Indian Journal of Respiratory Care

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VOLUME 10 , ISSUE 3 ( September-December, 2021 ) > List of Articles

Original Article

Comparative Assessment of Depression, Quality of Sleep, and Respiratory Functions among Tuberculosis Patients with their Nontuberculosis Family Contacts

Afreen Begum H. Itagi, Amudharaj Dharmalingam, G. Y. Yunus, Senthil M. Velou, Senthil Kumar Subramanian, L. Sundareswaran

Keywords : Caregivers, depression, pulmonary function tests, sleep, tuberculosis

Citation Information : Itagi AB, Dharmalingam A, Yunus GY, Velou SM, Subramanian SK, Sundareswaran L. Comparative Assessment of Depression, Quality of Sleep, and Respiratory Functions among Tuberculosis Patients with their Nontuberculosis Family Contacts. Indian J Respir Care 2021; 10 (3):312-317.

DOI: 10.4103/ijrc.ijrc_54_21

License: CC BY-NC-SA 4.0

Published Online: 06-12-2022

Copyright Statement:  Copyright © 2021; Indian Journal of Respiratory Care.


Context: Tuberculosis (TB) patients may present depression as comorbidity. This presents great challenges including the stigma of increased risk of developing TB in tackling such patients. Aims: The main aim of the study was to assess the lung function, sleep quality, and extent of depression in TB patients as compared to non-TB family contacts. Methods: TB patients and their family contacts (60 each) stopping by specialized directly observed therapy short-course center at a tertiary care hospital were assessed for depression and quality of sleep. Pulmonary functions were analyzed by spirometry. Descriptive statistics and t-tests were applied using SPSS version 19.0. P ≤ 0.05 was considered significant. Results: Depression with a significantly higher mean Patient Health Questionnaire-9 score was more prevalent among TB patients (73.3%) when compared to their family contacts (46.7%). TB patients presented with significantly higher levels of mean global Pittsburgh Sleep Quality Index score (9.56 ± 3.97) compared to their non-TB family contacts (4.36 ± 2.07), indicating a poorer sleep quality and also the sleep disturbance and daytime dysfunction were significantly more in TB patients (P = 0.000). The lung function measures were reduced in TB patients, and the difference was significant compared to their non-TB family contacts. Conclusions: The present study shows that TB patients have a poor quality of sleep, higher depression levels, and reduced lung functions compared to their non-TB family contacts. This calls for well-organized screening strategies to screen the in-apparent symptoms of adverse mental conditions among TB patients and their family caregivers/contacts with aid of mental health professionals to enable better management of this population.

  1. World Health Organization. WHO TB Report; 2018. https://www. [Last accessed on 2020 Mar 05].
  2. Central TB Division, Government of India. India TB Report 2018. Revised National TB Control Program. Annual Status Report. New Delhi: Directorate General of Health Services, Ministry of Health and Family Welfare; 2018. Available from: [Last accessed on 2020 Mar 05].
  3. World Health Organization. Fact Sheet on Depression. Available from: [Last accessed on 2020 Mar 06].
  4. Basu G, Chatterjee C, Singh R, Biswas S. Prevalence of depression in tuberculosis patients: An experience from a DOTS clinic. IJRRMS 2012;2:14-7.
  5. Shrestha P, Subba UK, Brouwer M, Sweetland AC. Depression among TB patients and associated factors in Kathmandu Valley, Nepal. Glob Ment Health (Camb) 2020;7:e4.
  6. Ravimohan S, Kornfeld H, Weissman D, Bisson GP. Tuberculosis and lung damage: From epidemiology to pathophysiology. Eur Respir Rev 2018;27:170077.
  7. Balkin TJ, Rupp T, Picchioni D, Wesensten NJ. Sleep loss and sleepiness: Current issues. Chest 2008;134:653-60.
  8. Banks S, Dinges DF. Behavioral and physiological consequences of sleep restriction. J Clin Sleep Med 2007;3:519-28.
  9. Mezick EJ, Matthews KA, Hall M, Kamarck TW, Buysse DJ, Owens JF, et al. Intra-individual variability in sleep duration and fragmentation: Associations with stress. Psychoneuroendocrinology 2009;34:1346-54.
  10. Yohannes K, Mokona H, Abebe L, Feyisso M, Tesfaye A, Tesfaw G, et al. Prevalence of depressive symptoms and associated factors among patients with tuberculosis attending public health institutions in Gede'o zone, South Ethiopia. BMC Public Health 2020;20:1702.
  11. Raj JP, Ramesh N. Quality of sleep among patients diagnosed with tuberculosis-a cross-sectional study. Sleep Breath 2020;25:1369-77.
  12. Ruiz-Grosso P, Cachay R, de la Flor A, Schwalb A, Ugarte-Gil C. Association between tuberculosis and depression on negative outcomes of tuberculosis treatment: A systematic review and meta-analysis. PLoS One 2020;15:e0227472.
  13. Amole TG, Yusuf AH, Salihu A, Tsiga-Ahmed FI. Prevalence and predictors of depression among tuberculosis patients in Kano, North-West Nigeria. Niger J Med 2020;29:369-76.
  14. Kamble BD, Singh SK, Jethani S, Chellaiyan VG, Acharya BP. Social stigma among tuberculosis patients attending DOTS centers in Delhi. J Family Med Prim Care 2020;9:4223-8.
  15. Ige OM, Lasebikan VO. Prevalence of depression in tuberculosis patients in comparison with non-tuberculosis family contacts visiting the DOTS clinic in a Nigerian tertiary care hospital and its correlation with disease pattern. Ment Health Fam Med 2011;8:235-41.
  16. Kumar R, Kushwaha RA, Jain A, Hasan Z, Gaur P, Panday S. Tuberculosis among household contacts of multidrug resistant tuberculosis cases at a tertiary hospital in Lucknow, India. Int J Life Sci Res 2018;4:1707-12.
  17. Singh J, Sankar MM, Kumar S, Gopinath K, Singh N, Mani K, et al. Incidence and prevalence of tuberculosis among household contacts of pulmonary tuberculosis patients in a peri-urban population of South Delhi, India. PLoS One 2013;8:e69730.
  18. Pan SW, Yen YF, Feng JY, Su VY, Kou YR, Su WJ. The risk of depressive disorder among contacts of tuberculosis patients in a TB-endemic area: A population-based cohort study. Medicine (Baltimore) 2015;94:e1870.
  19. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: Validity of a brief depression severity measure. J Gen Intern Med 2001;16:606-13.
  20. Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Res 1989;28:193-213.
  21. Bender A, Guruge S, Hyman I, Janjua M. Tuberculosis and common mental disorders: International lessons for Canadian immigrant health. Can J Nurs Res 2012;44:56-75.
  22. Naidoo P, Mwaba K. Helplessness, depression, and social support among people being treated for tuberculosis in South Africa. Soc Behav Pers Int J 2010;38:1323-34.
  23. Juliasih NN, Mertaniasih NM, Hadi C, Soedarsono, Sari RM, Alfian IN. Factors Affecting Tuberculosis Patients' Quality of Life in Surabaya, Indonesia. J Multidiscip Healthc 2020;13:1475-80.
  24. Ugarte-Gil C, Ruiz P, Zamudio C, Canaza L, Otero L, Kruger H, et al. Association of major depressive episode with negative outcomes of tuberculosis treatment. PLoS One 2013;8:e69514.
  25. Khalaila R, Cohen M. Emotional suppression, caregiving burden, mastery, coping strategies and mental health in spousal caregivers. Aging Ment Health 2016;20:908-17.
  26. Oshio T. How is an informal caregiver's psychological distress associated with prolonged caregiving? Evidence from a six-wave panel survey in Japan. Qual Life Res 2015;24:2907-15.
  27. Omachi TA, Blanc PD, Claman DM, Chen H, Yelin EH, Julian L, et al. Disturbed sleep among COPD patients is longitudinally associated with mortality and adverse COPD outcomes. Sleep Med 2012;13:476-83.
  28. Mehta JR, Ratnani IJ, Dave JD, Panchal BN, Patel AK, Vala AU. Association of psychiatric co-morbidities and quality of life with severity of chronic obstructive pulmonary disease. East Asian Arch Psychiatry 2014;24:148-55.
  29. Klink ME, Dodge R, Quan SF. The relation of sleep complaints to respiratory symptoms in a general population. Chest 1994;105:151-4.
  30. Manji M, Shayo G, Mamuya S, Mpembeni R, Jusabani A, Mugusi F. Lung functions among patients with pulmonary tuberculosis in Dar es Salaam - A cross-sectional study. BMC Pulm Med 2016;16:58.
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