By the same authors

From the same journal

Multidrug-resistant tuberculosis treatment programmes insufficiently consider comorbid mental disorders

Research output: Contribution to journalArticlepeer-review


  • I F Walker
  • S C Baral
  • X. Wei
  • R Huque
  • A Khan
  • J Walley
  • J N Newell
  • H Elsey


Publication details

JournalThe international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease
DateAccepted/In press - 26 Feb 2017
DatePublished (current) - 1 Jun 2017
Issue number6
Number of pages7
Pages (from-to)603-609
Original languageEnglish


The successful treatment of multidrug-resistant tuberculosis (MDR-TB) is a global health priority and a key pillar of the World Health Organization's (WHO's) End TB strategy. There has been significant global investment in diagnostic capabilities in recent years. However, we argue that the mental distress of those with MDR-TB and their families continues to be overlooked by TB programmes. Priorities in the End TB Strategy of 'patient-centred care' and 'patient support' are still to be delivered in practice in many low-income settings, and in particular consideration of mental distress. Our experience of undertaking MDR-TB operational research in China, Pakistan, Bangladesh, Nepal and Swaziland has given us detailed insight into the challenges facing patients, their families, health professionals and wider health systems. We are increasingly concerned that psychosocial support, and particularly support focused on mental health, is being insufficiently addressed in national MDR-TB programmes. We suggest that the presence of comorbid mental disorders reduces treatment adherence. We recommend the trialling within TB programmes of brief screening tools for common mental disorders and the incorporation of principles from the WHO Mental Health Gap Action Programme programme into TB programme treatment guidance. Our work in Nepal also suggests that brief psychological counselling delivered by non-specialist counsellors may be feasible.

    Research areas

  • Antitubercular Agents/administration & dosage, Family/psychology, Global Health, Humans, Mass Screening/methods, Mental Disorders/diagnosis, National Health Programs/organization & administration, Social Support, Tuberculosis, Multidrug-Resistant/epidemiology, World Health Organization

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