High depression rates among drug‑susceptible TB patients in Ogbomoso

Tuberculosis (TB), caused by Mycobacterium tuberculosis, remains a major public health problem despite progress in treatment and control. Previous studies have shown that depression is common in people with TB and that its prevalence can relate to the severity and duration of the infection. Motivated by the need to improve treatment outcomes and reduce the illness and deaths associated with TB, Sunday Olakunle Olarewaju and colleagues undertook a study to measure how common depression is among people being treated for drug‑susceptible tuberculosis in Ogbomoso, Oyo State. The research was a cross‑sectional hospital‑based survey designed to capture a snapshot of patients at the time of enrolment. The stated aim was straightforward: document the prevalence and pattern of depression in this group so that addressing mental health could become part of efforts to lower TB-related morbidity and mortality. The study focused only on drug‑susceptible TB patients and set out to identify which patient characteristics were linked with higher or lower chances of being depressed.

The study calculated a sample size of 333 respondents using Leslie Fischer’s formula (n= z 2 pq /d 2 ) and selected participants with a multistage sampling technique. Data were collected with a pre‑tested semi‑structured questionnaire and analysed using Statistical Package for Social Sciences (SPSS) version 20. Descriptive analyses were reported for all variables and associations were tested with bivariate and multivariate methods using chi-square and binomial regression respectively, with significance set at P < 0.05. The main finding was that more than half of respondents, 186 (55.9%), were depressed. Among those identified as depressed, 122 (65.5%) had mild depression, 46 (24.7%) had moderate depression, and 18 (9.7%) had moderately severe depression. At the bivariate level, sex, marital status, level of education and average monthly income were significantly associated with depression status. In multivariate analysis, respondents with no formal education were reported as 6 times less likely to develop depression (AOR = 0.175, P = 0.001), those with Primary level of education were 2 times less likely (AOR = 0.427, P = 0.023), and those with Secondary level of education were 3 times less likely compared to Tertiary education. Respondents living with HIV were 35 times more likely to develop depression (AOR = 35.303, P = 0.017) compared to those who were HIV negative.

These results underline a heavy burden of depressive symptoms among people starting care for drug‑susceptible TB in this setting and point to important links with social and clinical factors. The high overall prevalence—55.9%—and the finding that a substantial share of patients had at least mild depression suggest that mental health is a common co‑condition that could interfere with TB treatment and recovery. The very large association between living with HIV and depression highlights a subgroup that may need prioritized attention. The unexpected pattern seen with education—where lower formal education was associated with lower reported depression compared with tertiary education—was identified in the study and will need careful interpretation and follow‑up research. Overall, Sunday Olakunle Olarewaju and colleagues’ work suggests that integrating mental health screening and support into TB care, and paying particular attention to people with HIV, could be important steps toward improving outcomes and reducing morbidity and mortality among TB patients.