TB's Hidden Links

About 40-70 per cent of tuberculosis patients suffer from mental health disorders. As India has more than one-fourth of global TB cases and deaths, treatment protocols must take into account the new associations

- Karnika Bahuguna

THREE YEARS ago, 29-year-old Brihaspati Pandey came to New Delhi from Basti, Uttar Pradesh, to attend a two-day meeting on tuberculosis (TB) . Pandey was taking treatment for pulmonary TB for about two months. After the first day, he went to his room and unpacked his medicines. “A health advocate colleague, who was sharing the room with me, asked me if I had TB,” he says. When Pandey replied in the affirmative, the colleague vacated the room immediately. “I developed an inferiority complex and started hiding my TB medicines. I even stopped taking medicines in front of anyone. Some of my family members also distanced themselves when they learnt of my condition,” adds Pandey.

The stigma associated with TB patients not only hinders adherence to treatment, but also adds to the stress and leads to mental disorders. According to a report by the World Health Organization (who), the prevalence of mental disorders, including depression and anxiety, among TB patients is estimated to be between 40 and 70 per cent.

A study published in the International Journal of Tuberculosis and Lung Diseases in 2008 says that the stigma affects the quality of patients’ lives and the effectiveness of TB medicines. The overall stigma index is the highest for India, the study found. However, there is little research and focus on the impact of the disease on mental health in India, and these cascading health problems have not been incorporated in TB treatment protocols. These findings assume significance as India accounts for more than one-fourth of the global TB cases and deaths. In 2015 alone, there were 2.8 million new cases, and 0.47 million deaths due to TB.

Intrinsic relationship