When someone is diagnosed with tuberculosis (TB), they face a number of challenges, including social discrimination, economic pressures, and additional responsibilities brought on by the healthcare system. This can make people who have tuberculosis more susceptible to mental health problems such as anxiety, depression, and other conditions, according to a local expert on the disease.
According to Dr. Jennifer Furin, who works as the DR-TB Clinical Manager for Doctors Without Borders in Khayelitsha, studies have shown that anywhere from 10 to 50 percent of people living with TB experience depression that can be clinically defined at some point during the course of their illness.
According to Furin, “when there are delays in diagnostic procedures, the risk of depression and anxiety may get even higher, and individuals may become hopeless.”
Susceptible to Depression
In addition to this, she mentioned that “statistics indicate the stress factors from any severe illness can result in anxiety and depression.”
According to the World Health Organization (WHO), the prevalence of mental disorders, such as depression and anxiety disorders, is approximated to be between 40% and 70% among people living with tuberculosis (TB). Due to the high rates of homeless people and housing in shelters and group homes, many individuals suffering from mental disorders are at a higher risk of being exposed to TB infections. This is the case despite the fact that there are multiple factors at play.
According to Furin, several anti-tuberculosis medications, such as isoniazid, the fluoroquinolones (such as levofloxacin or moxifloxacin), and cycloserine/terizidone, can cause neuropsychiatric adverse reactions in some patients. Aside from the medication, studies show that social factors are the most detrimental to their mental health. Because of this, it is just as crucial to provide social support and make sure people have enough money to eat and get around as it is for them to take their medication.
In spite of the fact that tuberculosis can be treated, Furin thinks that a diagnosis of the condition reduces one’s overall quality of life.
“Depression has been linked to a decrease in immune function, a reduction in appetite, and a boost in substance use.” She explained that all of these factors can reduce a person’s chances of recovering from their illness.
According to the 2018 report on Mortality and Cause of death in South Africa published by Statistics South Africa (StatsSA), tuberculosis has remained the main leading cause of death in South Africa over the past three years, dropping from 6.5% in 2016 to 6.0% in 2018.
As part of the treatment for tuberculosis, “we must do more to ensure that individuals who suffer from depression and anxiety are provided services and care for these circumstances at no cost to the patient.” Also, according to Furin, “we must do a much better job screening people with tuberculosis for these issues and challenges so that we can find them early on and support them.” “Those who have tuberculosis are incredibly courageous.”
According to Furin, people who have tuberculosis are exceptionally brave due to everything that they have to go through. She went on to say that they are deserving of support across the board in terms of care as they work toward regaining their health.
When dealing with a disease as serious as tuberculosis, anyone would require assistance and support. Ironically, people who have tuberculosis frequently lose their usual sources of interpersonal support because they are too embarrassed to tell their loved ones that they have the disease because of the stigma and prejudice associated with it, according to Furin.
Discrimination and Prejudice
Sipho Mudau, 44, from Tshiulungoma village, outside of Thohoyandou, told us that he continues to confront discrimination and prejudice despite having fully recovered from tuberculosis approximately six years ago.
“I notice that close relatives, old friends, and some members of my neighborhood continue to view me as if I have some form of illness that I can pass on to them. “Knowing the ordeal I went through while receiving treatment makes this so much more excruciating,” Mudau said. “This is so painful.”
“Whenever I go out in public, I can see that people who are aware of the fact that I formerly had tuberculosis do not want to equate themselves with me or be too near to me. Perhaps they are concerned that I still have tuberculosis and will pass it on to them. “And it is so wrong because nobody chooses to have the disease,” he said.
The man who is a father to two children is also of the opinion that communities need to be provided with essential information regarding tuberculosis to end discrimination and prejudice.
The Importance of One’s Family
In spite of the fact that families play such an important role in the battle against tuberculosis (TB), according to Furin, it is highly worrying that they are very seldom included in TB counseling and assistance. Patients suffering from tuberculosis (TB), an illness that affects the entire family, fare better when they have the love and support of their families.
“However, when it comes to tuberculosis (TB), family members are frequently made to feel antagonistic toward one another, which is frequently done by the healthcare system. When someone is diagnosed with tuberculosis, one of the first things we tell them is to “Go home and tell your family that you might have contaminated them with TB, and that they all must come to the health center to get tested.” Imagine being in that position with little to no support available. “And the repercussions are extremely severe,” said Furin.
“Some people talk about how they were forced to leave their homes, or how they were physically abused, or how they had to take responsibility for other issues that occurred in their families. It is an excessive amount. Therefore, we need to stop discussing the possibility of infection and assigning blame and instead concentrate on how members of families can show love and support for one another while navigating these challenging times. We also need to assist families in accomplishing this,” Furin stated further.