Gupta Amanda J, Turimumahoro Patricia, Rosman Lori, Golub Jonathan E, Dowdy David W
Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America.
Johns Hopkins Bloomberg School of Public Health, Maryland, United States of America.
PLoS One. 2025 Jul 21;20(7):e0322753. doi: 10.1371/journal.pone.0322753. eCollection 2025.
Tuberculosis (TB) and depression frequently co-occur, yet research has largely focused on prevalence rather than diagnostic or treatment methodologies. Given overlapping symptoms, robust research approaches are critical for improving detection and treatment strategies in persons with TB (PWTB). This protocol defines a scoping review that aims to map methodologies used to study depression in individuals with TB, identifying gaps in research design, diagnosis, and treatment that may hinder clinical and public health advancements. A search was conducted in MEDLINE, Embase, PsycINFO, Global Health, Cochrane Library, and Africa-Wide Information using controlled vocabulary related to TB and depression. Studies examining the TB-depression relationship will be included. We will use Covidence to facilitate screening, selection, and data extraction. We will extract data on study design, diagnostic tools, treatment interventions, and analytical approaches. Descriptive characteristics of included studies will be presented using figures and tables. Using the Reach-Effectiveness-Adoption-Implementation-Maintenance (RE-AIM) framework, we will evaluate reach by assessing the extent to which studies explore both directions of the TB-depression relationship and include diverse, high-risk populations. Effectiveness will be examined by categorizing study designs to assess methodological diversity and evaluating the diagnostic tools and treatment interventions used, along with their reported efficacy. Adoption will be analyzed by identifying where and by whom depression diagnosis and treatment methodologies have been implemented and whether research findings have influenced clinical guidelines or public health policies. Implementation will be assessed by identifying barriers and facilitators reported in qualitative studies or by researchers regarding the integration of depression care into TB treatment settings. Finally, maintenance will be determined by examining whether diagnostic and treatment methodologies were sustained within health systems, including long-term patient outcomes and the persistence of interventions beyond the research phase. By mapping existing methodologies and identifying research gaps, this review will provide valuable insights to guide future research study designs and improve diagnostic and treatment strategies for depression in PWTB.
结核病（TB）与抑郁症常常同时出现，但研究主要集中在患病率上，而非诊断或治疗方法。鉴于症状重叠，强有力的研究方法对于改善结核病患者（PWTB）的检测和治疗策略至关重要。本方案定义了一项范围综述，旨在梳理用于研究结核病患者抑郁症的方法，识别可能阻碍临床和公共卫生进展的研究设计、诊断和治疗方面的差距。使用与结核病和抑郁症相关的受控词汇在MEDLINE、Embase、PsycINFO、全球卫生、Cochrane图书馆和非洲范围信息库中进行了检索。将纳入研究结核病与抑郁症关系的研究。我们将使用Covidence来促进筛选、选择和数据提取。我们将提取有关研究设计、诊断工具、治疗干预措施和分析方法的数据。将使用图表展示纳入研究的描述性特征。使用“普及-效果-采用-实施-维持”（RE-AIM）框架，我们将通过评估研究探索结核病与抑郁症关系的两个方向以及纳入不同高危人群的程度来评估普及情况。将通过对研究设计进行分类以评估方法多样性，并评估所使用的诊断工具和治疗干预措施及其报告的疗效来检验效果。将通过确定抑郁症诊断和治疗方法在何处以及由谁实施，以及研究结果是否影响了临床指南或公共卫生政策来分析采用情况。将通过识别定性研究或研究人员报告的关于将抑郁症护理纳入结核病治疗环境的障碍和促进因素来评估实施情况。最后，将通过检查诊断和治疗方法在卫生系统内是否得以维持来确定维持情况，包括长期患者结局以及干预措施在研究阶段之后的持续性。通过梳理现有方法并识别研究差距，本综述将提供有价值的见解，以指导未来的研究设计，并改善结核病患者抑郁症的诊断和治疗策略。
