Psychological distress among TB patients in sub-Saharan Africa

OBJECTIVE: To summarise the available evidence on the prevalence of psychological distress among patients with TB in sub-Saharan Africa, and suggest recommendations for future clinical practice. METHODS: We searched PubMed/Medline, SCOPUS and EMBASE databases for relevant studies. We further searched the reference lists of included studies to include other relevant studies. Cochran´s Q-statistic and the I ² test were used to compute the heterogeneity. The presence of publication bias was assessed by visual inspection of symmetry and Egger´s test. RESULTS: The pooled prevalence estimate of psychological distress among patients with TB in sub-Saharan African countries was 42.3% (95% CI 35.3-49.7). The pooled prevalence of psychological distress was 61.1% in Cameroon, 49.4% in Angola, 47.7% in Ethiopia, 34.0% in Nigeria and 29.3% in South Africa. The pooled prevalence estimate of psychological distress among patients with TB ranged from 40.1% to 43.7% in a leave-one-out-sensitivity analysis. Furthermore, the prevalence of psychological distress was higher in females when compared to males. CONCLUSION: The prevalence of psychological distress among TB patients was high. Therefore, TB programmes should integrate psychiatry services to screen and manage psychologically distressed patients.