Prevalence of tuberculosis among mentally ill patients in conflict-stricken Afghanistan: A cross-sectional study.
OBJECTIVES
Tuberculosis (TB) and mental illness share underlying factors such as poverty, malnutrition, and stress. This study's objective was to determine the prevalence of TB among mentally ill patients in Afghanistan.


METHODS
A cross-sectional study was conducted in five public and one private health facility. All patients in those centers were screened for TB, and the diagnosis of TB was made with GeneXpert or made clinically by a physician.


RESULTS
Out of 8598 patients registered, 8324 (96.8%) were reached and 8073 (93.9%) were screened for TB, of whom 1703 (21.1%) were found to be presumptive TB patients. A total of 275 (16.7%) were diagnosed with all forms of TB, of whom 90.5% were women. Eighty-eight (32%) of them were bacteriologically confirmed and 187 (68%) were clinically diagnosed. The number needed to screen (NNS) was 29.3 and the number needed to test (NNT) was 6.1. The overall prevalence of TB among mentally ill patients was 3,567/100,000-20 times higher than the national incidence rate. TB was independently associated with married and widowed adults, young adults, females, and oral sleep drug users.


CONCLUSIONS
TB among mentally ill patients is very high, and we recommend that TB care and prevention services be integrated into mental health centers.
['Qader|G|G|', 'Seddiq|M K|MK|', 'Rashidi|K M|KM|', 'Hamim|A|A|', 'Akhgar|M H|MH|', 'Ahmad|B|B|', 'Dryer|S|S|', 'Somji|A|A|', 'Melese|M|M|', 'Suarez|P G|PG|']
D000293:Adolescent D000346:Afghanistan D003430:Cross-Sectional Studies D003695:Delivery of Health Care D005260:Female D006801:Humans D008297:Male D044342:Malnutrition D001523:Mental Disorders D028642:Mentally Ill Persons D008875:Middle Aged D011203:Poverty D015995:Prevalence D014376:Tuberculosis D055815:Young Adult
Afghanistan Women Delivery of health care Disease susceptibility Mental disorders TB services