A Longitudinal Prospective Study of Active Tuberculosis Among Patients in Tétouan, Morocco

TL;DR

This study examines the clinical, nutritional, and psychosocial aspects of TB treatment in Tétouan, Morocco, highlighting the high rates of anxiety, depression, and side effects among patients.

Contribution

The study provides a comprehensive analysis of TB treatment challenges in Tétouan, emphasizing psychosocial and nutritional factors.

Findings

Most patients experienced anxiety and depression, linked to factors like side effects and urban residence.

A low sputum conversion rate was observed, correlating with symptom progression during treatment.

Over 90% of patients reported side effects, primarily muscle and joint pain.

Abstract

Background: Tuberculosis (TB) continues to be a significant global health challenge, particularly in developing countries. Tétouan, Morocco, is among the most affected cities in the country; however, limited information is available on the impact of TB and its treatment on various aspects of patients' lives. This study aims to comprehensively analyze the clinical, microbiological, nutritional, and psychosocial characteristics of patients undergoing intensive pulmonary TB treatment in Tétouan.

Methods: We conducted a 1.5-year prospective study on patients with bacteriologically confirmed pulmonary TB during the intensive treatment phase. Clinical, social, psychological, and nutritional data were collected, and bacteriological monitoring was performed. Statistical analysis was conducted using SPSS software (IBM Corp., Armonk, NY), with a 95% significance level.

Results: Among the 125 surveyed patients (mean age: 37.5 years, male-to-female ratio: 3.8), 91 (73.2%) resided in urban areas, 19 (15.4%) had difficulties reaching a healthcare center, and 89 (71%) were newly diagnosed. Side effects were reported by 121 patients (97%), primarily muscle and joint pain. A balanced diet was maintained by 80 patients (63.9%) during treatment. Anxiety was observed in 102 patients (82%) and correlated with female gender, retreatment cases, smoking, side effects, and living in urban areas. Depression was experienced by 113 patients (91%), significantly associated with smoking, side effects, and retreatment cases. The sputum conversion rate was low (62.4%) and showed a significant correlation with symptom progression after two months of intensive treatment.

Conclusion: Consistent patient support throughout the entire treatment period is crucial to preventing dropout and treatment failure. Greater efforts are needed to strengthen economic, social, and psychological support for patients. Healthcare educational units play a key role in informing patients about nutrition, potential side effects, and nicotine withdrawal symptoms. These interventions are essential to enhancing adherence and improving overall treatment outcomes in Tétouan.