Psychological distress and its relationship with non-adherence to TB treatment: a multicentre study

dc.contributor.authorTheron, Granten_ZA
dc.contributor.authorPeter, Jonnyen_ZA
dc.contributor.authorZijenah, Lynnen_ZA
dc.contributor.authorChanda, Duncanen_ZA
dc.contributor.authorMangu, Chachaen_ZA
dc.contributor.authorClowes, Petraen_ZA
dc.contributor.authorRachow, Andreaen_ZA
dc.contributor.authorLesosky, Maiaen_ZA
dc.contributor.authorHoelscher, Michaelen_ZA
dc.contributor.authorPym, Alexen_ZA
dc.contributor.authorMwaba, Peteren_ZA
dc.contributor.authorMason, Peteren_ZA
dc.contributor.authorNaidoo, Pamelaen_ZA
dc.contributor.authorPooran, Anilen_ZA
dc.contributor.authorSohn, Hojoonen_ZA
dc.contributor.authorPai, Madhukaren_ZA
dc.contributor.authorStein, Danen_ZA
dc.date.accessioned2015-11-04T11:48:03Z
dc.date.available2015-11-04T11:48:03Z
dc.date.issued2015en_ZA
dc.description.abstractBACKGROUND:The successful cure of tuberculosis (TB) is dependent on adherence to treatment. Various factors influence adherence, however, few are easily modifiable. There are limited data regarding correlates of psychological distress and their association with non-adherenceto anti-TB treatment. METHODS: In a trial of a new TB test, we measured psychological distress (K-10 score), TB-related health literacy, and morbidity (TBscore), prior to diagnosis in 1502 patients with symptoms of pulmonary TB recruited from clinics in Cape Town (n = 419), Harare (n = 400), Lusaka (n = 400), Durban (n = 200), and Mbeya (n = 83). Socioeconomic, demographic, and alcohol usage-related data were captured. Patients initiated on treatment had their DOTS cards reviewed at two-and six-months. RESULTS: 22 %(95 % CI: 20 %, 25 %) of patients had severe psychological distress (K-10 [greater than or equal to] 30). In a multivariable linear regression model, increased K-10 scorewas independently associated with previous TB [estimate (95 % CI) 0.98(0.09-1.87); p = 0.0304], increased TBscore [1(0.80, 1.20); p <0.0001], and heavy alcohol use [3.08(1.26, 4.91); p = 0.0010], whereas male gender was protective [-1.47(2.28, 0.62); p = 0.0007]. 26 % (95 % CI: 21 %, 32 %) of 261 patients with culture-confirmed TB were non-adherent. In a multivariable logistic regression modelfor non-adherence, reduced TBscore [OR (95 % CI) 0.639 (0.497, 0.797); p = 0.0001], health literacy score [0.798(0.696, 0.906); p = 0.0008], and increased K-10 [1.082(1.033, 1.137); p = 0.0012], and heavy alcohol usage [14.83(2.083, 122.9); p = 0.0002], were independently associated. Culture-positive patients with aK-10 score[greater than or equal to] 30 were more-likely to be non-adherent (OR = 2.290(1.033-5.126); p = 0.0416]. CONCLUSION: Severe psychological distress is frequent amongst TB patients in Southern Africa. Targeted interventions to alleviate psychological distress, alcohol use, and improve health literacy in newly-diagnosed TB patients could reduce non-adherenceto treatment.en_ZA
dc.identifier.apacitationTheron, G., Peter, J., Zijenah, L., Chanda, D., Mangu, C., Clowes, P., ... Stein, D. (2015). Psychological distress and its relationship with non-adherence to TB treatment: a multicentre study. <i>BMC Infectious Diseases</i>, http://hdl.handle.net/11427/14666en_ZA
dc.identifier.chicagocitationTheron, Grant, Jonny Peter, Lynn Zijenah, Duncan Chanda, Chacha Mangu, Petra Clowes, Andrea Rachow, et al "Psychological distress and its relationship with non-adherence to TB treatment: a multicentre study." <i>BMC Infectious Diseases</i> (2015) http://hdl.handle.net/11427/14666en_ZA
dc.identifier.citationTheron, G., Peter, J., Zijenah, L., Chanda, D., Mangu, C., Clowes, P., ... & Dheda, K. (2015). Psychological distress and its relationship with non-adherence to TB treatment: a multicentre study. BMC infectious diseases, 15(1), 253.en_ZA
dc.identifier.ris TY - Journal Article AU - Theron, Grant AU - Peter, Jonny AU - Zijenah, Lynn AU - Chanda, Duncan AU - Mangu, Chacha AU - Clowes, Petra AU - Rachow, Andrea AU - Lesosky, Maia AU - Hoelscher, Michael AU - Pym, Alex AU - Mwaba, Peter AU - Mason, Peter AU - Naidoo, Pamela AU - Pooran, Anil AU - Sohn, Hojoon AU - Pai, Madhukar AU - Stein, Dan AB - BACKGROUND:The successful cure of tuberculosis (TB) is dependent on adherence to treatment. Various factors influence adherence, however, few are easily modifiable. There are limited data regarding correlates of psychological distress and their association with non-adherenceto anti-TB treatment. METHODS: In a trial of a new TB test, we measured psychological distress (K-10 score), TB-related health literacy, and morbidity (TBscore), prior to diagnosis in 1502 patients with symptoms of pulmonary TB recruited from clinics in Cape Town (n = 419), Harare (n = 400), Lusaka (n = 400), Durban (n = 200), and Mbeya (n = 83). Socioeconomic, demographic, and alcohol usage-related data were captured. Patients initiated on treatment had their DOTS cards reviewed at two-and six-months. RESULTS: 22 %(95 % CI: 20 %, 25 %) of patients had severe psychological distress (K-10 [greater than or equal to] 30). In a multivariable linear regression model, increased K-10 scorewas independently associated with previous TB [estimate (95 % CI) 0.98(0.09-1.87); p = 0.0304], increased TBscore [1(0.80, 1.20); p <0.0001], and heavy alcohol use [3.08(1.26, 4.91); p = 0.0010], whereas male gender was protective [-1.47(2.28, 0.62); p = 0.0007]. 26 % (95 % CI: 21 %, 32 %) of 261 patients with culture-confirmed TB were non-adherent. In a multivariable logistic regression modelfor non-adherence, reduced TBscore [OR (95 % CI) 0.639 (0.497, 0.797); p = 0.0001], health literacy score [0.798(0.696, 0.906); p = 0.0008], and increased K-10 [1.082(1.033, 1.137); p = 0.0012], and heavy alcohol usage [14.83(2.083, 122.9); p = 0.0002], were independently associated. Culture-positive patients with aK-10 score[greater than or equal to] 30 were more-likely to be non-adherent (OR = 2.290(1.033-5.126); p = 0.0416]. CONCLUSION: Severe psychological distress is frequent amongst TB patients in Southern Africa. Targeted interventions to alleviate psychological distress, alcohol use, and improve health literacy in newly-diagnosed TB patients could reduce non-adherenceto treatment. DA - 2015 DB - OpenUCT DO - 10.1186/s12879-015-0964-2 DP - University of Cape Town J1 - BMC Infectious Diseases LK - https://open.uct.ac.za PB - University of Cape Town PY - 2015 T1 - Psychological distress and its relationship with non-adherence to TB treatment: a multicentre study TI - Psychological distress and its relationship with non-adherence to TB treatment: a multicentre study UR - http://hdl.handle.net/11427/14666 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/14666
dc.identifier.urihttp://dx.doi.org/10.1186/s12879-015-0964-2
dc.identifier.vancouvercitationTheron G, Peter J, Zijenah L, Chanda D, Mangu C, Clowes P, et al. Psychological distress and its relationship with non-adherence to TB treatment: a multicentre study. BMC Infectious Diseases. 2015; http://hdl.handle.net/11427/14666.en_ZA
dc.language.isoengen_ZA
dc.publisherBiomed Central Ltden_ZA
dc.publisher.departmentDivision of Pulmonologyen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution Licenseen_ZA
dc.rights.holder2015 Theron et al.en_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourceBMC Infectious Diseasesen_ZA
dc.source.urihttp://www.biomedcentral.com/bmcinfectdis/en_ZA
dc.subject.otherTuberculosisen_ZA
dc.subject.otherPsychological distressen_ZA
dc.subject.otherSocioeconomic statusen_ZA
dc.subject.otherTreatment non-adherenceen_ZA
dc.titlePsychological distress and its relationship with non-adherence to TB treatment: a multicentre studyen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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