The association of household food insecurity and HIV infection with common mental disorders among newly diagnosed tuberculosis patients in Botswana

Abstract

AbstractObjectiveTo determine the association between food insecurity and HIV-infection with depression and anxiety among new tuberculosis patients.DesignOur cross-sectional study assessed depression, anxiety, and food insecurity with Patient Health Questionnaire (PHQ9), Zung Anxiety Self-Assessment Scale (ZUNG), and Household Food Insecurity Access Scale, respectively. Poisson regression models with robust variance were used to examine correlates of depression (PHQ9 ≥ 10) and anxiety (ZUNG ≥ 36)SettingGaborone, Botswana.ParticipantsPatients who were newly diagnosed with tuberculosis.ResultsBetween January and December 2019, we enrolled 180 TB patients from primary health clinics in Botswana. Overall, 99 (55.0%) were HIV-positive, 47 (26.1%),85 (47.2%), and 69 (38.5%) indicated depression, anxiety, and moderate to severe food insecurity, respectively. After adjusting for potential confounders, food insecurity was associated with a higher prevalence of depression (adjusted prevalence ratio [aPR] =2.30; 95% confidence interval [CI] = 1.40, 3.78) and anxiety (aPR = 1.41; 95% CI = 1.05, 1.91). Prevalence of depression and anxiety were similar between HIV-infected and -uninfected participants. Estimates remained comparable when restricted to HIV-infected participants.ConclusionsMental disorders may be affected by food insecurity among new tuberculosis patients, regardless of HIV status.