The dual burden of disease: Depression among patients with multidrug resistance tuberculosis in low-income and lower- middle-income countries: A systematic review and meta-analysis
6 affiliations
- 1Department of Psychiatry, School of medicine, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
- 2Department of Biomedical Science, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
- 3Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
- 4Department of Medical Biochemistry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
- 5Department of Clinical Pharmacy, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
- 6Department of Public Health, Amhara Regional Health Bureau, South Gondar Zone, Debre Tabor, Ethiopia
Abstract
Introduction: Multidrug-Resistant Tuberculosis (MDR-TB) continues to pose a serious global health challenge, particularly in low-income and lower-middle-income countries where the disease burden, fragile health systems, and socioeconomic hardships are most pronounced. These conditions not only complicate treatment but also worsen patients’ vulnerability to depression. Although numerous primary studies have investigated the prevalence of depression among individuals with MDR-TB, their findings have been inconsistent. To address this gap, the present study seeks to estimate the pooled prevalence of depression and identify its associated factors among MDR-TB patients in low- and lower-middle-income countries. Methods: Relevant studies were sourced from Google Scholar, Scopus, PubMed, and Web of Science. Additionally, the reference lists of selected articles were manually reviewed to identify further eligible publications. A random-effects model was employed to calculate the pooled prevalence of depression among MDR-TB patients in low- and lower-middle-income countries. Results: The meta-analysis incorporated 23 primary studies with a combined sample of 5,734 MDR-TB patients. The pooled prevalence of depression among this population was 41.89% (95% CI: 32.63–51.15; I² = 98.51%, P < 0.001). Several factors were significantly linked to depression, including female gender (AOR = 2.00, 95% CI: 1.66–2.41), financial hardship (AOR = 2.56, 95% CI: 1.44–4.55), presence of comorbidities (AOR = 3.72, 95% CI: 2.11–5.38), greater disease severity (AOR = 2.13, 95% CI: 1.42–3.12), medication-related side effects (AOR = 2.77, 95% CI: 2.20–3.48), and perceived stigma (AOR = 3.58, 95% CI: 2.13–6.02). Conclusions: The prevalence of depression among MDR-TB patients in low- and lower-middle-income countries was found to be notably high. These findings emphasize the importance of implementing routine depression screening and integrating psychosocial support into patient care.
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BibTeX
@article{abate2026dual,
title = {{The dual burden of disease: Depression among patients with multidrug resistance tuberculosis in low-income and lower- middle-income countries: A systematic review and meta-analysis}},
author = {Agmas Wasie Abate and Assasahegn Tedla and Gashaw Mehiret Wubet and Getasew Legas and Amsalu Belete and Kirubel Shiferaw and Getnet Mihretie Beyene and Assefa Agegnehu Teshome and Wondimnew Desalegn Addis and Melaku Mekonnen Agidew and Samuel Berihun Dagnew and Belete Asnake Sitotaw and Birhanu Mengist Munie},
journal = {PLOS One},
year = {2026},
month = oct,
doi = {10.1371/journal.pone.0360738},
url = {https://doi.org/10.1371/journal.pone.0360738},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - The dual burden of disease: Depression among patients with multidrug resistance tuberculosis in low-income and lower- middle-income countries: A systematic review and meta-analysis
AU - Agmas Wasie Abate
AU - Assasahegn Tedla
AU - Gashaw Mehiret Wubet
AU - Getasew Legas
AU - Amsalu Belete
AU - Kirubel Shiferaw
AU - Getnet Mihretie Beyene
AU - Assefa Agegnehu Teshome
AU - Wondimnew Desalegn Addis
AU - Melaku Mekonnen Agidew
AU - Samuel Berihun Dagnew
AU - Belete Asnake Sitotaw
AU - Birhanu Mengist Munie
PY - 2026
DA - 2026/10/13
JO - PLOS One
DO - 10.1371/journal.pone.0360738
UR - https://doi.org/10.1371/journal.pone.0360738
AB - Introduction: Multidrug-Resistant Tuberculosis (MDR-TB) continues to pose a serious global health challenge, particularly in low-income and lower-middle-income countries where the disease burden, fragile health systems, and socioeconomic hardships are most pronounced. These conditions not only complicate treatment but also worsen patients’ vulnerability to depression. Although numerous primary studies have investigated the prevalence of depression among individuals with MDR-TB, their findings have been inconsistent. To address this gap, the present study seeks to estimate the pooled prevalence of depression and identify its associated factors among MDR-TB patients in low- and lower-middle-income countries. Methods: Relevant studies were sourced from Google Scholar, Scopus, PubMed, and Web of Science. Additionally, the reference lists of selected articles were manually reviewed to identify further eligible publications. A random-effects model was employed to calculate the pooled prevalence of depression among MDR-TB patients in low- and lower-middle-income countries. Results: The meta-analysis incorporated 23 primary studies with a combined sample of 5,734 MDR-TB patients. The pooled prevalence of depression among this population was 41.89% (95% CI: 32.63–51.15; I² = 98.51%, P < 0.001). Several factors were significantly linked to depression, including female gender (AOR = 2.00, 95% CI: 1.66–2.41), financial hardship (AOR = 2.56, 95% CI: 1.44–4.55), presence of comorbidities (AOR = 3.72, 95% CI: 2.11–5.38), greater disease severity (AOR = 2.13, 95% CI: 1.42–3.12), medication-related side effects (AOR = 2.77, 95% CI: 2.20–3.48), and perceived stigma (AOR = 3.58, 95% CI: 2.13–6.02). Conclusions: The prevalence of depression among MDR-TB patients in low- and lower-middle-income countries was found to be notably high. These findings emphasize the importance of implementing routine depression screening and integrating psychosocial support into patient care.
SN - 1932-6203
ER -