Latest News Archive

Please select Category, Year, and then Month to display items

Undiagnosed depression in tuberculosis patients threatens control of the disease

24 March 2023 | Story Profs Gladys Kigozi-Male, Christo Heunis, and Michelle Engelbrecht | Photo Supplied

Prof Christo Heunis, Prof Michelle Engelbrecht, Prof Gladys Kigozi-Male — From the left, Prof Christo, Prof Michelle Engelbrecht, and Prof Gladys Kigozi-Male.

Opinion article by Profs Gladys Kigozi-Male, Christo Heunis, and Michelle Engelbrecht, Centre for Health Systems Research and Development, University of the Free State.

Each year on 24 March, the world commemorates World TB (Tuberculosis) Day. This date coincides with the day in 1882 when Robert Koch announced his discovery of the Mycobacterium Tuberculosis, the germ that causes TB. This infectious disease is transmitted through airborne droplets when an infected person coughs, sings, shouts, or sneezes. TB primarily affects the lungs (i.e., pulmonary TB), but other organs in the body such as the pleura, lymph nodes, abdomen, genitourinary tract, skin, joints and bones, or meninges (i.e., extra-pulmonary TB) can also be affected. TB can be cured; effective anti-TB drugs have been available for almost eight decades. Despite this, TB continues to wreak havoc across the world and in South Africa. According to a report released by the World Health Organisation (WHO), an estimated 304 000 new TB cases were reported in South Africa in 2021 and 56 000 people succumbed to the disease in the same year

A world without TB

In 2014, the sixty-seventh World Health Assembly endorsed a global strategy and targets for TB prevention, care, and control. The strategy envisions a world without TB, aiming to end the epidemic by 2035. By this target date, a reduction in TB deaths of 95% and new infections of 90% – compared to the respective levels in 2015 – are anticipated. Further to this, the United Nations’ Stop TB Partnership was mandated to drive activities to end the global TB epidemic. In 2015, the partnership launched the 90-(90)-90 targets; to reach at least 90% of people with TB and place them on appropriate treatment, including at least 90% of vulnerable populations such as people living with HIV, and to ensure that at least 90% of people with TB are successfully treated. Despite commendable progress, persisting high TB infection and death rates are adversely affecting global and national efforts to end the TB epidemic. With a treatment success rate of only 78% in 2020, South Africa is sorely challenged to attain the global target of 95%.

TB with mental health illness

One of the challenges confronting TB control is the frequent comorbidity of TB with mental health illness. There is compelling evidence linking TB to common mental health problems such as depression, anxiety, and alcohol misuse. Research indicates that TB patients can experience mental health problems at any time during the course of their TB treatment. Undiagnosed mental illness among TB patients may result in poor health-seeking behaviour and non-adherence to treatment, subpar quality of life, and negative treatment outcomes. The WHO's Global End TB Strategy thus recommends integrated patient-centred TB care. This implies that TB care should be provided in close collaboration with other primary health-care (PHC) programmes such as mental health. However, in many countries – South Africa included – efforts to integrate mental health and TB care are confronted by challenges such as limited capacity, nonrecognition of mental health as a problem, insufficient resources, and TB-related social stigma. Consequently, mental health conditions in TB patients are often un-/under-/mis-diagnosed.

Taking depression as a compelling example, a scoping review reported the prevalence of depression as high as 84% among people with TB in studies conducted internationally. However, little is known about the prevalence of depression among TB patients in South Africa. Using a nine-item Patient Health Questionnaire, we assessed probable depression among a sample of TB patients attending PHC facilities in the Free State. We found that almost half (46,1%) of the 208 patients interviewed had probable depression, with 22,6%, 18,8%, and 4,8% having mild, moderate, and severe symptoms, respectively. Probable depression was almost four times more likely among patients diagnosed with extra-pulmonary TB compared to pulmonary TB patients. HIV-infected TB patients undergoing antiretroviral therapy were more than twice as likely to experience symptoms of depression compared to their counterparts who were not undergoing such therapy. This could possibly be attributed to non-adherence to antiretroviral therapy. Studies elsewhere have established a significant association between depression and ART non-adherence. We further found that the longer patients were retained on TB treatment, the less likely they were to display symptoms of depression.

Important to monitor TB patients for depression

Based on these findings, it is important to monitor TB patients for symptoms of depression – particularly those with comorbid HIV – in PHC settings. At the same time, ensuring that patients stay on treatment by providing adequate support for treatment adherence may help to mitigate depression during TB treatment.

The theme for this year’s World TB Day is ‘Yes! We can end TB’. It is a call for concerted multi-sectoral collaboration between governments, civil society, communities, academia and technical partners, international aid and scientific organisations, the private sector, and disease control programmes in the country to eliminate the TB epidemic. To this end, TB patients attending PHC facilities in South Africa need to be routinely screened for mental health illness. Given the critical shortage of mental health specialists, screening for mental illnesses could be undertaken by trained and well-supervised non-specialist healthcare cadres such as community health workers.

News Archive

Fundraising campaign launched to help feed hungry students

2012-03-28

From the left is Dr. Carin Buys (Patron of NSH), Ms. Nicky Abdinor (guest speaker), Mrs. Grace Jansen (patron of NSH) and Redi Tlhabi (master of ceremonies).
Photo: Johan Roux
28 March 2012

Video clip (YouTube)

The University of the Free State (UFS) received over R200 000 for its No Student Hungry (NSH) Programme at the NSH launch dinner on Friday 23 March 2012 in Bloemfontein.

Prof. Jonathan Jansen, Vice-Chancellor and Rector of the UFS as well as founder of the NSH Programme donated R100 000 from the proceeds of his book We Need to Talk to this programme. Standard Bank also donated R30 000.

An additional amount of about R90 000 was raised by means of pledges made by guests and the auctioning of several items. These items were donated by local companies and university staff.

The No Student Hungry Programme (NSH) aims to raise funds to provide modest food bursaries for needy students and give them daily access to a balanced meal.
Prof. Jansen started the NSH programme in 2011 with the proceeds of his book, We Need to Talk.

The NSH funds more than 100 students in the hope of helping them to excel in their academic endeavours and, ultimately, to obtain their degrees.

In 2011, Prof. Jansen discovered that a significant number of students were studying without eating on a regular basis. These were often students with strong academic records but without adequate funding to sustain themselves with regular meals.

The project was established in January 2011 when the NSH Team started to develop the structure and processes of the programme. The first 100 students who were awarded the food bursaries started using their student cards for daily meals on campus on 1 April 2011.

“The No Student Hungry Campaign is not only about creating a university campus that cares. It is about creating a country where being human matters. Our students on the NSH project are amazing young people. They struggle to get by, but they have great potential and achieve good marks," Prof. Jansen said on Friday.

Prof. Jansen’s wife, Grace, and Dr Carin Buys, wife of Mr Rudi Buys, Dean of Student Affairs, volunteered to drive the programme and raise funds to address the problem. They are supported by various divisions within the university.

Students apply for the bursaries and are selected on the basis of their financial needs, good academic results, active participation in student life programmes and commitment to give something back to the community.

The raising of funds is a continuous process involving awareness campaigns, seeking of partnerships with companies and institutions and support from the general public, staff and individuals.

An agreement has been made with several food outlets/restaurants on campus who offer healthy, balanced meals to NSH students when they swipe their student cards that are funded by the programme.

At the end of the year the process is reviewed and students who still qualify are reinstated on the programme, whilst those whose circumstances have changed or are no longer in need of the bursaries, make way for new applications.

The NSH Team meets with students on a regular basis with the purpose of offering training, motivation and opportunities for personal growth and career development. Students are also expected to become involved in projects as a way of ploughing back into the community.

The goal is to expand the project annually as support for it grows.
Ms Nicky Abdinor, a clinical psychologist from Cape Town, who was born without arms and with shortened legs, provided an entertaining motivational speech at the launch. Ms Abdinor, founder of the Nicky's Drive organisation, also visited the UFS’ Unit for Students with disabilities where she delivered a talk on independence for people living with disabilities.

To become involved with the NSH Programme, please contact Mrs René Pelser on +27(0)51 4019087 or e-mail pelserr@ufs.ac.za.

Media Release
28 March 2012
Issued by: Lacea Loader
Director: Strategic Communication
Tel: +27(0)51 401 2584
Cell: +27(0)83 645 2454
E-mail: news@ufs.ac.za

Back

Economic and Management Sciences

Education

Health Sciences

The Humanities

Law

Natural and Agricultural Sciences

Theology and Religion

Open Distance Learning

Business School

We use cookies to make interactions with our websites and services easy and meaningful. To better understand how they are used, read more about the UFS cookie policy. By continuing to use this site you are giving us your consent to do this.

Accept