changes in their severity during treatment.

Design: An observational study using a screening tool, the Hopkins Symptom Checklist (HSCL-25) for depression and anxiety, administered monthly to a group of 135 patients in Nepal. Logistic and multilevel linear regression models were used to identify any patient characteristics associated with depression and anxiety.

Results: Most of the 135 patients were male (76%) and living with their families (68%). The period prevalences of depression and anxiety were respectively 22.2% and 15.6%. Patients reporting physical side effects of MDR-TB treatment had a higher depression score on HSCL by 2.63 points (95%CI 0.77–4.48) and a 1.59 point higher anxiety score (95%CI 0.45–2.73) than those who did not report any side effects. Being single was associated with having anxiety (aOR 0.2, 95%CI 0.03–1.0).

Conclusion: Given the high rates of depression observed among MDR-TB patients, national TB treatment programmes should ensure their patients are routinely screened for depression and anxiety, and effective treatment offered.
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Keywords: common mental disorders; comorbidity; drug resistance; epidemiology; infectious disease

Document Type: Research Article

Affiliations: 1: Nuffield Centre for International Health and Development, University of Leeds, Leeds, UK 2: Health Research and Social Development Forum, Kathmandu, Nepal 3: Leeds Institute of Health Sciences, University of Leeds, Leeds, UK

Publication date: March 21, 2019

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  • Public Health Action (PHA), The Union's quarterly Open Access journal, welcomes the submission of articles on operational research. It publishes high-quality scientific research on health services, providing new knowledge on how to improve access, equity, quality and efficiency of health systems and services.

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