Depression, a complication of tuberculosis?
One of the most devastating human intracellular pathogens is Mycobacterium tuberculosis, a bacillus that causes tuberculosis. According to the World Health Organization, 1.5 million people died in 2019 from this disease that generally affects the lungs. The rise of multidrug resistant M. tuberculosis strains, which are resistant to many of the most effective anti-tuberculosis drugs, is particularly worrying. In other words, novel drugs to treat tuberculosis are urgently needed.
The bacteria that cause tuberculosis need iron to survive. Researchers have now solved the first detailed structure of the transport protein responsible for the iron supply. When the iron transport into the bacteria is inhibited, the pathogen can no longer grow. This opens novel ways to develop targeted tuberculosis drugs.
Depression is a condition that is often co-morbid to tuberculosis and can increase morbidity and mortality associated with tuberculosis. The current prevalence of depression worldwide among individuals receiving treatment for TB ranged from 11.3 to 80.2%, with a mean weighted prevalence of 48.9%.
Madeeha Malik, Rida Nasir, and Azhar Hussain conducted an assessment of the depression among pulmonary tuberculosis patients in Pakistan, which was published on the journal of Nursing.
A descriptive cross-sectional study design was used. All the public and private tertiary healthcare facilities treating TB located in Rawalpindi and Islamabad were included in the study. Patient health questionnaire-9 (PHQ-9) was used to collect data from 382 patients of pulmonary tuberculosis. Non-parametric tests, Mann-Whitney and Kruskal-Wallis, were performed to find out the difference among different variables.
They concluded that majority of patients suffering from tuberculosis suffered from some sort of depression. This depression was more evident at baseline phase of therapy. Patients undergoing directly observed therapy appeared to be more depressed due to increased stigma along with increase in financial burden. Counseling and psychotherapy could play a massive role in combating depression and improving medication adherence in TB patients.
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