Prevalence and Determinant of Depression among Multi-Drug Resistance Tuberculosis: Study in Dr. Kariadi General Hospital

Mahalul Azam, Arulita Ika Fibriana, Fitri Indrawati, Indah Septiani


Backgrouds: Multi-drug resistance tuberculosis (MDR-TB) adds the burden of tuberculosis (TB). Depression is a common comorbidity in TB patients. Prevalence of depression among MDR-TB patients was higher, i.e. 11-70%. Prevalence of depression among TB patients in Dr. Kariadi General Hospital was 51.9%. Previous study reported the determinants related to the depression in MDR-TB patients. This study explored the prevalence of depression in MDR-TB patients and its determinants.
Methods: This study was a cross-sectional study conducted from July-August 2019. Data consisted of primary and secondary data from Dr. Kariadi General Hospital patients. Sample in this study involved 72 respondents, over 16 years old from 151 registered MDR-TB patients. Depression status was determined using Depression Anxiety Stress Scales obtained from the medical record. Subjects’ characteristics and determinants were collected from primary as well as secondary data. Descriptive data were presented in proportion. Chi-square test continued by Binary logistic regression was performed to determine the association between depression status and its determinants. A P-value <0.05 considered as statistically significant.
Results: Of 72 MDR-TB patients, 26.4% had depression status. Underweight (AOR=8.24; 95% CI=1.731-39.197), female patients (AOR=7.61; 95% CI=1.797-32.213), presence of comorbidities (AOR=7.62; 95% CI=1,748-33,204) and patient’s perception of stigma in the community (AOR=5.08; 95% CI=1.238-20.826) were significantly related to the incidence of depression in MDR-TB patients.
Conclusions: Prevalence of depression among MDR-TB patients was 26.4%. Underweight, female patient, comorbidity and the patient's perception of stigma were related to depression status. (J Respir Indo. 2020; 40(2): 88-96)


depression; multi-drug-resistance; tuberculosis; cross-sectional

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WHO. Global tuberculosis report 2017. Switzerland; 2017.

WHO. Towards universal access to diagnosis and treatment of multidrug-resistant and extensively drug-resistant tuberculosis by 2015. 2011.

Duko B, Gebeyehu A, Ayano G. Prevalence and correlates of depression and anxiety among patients with tuberculosis at WolaitaSodo University Hospital and Sodo Health Center, WolaitaSodo, South Ethiopia, Cross sectional study. BMC Psychiatry. 2015;15:214.

Pachi A, Bratis D, Moussas G, Tselebis A. Psychiatric morbidity and other factors affecting treatment adherence in pulmonary tuberculosis patients. Tuberc Res Treat. 2013;1–37.

Marcus M, Taghi Yasami M, van Ommeren M, Chisholm D SS. Depression, a global public health concern. WHO Dep Ment Heal Subst Abus. 2012;1–8.

Kumar K, Kumar A, Chandra P, Kansal H. A study of prevalence of depression and anxiety in patients suffering from tuberculosis. J Fam Med Prim Care. 2016;5(1):150.

Tomita A, Ramlall S, Naidu T, Mthembu SS, PadayatchiNesri. Major depression and household food insecurity among individuals with multidrug-resistant tuberculosis (MDR-TB) in South Africa. Soc Psychiatry Psychiatr Epidemiol. 2019;

Walker IF, Khan AM, Khan AM, Khan NM, Ayub RM, Ghias KN, et al. Depression among multidrug-resistant tuberculosis patients in Punjab, Pakistan: a large cross-sectional study. Int J Tuberc Lung Dis. 2018;22(7):773–8.

Javaid A, Mehreen S, Khan MA, Ashiq N, Ihtesham M, Khan A, et al. Depression and its associated factors with multidrug-resistant tuberculosis at baseline. J Depress Anxiety. 2017;6(1):1–6.

Marselia R, Wilson, Pratiwi SE. Hubungan antara Lama Terapi terhadap Tingkat Gejala Depresi pada Pasien TB Paru di Unit pengobatan Penyakit Paru-Paru Pontianak. J Cerebellum. 2017;3:3.

Laxmeshwar C, Stewart AG, Dalal A, Kumar AM V., Kalaiselvi S. Beyond ‘cure’ and ‘treatment success’: quality of life of patients with multidrug-resistant tuberculosis. Int J Tuberc Lung Dis. 2019;23(1):73–81.

Mizarti D, Herman D, Sabri YS, Yanis A. Hubungan kejadian ansietas dan depresi dengan kualitas hidup pada pasien penyakit paru obstruktif kronis. J Respir Indo. 2019;39(2).

Katon WJ. Epidemiology and treatment of depression in patients with chronic medical illness. Dialogues Clin Neurosci. 2011;13:1:7–23.

Das M, Isaakidis P, Van Den Bergh R, Kumar AMV, Nagaraja SB, Valikayath A, et al. HIV, multidrug-resistant TB and depressive symptoms: When three conditions collide. Glob Health Action. 2014;7(1):1–5.

Nahda ND, Kholis FN, Wardani ND, Hardian. Faktor – faktor yang berpengaruh terhadap kejadian kejadian depresi pada pasien tuberkulosis di RSUP Dr. Kariadi SEMARANG. J Kedokt Diponegoro. 2017;6(4):1529–42.

Lovibond SH, Lovibond PS. Manual for the Depression Anxiety Stress Scale. The Psychological Foundation of Australia, Inc.; 1995.

Basha E, Kaya M. Depression , anxiety and stress scale ( DASS ): The study of validity and reliability. Univers J Educ Res. 2016;4(12):2701–5.

Masumoto S, Yamamoto T, Ohkado A, Yoshimatsu S, Querri AG, Kamiya Y. Prevalence and associated factors of depressive state among pulmonary tuberculosis patients in Manila , The Philippines. Int J Tuberc Lung Dis. 2014;18(2):174–9.

Kehbila J, Ekabe CJ, Aminde LN, Noubiap JJN, Fon PN. Prevalence and correlates of depressive symptoms in adult patients with pulmonary tuberculosis in the Southwest Region of Cameroon. Infect Dis Poverty. 2016;5(51):1–8.

Sulehri MA, Dogar IA, Sohail H, Mehdi Z, Azam M, Niaz O, et al. Prevalence of Depression Among Tuberculosis Patients. APMC. 2010;4:133–7.

Sassarini Dr.Jenifer. Depression in midlife women. Maturitas. 2016;

Pesa JA, Syre TR, Jones E. Psychosocial differences associated with body weight among female adolescents : the importance of body mmage. J Adolesc Heal. 2000;26(8):330–7.

Legey S, Lamego MK, Lattari E, Campos C, Paes F, Sancassiani F, et al. Relationship among body image , anthropometric parameters and mental health in physical education students. 2016;177–87.

Ambaw F, Mayston R, Hanlon C, Alem A. Depression among patients with tuberculosis: determinants, course and impact on pathways to care and treatment outcomes in a primary care setting in southern Ethiopia—a study protocol. BMJ Open [Internet]. 2015;5(e007653):1–11. Available from:

Jung SJ, Woo H, Cho S, Park K, Jeong S. Association between body size , weight change and depression : systematic review and meta-analysis. Br J Psychiatry. 2017;14–21.

Manu P, Dima L, Shulman M, Vancampfort D, M DH. Weight gain and obesity in schizophrenia : epidemiology , pathobiology , and management. Acta Psychiatr Scand. 2015;97–108.

Gordis L. Epidemiology. 5th Editio. Elsevier Health Sciences; 2013.

Gong Y, Yan S, Qiu L, Zhang S, Lu Z, Tong Y, et al. Prevalence of depressive symptoms and related risk factors among patients with tuberculosis in China : a multistage cross-sectional study. Am Soc Trop Med Hyg Preval. 2018;98(6):1624–8.

Peltzer K, Naidoo P, Matseke G, Louw J, Mchunu G, Tutshana B. Prevalence of psychological distress and associated factors in tuberculosis patients in public primary care clinics in South Africa. BMC Psychiatry. 2012;12(89).

Wang X, Li X, Zhang Q, Zhang J, Chen H, Zhang J. A Survey of anxiety and depressive symptoms in pulmonary tuberculosis patients with and without tracheobronchial tuberculosis. Front Psychiatr. 2018;9(July):1–10.

Sunderland M, Slade T, Stewart G, Andrews G. Estimating the prevalence of DSM-IV mental illness in the Australian general population using the Kessler Psychological Distress Scale. Aust N Z J Psychiatry. 2011;45:80–9.

Lee E. Prevalence of depression among active tb and tb / hiv patients in Kisumu County. 2015;

Sweetland AC, Kritski A, Oquendo MA, Sublette ME, Pala AN, Silva B, et al. Addressing the tuberculosis–depression syndemic to end the tuberculosis epidemic. Int J Tuberc Lung Dis. 2018;21(8):852–61.



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