Background Evidence has shown that the prevalence of depression is much higher among patients with tuberculosis (TB) and this, in turn, may adversely impact compliance with anti-TB medications. Therefore, this systematic review and meta-analysis aimed to quantitatively summarize epidemiologic evidence on the prevalence of depression among patients with TB and formulate a recommendation for future clinical practice as well as research. Methods We followed the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines to conduct this review. We searched PubMed, EMBASE, SCOPUS and Psych INFO to identify relevant studies that investigated the prevalence of depression among TB patients. We also supplemented our electronic search with manual searching to include all pertinent studies in the analysis. We used a Comprehensive Meta-Analysis software version 3.0 (CMA 3.0) to conduct a meta-analysis. We conducted a subgroup and sensitivity analysis and Cochran’s Q - and the I 2 -statistics were used to assess heterogeneity. The evidence for the presence of publication bias was checked by using Egger’s test and visual inspection of the symmetry in funnel plots. Results We identified a total of 25 studies that included 4903 participants across seven countries. In our analysis, the pooled estimated prevalence of depression among TB patients was found to be 45.19% (95% CI 38.04–52.55). The prevalence was higher in MDR-TB 52.34% (95% CI 38.09–66.22) than non-MDR-TB 43.47% (95% CI 35.88–51.37) patients. We also found that the pooled prevalence of depression was higher among females 51.54% (95% CI 40.34–62.60) when compared to males 45.25% (95% CI 35.19–55.71). The pooled prevalence of depression was 45.45% as measured by HRDS, and it was 55.62%, 45.52%, and 38.36% as measured by BDI, HADS and PHQ-9, respectively. Conclusion Our finding suggested that the pooled estimated prevalence of depression among tuberculosis patients was relatively high. Screening and management of depression among TB patients were warranted to alleviate suffering. Moreover, the integration of tuberculosis program with regular psychiatry services may substantially reduce the burden.

中文翻译：

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结核病患者抑郁症的患病率：系统评价和荟萃分析

背景证据表明，结核病 (TB) 患者的抑郁症患病率要高得多，这反过来可能会对抗结核药物的依从性产生不利影响。因此，本系统评价和荟萃分析旨在定量总结结核病患者抑郁症患病率的流行病学证据，并为未来的临床实践和研究提出建议。方法 我们遵循系统评价和荟萃分析 (PRISMA) 指南的首选报告项目进行本次评价。我们搜索了 PubMed、EMBASE、SCOPUS 和 Psych INFO，以确定调查结核病患者抑郁症患病率的相关研究。我们还通过手动搜索补充了我们的电子搜索，以将所有相关研究纳入分析。我们使用综合 Meta-Analysis 软件 3.0 版 (CMA 3.0) 进行荟萃分析。我们进行了亚组和敏感性分析，并使用 Cochran's Q - 和 I 2 - 统计量来评估异质性。通过使用 Egger 检验和漏斗图中对称性的目视检查来检查存在发表偏倚的证据。结果 我们共确定了 25 项研究，包括来自 7 个国家的 4903 名参与者。在我们的分析中，TB 患者中抑郁症的综合估计患病率为 45.19%（95% CI 38.04-52.55）。MDR-TB 52.34% (95% CI 38.09–66.22) 的患病率高于非 MDR-TB 43.47% (95% CI 35.88–51.37) 患者。我们还发现，与男性 45.25% (95% CI 35. 19–55.71)。用 HRDS 测量的抑郁症综合患病率为 45.45%，用 BDI、HADS 和 PHQ-9 测量的抑郁症患病率分别为 55.62%、45.52% 和 38.36%。结论 我们的研究结果表明，结核病患者的合并估计抑郁症患病率相对较高。有必要对结核病患者的抑郁症进行筛查和管理，以减轻痛苦。此外，将结核病项目与常规精神病学服务相结合可以大大减轻负担。有必要对结核病患者的抑郁症进行筛查和管理，以减轻痛苦。此外，将结核病项目与常规精神病学服务相结合可以大大减轻负担。有必要对结核病患者的抑郁症进行筛查和管理，以减轻痛苦。此外，将结核病项目与常规精神病学服务相结合可以大大减轻负担。