Psychological distress and its effect on tuberculosis treatment outcomes in Ethiopia

Figures & data

Fig. 1 Magnitude of psychological distress at 1–2 and 6 months after treatment initiation.

Table 1 Distribution of psychological distress across participant characteristics at baseline

		Psychological distress symptoms at 2 months (N=330)
Variable		No symptoms N (%)	Symptoms exist N (%)
Gender	Male	62 (32.5)	129 (67.5)
	Female	45 (32.4)	94 (67.6)
Age group (in years)	<35	84 (36.2)	148 (63.8)
	≥35	23 (23.7)	74 (76.3)
Smoking history	Smoker	4 (14.3)	24 (85.7)
	Nonsmoker	103 (34.1)	199 (65.9)
TB treatment history	First time treated	98 (38.1)	159 (61.9)
	Previously treated	9 (12.3)	64 (87.7)
HIV status	Nonreactive	103 (35.6)	186 (64.4)
	Reactive	4 (9.8)	37 (90.2)
Marital status	Married	59 (49.6)	60 (50.4)
	Unmarried	48 (22.7)	163 (77.3)
ART status	Not on ART	102 (36.7)	176 (63.3)
	On ART	5 (9.6)	47 (90.4)
Education status	High school or less	92 (32.6)	190 (67.4)
	Diploma or above	15 (31.2)	33 (68.8)
TB type	PTB	53 (28.2)	135 (71.8)
	MDR-TB	16 (30.2)	37 (69.8)
	EPTB	38 (42.7)	51 (57.3)
Employment status	Daily labor	11 (40.7)	16 (59.3)
	Unemployed	44 (28.8)	109 (71.2)
	Employed	52 (34.7)	98 (65.3)
Alcohol use disorder risk	No risk	99 (36.9)	169 (63.1)
	Risk exists	8 (12.9)	54 (87.1)
Economic status	Low	57 (23.5)	186 (76.5)
	High	50 (57.5)	37 (42.5)

TB, tuberculosis; ART, antiretroviral therapy; PTB, pulmonary TB; MDR-TB, multidrug-resistant tuberculosis; EPTB, extra pulmonary TB.

Table 2 Predictors of psychological distress at baseline and 6 months (K-10>16)

		At enrollment (N=330)		At 6 months (N=298)
Variable		Crude OR (95% CI)	Adjusted OR (95% CI)	Crude OR (95% CI)	Adjusted OR (95% CI)
Gender	Female	1.00		1.00
	Male	1.00 (0.62–1.59)		1.44 (0.85–2.44)	1.32 (0.77–2.26)
Age group	<35 years	1.00		1.00
	≥35 years	1.83 (1.07–3.13)*	1.35 (0.76–2.39)	2.24 (1.16–4.33)*	1.81 (0.89–3.82)
Smoking history	Nonsmoker	1.00		1.00
	Smoker	3.11 (1.05–9.19)*	1.37 (0.39–4.86)	8.35 (1.11–62.97)*	4.04 (0.49–33.10)
TB treatment history	First time treated	1.00		1.00
	Previously treated	4.33 (2.09–9.20)*	3.76 (1.67–8.45)*	2.18 (1.05–4.54)*	1.56 (0.73–3.36)
HIV status	Nonreactive	1.00		1.00
	Reactive	5.12 (1.78–14.78)*	2.01 (0.71–6.92)	2.81 (0.96–8.25)	1.76 (0.34–8.99)
ART status	Not on ART	1.00		1.00
	On ART	5.45 (2.10–14.14)*	5.35 (1.83–15.65)*	3.00 (1.14–7.91)*	1.47 (0.33–6.51)
Marital status	Married	1.00		1.00
	Unmarried	3.34 (2.06–5.41)*	4.29 (2.45–7.53)*	1.28 (0.74–219)
Education status	Diploma or above	1.00
	High school or less	0.94 (0.49–1.82)		0.94 (0.44–2.01)
TB type	Drug suspect TB	1.00		1.00
	MDR-TB	1.13 (0.60–2.14)		2.77 (1.13–6.80)*	3.02 (1.17–7.75)*
Employment status	Employed	1.00		1.00
	Unemployed	1.21 (0.76–1.92)		1.24 (0.73–2.10)	1.04 (0.59–1.83)
AUD symptoms	No symptoms	1.00		1.00
	Symptoms exist	3.95 (1.81–8.65)*	2.95 (1.25–6.99)*	3.57 (1.36–9.35)*	2.17 (0.78–6.03)
Economic status	High	1.00		1.00
	Low	4.41 (2.63–7.41)*	4.41 (2.44–7.97)*	3.88 (2.21–6.80)*	3.75 (2.08–6.74)*

*Statistically significant. K-10, the 10-item Kessler scale; OR, odds ratio; CI, confidence interval; AUD, alcohol use disorder; ART: antiretroviral therapy.

Table 3 Predictors of TB treatment success

Variable		Crude OR (95% CI)	Adjusted OR (95% CI)
Gender	Female	1.00
	Male	1.30 (0.79–2.13)
Age group (in years)	<35	1.00
	≥35	1.29 (0.77–2.16)
Smoking history	Nonsmoker	1.00
	Smoker	1.45 (0.65–3.31)
TB treatment history	First time treated	1.00
	Previously treated	2.15 (1.24–3.71)*	2.13 (1.10–4.12)*
HIV status	Nonreactive	1.00
	Reactive	2.00 (1.01–3.90)*	2.10 (0.90–4.89)
Marital status	Married	1.00
	Unmarried	1.26 (0.76–2.10)
ART status	Not on ART	1.00
	On ART	1.59 (0.85–2.96)
Education status	High school or less	1.00
	Diploma or above	1.19 (0.61–2.31)
Employment status	Employed	1.00
	Unemployed	2.30 (1.39–3.82)*	2.06 (1.06–7.00)*
Alcohol use disorder symptoms	No risk	1.00
	Risk exists	1.82 (1.02–3.25)*	1.25 (0.59–2.65)
Economic status	High	1.00
	Low	1.13 (0.65–1.95)
Psychological distress at 1–2 months after treatment initiation	No symptoms	1.00
	Symptoms exist	1.25 (0.74–2.10)
Psychological distress at 6 months after treatment initiation	No symptoms	1.00
	Symptoms exist	4.82 (1.85–12.54)*	2.87 (1.05–7.81)*

TB, tuberculosis; OR, odds ratio; CI, confidence interval; ART: antiretroviral therapy; *significant variables.