Depression in adolescents on treatment for rifampicin-susceptible TB in Lima, Peru

Sanchez-Guzman V.; Tanzer J.R.; Roman-Sinche B.; Santacruz J.; Contreras C.; Desrosiers A.; Lecca L.; Chiang S.S. · IJTLD Open (2025) · DOI: 10.5588/ijtldopen.25.0305

Resumen

BACKGROUND: At least 1 million adolescents develop TB disease annually. Adolescents are also at risk for depression due to TB, but this is poorly understood. METHODS: This prospective cohort study aimed to identify the frequency and risk factors for depression amongst adolescents with rifampicin-susceptible TB in Lima, Peru. During weeks 3–5 of treatment, participants completed a survey that included socio-demographic characteristics, symptoms, treatment side effects, and the Patient Health Questionnaire-9 depression scale. Those with depression received psychological evaluation and were referred for treatment, with treatment intensity corresponding to depression severity. Applying k-means cluster analysis, we grouped participants by sociodemographic characteristics. We used generalised linear mixed-effects regression to model the relationship between cluster, symptoms and side effects, and depression. RESULTS: Of 249 participants, 98 (39%), 62 (25%), and 33 (13%) had mild, moderate, and severe depression, respectively. We identified three clusters; Cluster 1 – adolescents with lower social support and more prior trauma – had the highest frequency of depression. Across all clusters, symptoms and side effects correlated with depression. CONCLUSION: Given their high frequency of depression, adolescents on TB treatment – particularly those with trauma history, weak social support, or numerous symptoms and side effects – should be routinely screened for depression.