Depression among patients with tuberculosis: determinants, course and impact on pathways to care and treatment outcomes in a primary care setting in southern Ethiopia--a study protocol.

Journal: BMJ open

Volume: 5

Issue: 7

Year of Publication: 2016

Affiliated Institutions:  School of Public Health, Bahir Dar University, Bahir Dar, Ethiopia Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia. Centre for Global Mental Health, Institute of Psychiatry, King's College, London, UK. Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia Centre for Global Mental Health, Institute of Psychiatry, King's College, London, UK. Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.

Abstract summary 

Depression is commonly comorbid with chronic physical illnesses and is associated with a range of adverse clinical outcomes. Currently, the literature on the role of depression in determining the course and outcome of tuberculosis (TB) is very limited.Our aim is to examine the relationship between depression and TB among people newly diagnosed and accessing care for TB in a rural Ethiopian setting. Our objectives are to investigate: the prevalence and determinants of probable depression, the role of depression in influencing pathways to treatment of TB, the incidence of depression during treatment, the impact of anti-TB treatment on the prognosis of depression and the impact of depression on the outcomes of TB treatment.We will use a prospective cohort design. 703 newly diagnosed cases of TB (469 without depression and 234 with depression) will be consecutively recruited from primary care health centres. Data collection will take place at baseline, 2 and 6 months after treatment initiation. The primary exposure variable is probable depression measured using the Patient Health Questionnaire-9. Outcome variables include: pathways to treatment, classical outcomes for anti-TB treatment quality of life and disability. Descriptive statistics, logistic regression and multilevel mixed-effect analysis will be used to test the study hypotheses.Ethical approval has been obtained from the Institutional Review Board (IRB) of the College of Health Sciences, Addis Ababa University. Findings will be disseminated through scientific publications, conference presentations, community meetings and policy briefs.Findings will contribute to a sparse evidence base on comorbidity of depression and TB. We hope the dissemination of findings will raise awareness of comorbidity among clinicians and service providers, and contribute to ongoing debates regarding the delivery of mental healthcare in primary care in Ethiopia.

Authors & Co-authors:  Ambaw Fentie F Mayston Rosie R Hanlon Charlotte C Alem Atalay A

Study Outcome 

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Statistics
Citations :  Katon WJ. Epidemiology and treatment of depression in patients with chronic medical illness. Dialogues Clin Neurosci 2011;13:7–23.
Authors :  4
Identifiers
Doi : e007653
SSN : 2044-6055
Study Population
Male,Female
Mesh Terms
Antidepressive Agents
Other Terms
EPIDEMIOLOGY;PRIMARY CARE
Study Design
Cohort Study,Descriptive Study,Cross Sectional Study
Study Approach
Country of Study
Ethiopia
Publication Country
England