Multidrug-resistant tuberculosis treatment programmes insufficiently consider comorbid mental disorders

I. F. Walker*, S. C. Baral, X. Wei, R. Huque, A. Khan, J. Walley, J. N. Newell, H. Elsey

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

14 Citations (Scopus)

Abstract

The successful treatment of multidrug-resistant tuberculosis (MDR-TB) is a global health priority and a key pillar of the World Health Organization's (WHO's) End TB strategy. There has been significant global investment in diagnostic capabilities in recent years. However, we argue that the mental distress of those with MDR-TB and their families continues to be overlooked by TB programmes. Priorities in the End TB Strategy of 'patient-centred care' and 'patient support' are still to be delivered in practice in many low-income settings, and in particular consideration of mental distress. Our experience of undertaking MDR-TB operational research in China, Pakistan, Bangladesh, Nepal and Swaziland has given us detailed insight into the challenges facing patients, their families, health professionals and wider health systems. We are increasingly concerned that psychosocial support, and particularly support focused on mental health, is being insufficiently addressed in national MDR-TB programmes. We suggest that the presence of comorbid mental disorders reduces treatment adherence. We recommend the trialling within TB programmes of brief screening tools for common mental disorders and the incorporation of principles from the WHO Mental Health Gap Action Programme programme into TB programme treatment guidance. Our work in Nepal also suggests that brief psychological counselling delivered by non-specialist counsellors may be feasible.

Original languageEnglish
Pages (from-to)603-609
Number of pages7
JournalInternational Journal of Tuberculosis and Lung Disease
Volume21
Issue number6
DOIs
Publication statusPublished - 1 Jun 2017
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2017 The Union.

Keywords

  • Mental health
  • Multidrug-resistant tuberculosis
  • Patient support
  • Treatment adherence

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