Effectiveness of Cognitive Behavioral Therapy on Multi-drug Resistant Tuberculosis Patients in Mongolia: 10 years experiences

Objective: During multidrug-resistant tuberculosis (MDR-TB) treatment, patients face de­pression and anxiety. This study aims to evaluate the effects of cognitive behavioral therapy (CBT) on the psychological status and risk of loss to follow-up (LTFU) during MDR-TB treat­ment in Mongolia. Method: Eligible participants were randomly assigned to intervention and control groups. Intervention group participants underwent CBT, while control group par­ticipants received standard patient education. Psychological status was assessed before and after CBT. MDR-TB treatment outcomes were evaluated as internationally defined. Results: The study included a total of 83 patients. After CBT, depression and anxiety levels decreased by 12% and 16%, respectively, in the intervention group, whereas the control group showed a 4% decrease in depression and an 8.5% increase in anxiety levels. MDR-TB treatment outcomes revealed an 8% higher treatment success rate and a fivefold reduction in LTFU rate in the intervention group compared to the control group. In multivariable logistic regression, risk factors associated with increased LTFU were living alone (OR 12.7, p=0.031) and not being provided CBT (OR 16.1, p=0.040). Conclusion: Our study suggests that CBT not only alleviates these psychological challenges but also diminishes the risk of LTFU during treat­ment, leading to improved MDR-TB treatment success.