Prevalence and factors associated with depressive illness in patients with tuberculosis in Mulago Hospital

Abstract

Background: Depression is a major cause of the global disease burden and globally affects 350-400 million persons making it the largest contributor to years lived with disability. Among patients with chronic physical illnesses like tuberculosis (TB)especially in developing countries, depression can affect up to 25-33% of patients. More than 1.5 million tuberculosis cases occur in Sub Saharan Africa yearly. Uganda is one of the world’s high TB/Human Immunodeficiency Virus (HIV)- burden countries with a 2015 prevalence of all TB cases in Uganda found at 202 per 100,000.The treatment success rate was75 %for new and relapse cases and 73% for HIV-positive TB cases. Objective: To determine the prevalence and factors associated with depressive illness in patients with tuberculosis in Mulago Hospital. Methods: This was a cross sectional study involving participants aged 18 years and above diagnosed with tuberculosis attending the tuberculosis clinic in Mulago Hospital. Consecutive sampling was done until the sample size of 308 participants was achieved. Participants had the following instruments administered to them; the Socio-demographic questionnaire, the Mini Neuropsychiatric Interview (MINI) to diagnose depressive illness and the Patient Health Questionnaire- 9 for rating the severity of depression. Data was entered using Epi-Data. Descriptive, bivariate and multivariate analyses were done with SPSS. Results: The prevalence of depressive illness was 23.7% (95% confidence interval 19.32 -28.89) as diagnosed by the MINI. Depressive illness was independently associated with low education level (p= 0.003), being in the intensive phase of TB treatment (OR=2.344, p=0.007) and family history of depressive illness (OR=5.422, p=0.001). Conclusion: The prevalence of depressive illness in patients with TB is high and is associated with low education level, being in the intensive phase of TB treatment and family history of depressive illness. Depressive illnesses should be screened and managed among patients with TB.