PESHAWAR: Contrary to 40 per cent prevalence of depression among patients of tuberculosis globally, 90 per cent of TB patients in Pakistan and Afghanistan suffer from depression, a UK-funded study has found.

It says that depression among patients obstructs completion of their treatment regime and subsequently snowballs into multi-drug resistant TB, which often kills people.

The alarming preliminary findings of a joint programme of Khyber Medical University (KMU) Peshawar and Keele University shared with media people have posed challenging situation for health department and donor agencies, especially Global Fund, to offer psychiatric and psychological support to TB patients with depression in Pakistan and Afghanistan to ensure their adherence to the prescribed treatment plans.

The study involving patients from Pakistan and Afghanistan was conducted under ‘cognitive therapy for depression in tuberculosis treatment’ (Control). It was meant to implement strategies to deal with depression found among TB patients, who did not take their full six-month course and ended up with MDR-TB.

Health experts warn most such patients risk their lives by not completing treatment

The multi-drug resistant TB is 10 times more dangerous than simple TB, according to Dr Zohaib Khan, the director of the office of research, innovation and commercialisation (ORIC) at KMU.

Flanked by psychiatrist Saeed Farooq, the programme head and a professor at Keele University UK, Dr Zohaib said that groundbreaking findings of the research project were meant to ensure treatment of patients and reduce cases of MDR-TB. He said that treatment of MDR-TB was very costly yet mostly ineffective.

“The project with a grant of £4.9 million will complete in June this year,” he said. He said that execution of the project was not possible without the support of health department and Khyber Pakhtunkhwa TB Control Programme. The patients of MDR-TB require interventions by psychiatrists and psychologists to help them complete their 24-month treatment course and stay healthy.

“We have run the programme through innovative measures and established community engagement centre to enlist support of general population. We have employed 75 research assistants, who can be useful in coping with prevalence of depression among TB patients,” said Dr Zohaib.

Dr Zeeshan Kibriya, the additional director of ORIC, said on the occasion that they had used actors and actresses to send a message to people that TB was entirely curable provided patients continued their treatment.

Dr Alamgir Khan Afridi, the director media, said that of 1,200 patients registered under the project, 570 were found to have significant mental health problems, with approximately 66 per cent experiencing moderate to severe depression.

Prof Farooq, a former psychiatrist at Lady Reading Hospital Peshawar, said that Keele University was also supporting five PhD and 15 master scholars in health research as part of large trials to implement research on the patients’ adherence to completion of treatment.

He said that TB patients could infect 15 people if they were left untreated. He added that the same was true for MDR-TB, which was a death warrant.

Dr Saeed, recipient of Academic Researcher Award 2024 from Royal College of Psychiatrists UK for his research proposals, said that the grant for Control project was approved by National Institute of Health Research, UK, to ensure treatment of TB, the 10th leading cause of death, with depression being a major multi-morbidity in patients from most low or middle income countries.

Pakistan has been ranked fifth among TB high-burden countries and has the fourth highest MDR-TB prevalence globally. The study seeks to develop and test psychological intervention for treating depression in Pakistani and Afghan refugee patients with TB, including those of MDR-TB, and improve their adherence to treatment.

“So far, we have worked for capacity building of health workers. Our preliminary findings should serve as wakeup call for policymakers to pay attention to the challenge posed by the situation regarding increasing trend of people with TB, who also have co-morbid depression,” said Dr Saeed.

He said that the project provided guidelines for effective interventions to treat depression in TB patients. “The government can uniquely address depression and poor treatment adherence among TB patients and curtail drastically MDR-TB,” he said.

Published in Dawn, June 7th, 2026