prevalence of psychological distress and associated factors in tuberculosis patients in public primary care clinics in south africa肺结核患者普遍存在的心理压力和相关因素在南非公共初级保健诊所.pdfVIP

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prevalence of psychological distress and associated factors in tuberculosis patients in public primary care clinics in south africa肺结核患者普遍存在的心理压力和相关因素在南非公共初级保健诊所.pdf

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prevalence of psychological distress and associated factors in tuberculosis patients in public primary care clinics in south africa肺结核患者普遍存在的心理压力和相关因素在南非公共初级保健诊所

Peltzer et al. BMC Psychiatry 2012, 12:89 /1471-244X/12/89 RESEARCH ARTICLE Open Access Prevalence of psychological distress and associated factors in tuberculosis patients in public primary care clinics in South Africa 1,2* 1,3 1 1 1 1 Karl Peltzer , Pamela Naidoo , Gladys Matseke , Julia Louw , Gugu Mchunu and Bomkazi Tutshana Abstract Background: Psychological distress has been rarely investigated among tuberculosis patients in low-resource settings despite the fact that mental ill health has far-reaching consequences for the health outcome of tuberculosis (TB) patients. In this study, we assessed the prevalence and predictors of psychological distress as a proxy for common mental disorders among tuberculosis (TB) patients in South Africa, where over 60 % of the TB patients are co-infected with HIV. Methods: We interviewed 4900 tuberculosis public primary care patients within one month of initiation of anti-tuberculosis treatment for the presence of psychological distress using the Kessler-10 item scale (K-10), and identified predictors of distress using multiple logistic regressions. The Kessler scale contains items associated with anxiety and depression. Data on socio-demographic variables, health status, alcohol and tobacco use and adherence to anti-TB drugs and anti-retroviral therapy (ART) were collected using a structured questionnaire. Results: Using a cut off score of ≥28 and ≥16 on the K-10, 32.9 % and 81 % of tuberculosis patients had symptoms of distress, respectively. In multivariable analysis older age (OR = 1.52; 95 % CI = 1.24-1.85), lower formal education (OR = 0.77; 95 % CI = 0.65-0.91), poverty (OR = 1.90; 95 % CI = 1.57-2.31) and not married, separated,