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埃塞俄比亚南部盖多地区公立医疗机构结核病患者的抑郁症状发生率及相关因素。

Prevalence of depressive symptoms and associated factors among patients with tuberculosis attending public health institutions in Gede'o zone, South Ethiopia.

机构信息

Department of Psychiatry, College of Medicine and Health Sciences, Dilla University, P.O. Box 419, Dilla, Ethiopia.

School of Public Health, College of Medicine and Health Sciences, Dilla University, Dilla, Ethiopia.

出版信息

BMC Public Health. 2020 Nov 13;20(1):1702. doi: 10.1186/s12889-020-09794-z.

Abstract

BACKGROUND

Depression is a common mental disorder among patients with tuberculosis and it is associated with a greater risk of suicide, multidrug-resistant tuberculosis, and poor quality of life. Evidence suggests the early identification of depression among patients with tuberculosis is important to decrease adverse outcomes. However, there are limited studies that examined the prevalence and determinants of depressive symptoms among patients with tuberculosis. This study aimed to assess the prevalence and associated factors of depressive symptoms among patients with tuberculosis attending public health institutions in Gede'o zone, South Ethiopia.

METHODS

An institution-based a cross-sectional study was conducted from November 1 to December 30, 2018, among a randomly selected sample of 415 patients with tuberculosis attending public health institutions in Gede'o zone, South Ethiopia. Patient Health Questionnaire (PHQ-9) was used to assess depressive symptoms. Logistic regression was used to identify the potential risk factors of depressive symptoms. The strength of the association was presented by crude odds and adjusted odds ratio with their corresponding 95% CI. Finally, the statistical significance was set at p < 0.05.

RESULTS

The prevalence of depressive symptoms was found to be 45.5% (95% CI; 41.1-50.1%) among patients with tuberculosis; 33.3% had moderate, 9.8% had moderately severe, and 2.4% had severe depression. After adjusting for the possible confounders, being on re-treatment for tuberculosis (AOR = 2.47, 95% CI: 1.17-5.22), aged ≥45 years (AOR = 2.41, 95% CI: 1.09-5.32), having poor social support (AOR = 4.21, 95% CI: 2.10-8.47), and Tuberculosis/Human Immunodeficiency Virus (TB/HIV) co-infection) (AOR = 3.96, 95% CI 2.0, 7.84) were significantly associated with depressive symptoms among patients with TB.

CONCLUSIONS

This study suggests that a substantial percentage of patients with TB had depressive symptoms (45.5%). TB/HIV coinfection, being on re-treatment for tuberculosis, those having poor social support, patients aged 45 and above were factors associated with depressive symptoms. Routine screening of depression among patients with TB is warranted. Moreover, patients with TB falling into the risk categories should be more carefully monitored for depression and when possible referred to mental health professionals.

摘要

背景

抑郁症是结核病患者中常见的精神障碍,与自杀、耐多药结核病和生活质量下降的风险增加有关。有证据表明,早期识别结核病患者的抑郁症对于降低不良后果很重要。然而,目前很少有研究检查结核病患者中抑郁症状的患病率和决定因素。本研究旨在评估埃塞俄比亚南部盖多地区公立卫生机构结核病患者中抑郁症状的患病率和相关因素。

方法

这是一项于 2018 年 11 月 1 日至 12 月 30 日在埃塞俄比亚南部盖多地区公立卫生机构随机选择的 415 例结核病患者中进行的基于机构的横断面研究。使用患者健康问卷(PHQ-9)评估抑郁症状。采用 logistic 回归识别抑郁症状的潜在危险因素。关联强度以粗比值比和调整比值比及其相应的 95%CI 表示。最后,将统计学意义设定为 p<0.05。

结果

研究发现,结核病患者中抑郁症状的患病率为 45.5%(95%CI;41.1-50.1%);33.3%为中度,9.8%为中度严重,2.4%为严重抑郁。在调整了可能的混杂因素后,复治结核病(AOR=2.47,95%CI:1.17-5.22)、年龄≥45 岁(AOR=2.41,95%CI:1.09-5.32)、社会支持差(AOR=4.21,95%CI:2.10-8.47)和结核病/人类免疫缺陷病毒(TB/HIV)合并感染(AOR=3.96,95%CI 2.0,7.84)与结核病患者的抑郁症状显著相关。

结论

本研究表明,相当一部分结核病患者(45.5%)存在抑郁症状。TB/HIV 合并感染、复治结核病、社会支持差、年龄 45 岁及以上是与抑郁症状相关的因素。需要对结核病患者进行常规抑郁筛查。此外,应更仔细地监测处于风险类别的结核病患者是否患有抑郁症,并在可能的情况下将其转介给心理健康专业人员。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb14/7666498/bb359e63b1f4/12889_2020_9794_Fig1_HTML.jpg

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