Abstract
Background-The relationship between TB/HIV co-infection and common mental disorders (CMD) has been scarcely investigated. In this study, we compared the occurrence of CMD in TB/HIV co-infected and non-co-infected HIV patients in Ethiopia.Methods-We conducted a cross sectional study in three hospitals in Ethiopia from February to April, 2009. The study population consisted of 155 TB/HIV co-infected and 465 non-co-infected HIV patients. CMD was assessed through face to face interviews by trained clinical nurses using the Kessler 10 scale. Several risk factors for CMD were assessed using a structured questionnaire.Results-TB/HIV co-infected patients had significantly (p = 0.001) greater risk of CMD (63.7%) than the non-co-infected patients (46.7%). When adjusted for the effect of potential confounding variables, the odds of having CMD for TB/HIV co-infected individuals was 1.7 times the odds for non-co-infected patients [OR = 1.7, (95%CI: 1.0, 2.9)]. Individuals who had no source of income [OR = 1.7, (95%CI: 1.1, 2.8)], and day labourers [OR = 2.4, 95%CI: 1.2, 5.1)] were more likely to have CMD as compared to individuals who had a source of income and government employees respectively. Patients who perceived stigma [OR = 2.2, 95%CI: 1.5, 3.2)] and who rate their general health as "poor" [OR = 10.0, 95%CI: 2.8, 35.1)] had significantly greater risk of CMD than individual who did not perceive stigma or who perceived their general health to be "good".Conclusion-TB/HIV control programs should develop guidelines to screen and treat CMD among TB/HIV co-infected patients. Screening programs should focus on individuals with no source of income, jobless people and day labourers.
Highlights
The relationship between TB/HIV co-infection and common mental disorders (CMD) has been scarcely investigated
The recent Lancet series on global mental health highlighted the lack of research on the interactions between mental disorders and communicable diseases such as tuberculosis (TB) and HIV/AIDS in low income settings [4]
All of the 465 non-co-infected HIV patients and 124 (80%) of the co-infected HIV patients participated in the study; 31 TB/HIV co-infected patients were lost to follow up before interview
Summary
The relationship between TB/HIV co-infection and common mental disorders (CMD) has been scarcely investigated. In low and middle income countries (LAMIC), neuropsychiatric disorders such as depression, anxiety and somatoform disorders account for 9.8% of the global burden of diseases[2]. The recent Lancet series on global mental health highlighted the lack of research on the interactions between mental disorders and communicable diseases such as tuberculosis (TB) and HIV/AIDS in low income settings [4]. A high rate of depressive disorders has been reported among patients with HIV in high income countries. Bing and colleagues [7] reported that the 12-month prevalence of major depression was 36% in HIV infected adults compared to 7.6% in the general population in the United States. Some studies in LAMIC (Kenya, Democratic Republic of Congo and Thailand) revealed that the rate of depression was higher in HIV seropositive patients than in HIV negative individuals [8]
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