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Tuberculosis patients in South Africa have a high prevalence of psychological distress

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Question: What are the prevalence and predictors of psychological distress in people with tuberculosis in South Africa?

Population: In total 4935 patients, aged between 18 and 93 years, within 1 month of initiating first time treatment or retreatment for tuberculosis.

Setting: Public primary care clinics, South Africa; April–October 2011.

Assessment: Psychological distress was assessed using the Kessler Psychological Distress Scale (K-10), a 40-point scale with higher scores denoting greater psychological distress. Cut-off values of 16 and 28 points were used to identify individuals with likely clinical and subclinical anxiety and/or depression, based on previous validation studies in South Africa. Data were collected on potential predictors of psychological distress, including: age, gender, educational attainment, marital status, income, poverty, alcohol consumption and tobacco use. Poverty was assessed by five items asking about the availability or non-availability of shelter fuel or electricity, clean water, food and cash income in the past week. Alcohol consumption was assessed using the 10-item Alcohol Disorder Identification Test. Variables identified as significant in univariate analysis were included in multivariable regression models.

Outcomes: Prevalence and predictors of psychological distress. …

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  • Correspondence to: Karl Peltzer, HIV/STI and TB (HAST) Research Programme, Human Sciences Research Council, Pretoria, South Africa; and Department of Psychology, University of the Free State, Bloemfontein, South Africa; kpeltzer{at}

  • Sources of funding The Department of Health in South Africa.