Salud mental como predictor de egreso en pacientes con tuberculosis atendidos en centros de alta incidencia. Lima, Perú. 2015-2017

Background: Mental health problems in people with tuberculosis (TB) have been associated with negative outcomes. Some health care centers in Peru use an evaluation of mental health status proposed by the Dirección de Prevención y Control de Tuberculosis (DPCTB). Aim: To evaluate the association between the mental health evaluation indicators at the beginning of treatment and the outcome of people treated with TB. Methods: A retrospective cohort study in three health care centers from the district San Juan de Miraflores. The outcome was considered positive (cured) and negative (failure, dropout, death or change of treatment scheme). Results: A significant association was found between the negative outcome and depressive symptoms (RR: 2.39, 95%CI: 1.19-4.78), substance abuse (RR: 2.58; 95%CI: 1.31-5.09) and unprotected sexual intercourse (p = 0.04). The multivariate analysis found association with depressive symptoms (RR: 2.19, 95%CI: 1.10-4.35) and substance abuse (RR: 2.19, 95%CI: 1.14-4.20). Conclusion: Depressive symptoms and drug consumption were associated with negative outcomes. Intervention studies focusing on these factors should be evaluated to improve treatment success.