Prevalence and associated factors of depressive state among pulmonary tuberculosis patients in Manila, The Philippines

SETTING: Both depression and tuberculosis (TB) are global public health problems that have a substantial impact on human health. However, depressive state among TB patients has not been well investigated in the Philippines. OBJECTIVE: To assess depressive state among pulmonary tuberculosis (PTB) patients and to identify factors associated with depressive state in Manila, the Philippines. DESIGN: A cross-sectional survey of PTB patients was conducted at 10 public health centres and two nongovernment organisation clinics providing directly observed treatment in District I, Tondo, Manila. Face-toface interviews with 561 PTB patients using a structured questionnaire were conducted. RESULTS: Depressive state was observed in 16.8% of the participants. Logistic regression analysis indicated that body mass index < 18.5 kg/m2, marital status of cohabitation compared with married, four or more symptoms, four or more adverse drug reactions, grade 3 or higher on the Medical Research Council dyspnoea scale and low perceived confidant social support were significantly associated with depressive state. CONCLUSION: Depressive state among PTB patients in economically depressed areas is common, and screening for depression in the primary care setting can identify patients who need support and treatment, especially for malnourished patie nts and those with poor social support