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Association between tuberculosis and depression on negative outcomes of tuberculosis treatment: A systematic review and meta-analysis

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  • Paulo Ruiz-Grosso
  • Rodrigo Cachay
  • Adriana de la Flor
  • Alvaro Schwalb
  • Cesar Ugarte-Gil

Abstract

Background: Depression is a common comorbidity of tuberculosis (TB) and is associated with poor adherence to treatment of multiple disorders. We conducted a systematic review to synthesize the existing evidence on the relationship between depression and negative outcomes of TB treatment. Methods: We systematically reviewed studies that evaluated depressive symptoms (DS) directly or indirectly through psychological distress (PD) and measured negative treatment outcomes of drug-sensitive pulmonary TB, defined as death, loss to follow-up, or non-adherence. Sources included PubMed, Global Health Library, Embase, Scopus and Web of Science from inception to August 2019. Results: Of the 2,970 studies initially identified, eight articles were eligible for inclusion and two were used for the primary outcome meta-analysis. We found a strong association between DS and negative TB treatment outcomes (OR = 4.26; CI95%:2.33–7.79; I2 = 0%). DS were also associated with loss to follow-up (OR = 8.70; CI95%:6.50–11.64; I2 = 0%) and death (OR = 2.85; CI95%:1.52–5.36; I2 = 0%). Non-adherence was not associated with DS and PD (OR = 1.34; CI95%:0.70–2.72; I2 = 94.36) or PD alone (OR = 0.92; CI95%:0.81–1.05; I2 = 0%). Conclusions: DS are associated with the negative TB treatment outcomes of death and loss to follow-up. Considerable heterogeneity exists in the definition of depression and outcomes such as non-adherence across the limited number of studies on this topic.

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  • Paulo Ruiz-Grosso & Rodrigo Cachay & Adriana de la Flor & Alvaro Schwalb & Cesar Ugarte-Gil, 2020. "Association between tuberculosis and depression on negative outcomes of tuberculosis treatment: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 15(1), pages 1-13, January.
    • Handle: RePEc:plo:pone00:0227472
    DOI: 10.1371/journal.pone.0227472
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    References listed on IDEAS

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    1. Narges Alipanah & Leah Jarlsberg & Cecily Miller & Nguyen Nhat Linh & Dennis Falzon & Ernesto Jaramillo & Payam Nahid, 2018. "Adherence interventions and outcomes of tuberculosis treatment: A systematic review and meta-analysis of trials and observational studies," PLOS Medicine, Public Library of Science, vol. 15(7), pages 1-44, July.
    2. Cesar Ugarte-Gil & Paulo Ruiz & Carlos Zamudio & Luz Canaza & Larissa Otero & Hever Kruger & Carlos Seas, 2013. "Association of Major Depressive Episode with Negative Outcomes of Tuberculosis Treatment," PLOS ONE, Public Library of Science, vol. 8(7), pages 1-7, July.
    3. Salla A Munro & Simon A Lewin & Helen J Smith & Mark E Engel & Atle Fretheim & Jimmy Volmink, 2007. "Patient Adherence to Tuberculosis Treatment: A Systematic Review of Qualitative Research," PLOS Medicine, Public Library of Science, vol. 4(7), pages 1-16, July.
    4. Salla A Munro, 2007. "Patient Adherence to Tuberculosis Treatment: A Systematic Review of Qualitative Research," Working Papers id:1107, eSocialSciences.
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