Are trajectories of depressive symptoms during the first half of drug-sensitive pulmonary tuberculosis treatment associated with loss to follow-up? A secondary analysis of longitudinal data

BMJ Open. 2023 Jul 19;13(7):e068235. doi: 10.1136/bmjopen-2022-068235.

Abstract

Objective: The objective of this study was to identify trajectories of depressive symptoms (DSs) during the first half of drug-sensitive pulmonary tuberculosis (PTB) treatment and examine their association with loss to follow-up (LTFU) in the second half.

Design: This study involved a secondary analysis of longitudinal data to identify potential trajectories of DS and their relationship with LTFU.

Setting: The study was conducted in first and second-level health centres located in San Juan de Lurigancho, Lima, Peru.

Participants: Anonymised data from 265 individuals, including monthly measures of DSs from diagnosis to the completion of treatment, initiation of treatment for multidrug resistant TB, LTFU or death, were collected.

Results: Three trajectories were identified: 'declining', 'growth' and 'high'. These trajectories were observed in 182 (68.7%), 53 (20%) and 30 (11.3%) of the 265 individuals, respectively, during the first half of PTB treatment. Compared with those with a 'declining' trajectory, individuals with a 'growth' trajectory had a higher likelihood of experiencing LTFU during the second half of PTB treatment, after controlling for sociodemographic factors and at least weekly alcohol use (OR 3.9; 95% CI 1.09 to 13.97, p=0.036).

Conclusions: The findings suggest that a trajectory of increasing DSs during the first half of PTB treatment is associated with a higher risk of LTFU during the second half.

Keywords: depression & mood disorders; epidemiology; tuberculosis.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Depression* / drug therapy
  • Depression* / epidemiology
  • Follow-Up Studies
  • Humans
  • Peru / epidemiology
  • Probability
  • Risk Factors
  • Tuberculosis, Pulmonary* / drug therapy
  • Tuberculosis, Pulmonary* / epidemiology