Prevalence of depression among drug-resistant tuberculosis patients in South Asia: A systematic review and meta-analysis.

BACKGROUND

Drug-resistant tuberculosis (DR-TB) significantly increases the risk of depression, yet research on mental health in this population remains limited.

AIM

This meta-analysis aimed to evaluate the prevalence of depression among multidrug-resistant TB (MDR-TB) patients, emphasizing the necessity for integrated mental health care.

METHODS

A systematic search across PubMed, Cochrane, EBSCOhost, and Google Scholar identified 536 articles, which were screened for eligibility after removing duplicates. Prevalence data were analyzed using R programming, with back-transformation applied to enhance accuracy. The methodological quality of the included studies was assessed with the JBI Critical Appraisal Checklist, and the study protocol is registered in PROSPERO (CRD42023449156).

RESULTS

Ultimately, twelve studies involving 3,258 participants were included in the analysis. The pooled prevalence of depression among MDR-TB patients was found to be 54% (95% CI: 42%-65%). Although substantial heterogeneity was noted (I² = 72%; < 0.01), excluding one study (Walker .) due to high Cook's distance revised the prevalence to 55% (95% CI: 43%-68%), with reduced heterogeneity (I² = 68%; P < 0.01). Subgroup analyses indicated minimal variability among studies using the Hamilton Depression Rating Scale (52%, 95% CI: 40%-64%) and substantial variability among those employing the Patient Health Questionnaire (54%, 95% CI: 30%-79%). Funnel plot analysis and Egger's test revealed no significant publication bias ( = 0.2105).

CONCLUSION

This study highlights a high prevalence of depression among MDR-TB patients, underscoring the urgent need for integrated mental health care strategies tailored for this vulnerable population. Further research is essential to refine these strategies effectively.