{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T17:59:01Z","timestamp":1790618341356,"version":"4.1.0"},"reference-count":33,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>Depression is prevalent among people with tuberculosis (PWTB) and negatively affects diagnosis, treatment adherence, and clinical outcomes. However, the methodological approaches used to study depression among PWTB have not been systematically mapped. This scoping review aimed to evaluate methodologies used to study depression among PWTB and identify gaps in methodological approaches. We conducted a systematic scoping review following PRISMA-ScR guidelines. Nine databases were searched without date restrictions. Two reviewers independently screened titles, abstracts, and full texts. Inclusion criteria included primary, peer-reviewed, research studies that examined depression among PWTB, and reported outcomes related to TB and depression. Data were extracted on study characteristics, TB population, depression measurement tools, treatment approaches, and implementation considerations. Findings were organized using Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework. A total of 184 studies met inclusion criteria. Research was dominated by cross-sectional designs (65%), with fewer cohort studies (17%) and only eight randomized controlled trials (RCTs, 4%). The RCTs primarily evaluated psychological interventions that demonstrated modest improvements in depressive symptoms or TB-related outcomes. Depression was overwhelmingly assessed using screening tools with only 28 studies (15%) using a diagnostic interview or clinical criteria. None evaluated accuracy of any screening or diagnostic tool. Studies were geographically clustered, with more than one-third conducted in India or China. Implementation barriers to integrated TB and depression care included workforce shortages and stigma; facilitators included task-shifting and embedding screening into routine workflows. No studies reported on maintenance or long-term sustainability of depression care within TB programs. Existing research on depression among PWTB is largely cross-sectional, relies heavily on screening tools, and rarely evaluates interventions or their sustainability. Expanding population and geographic coverage, incorporating longitudinal designs and diagnostic evaluation, and strengthening implementation and maintenance research are critical for developing sustainable, integrated approaches to depression care within TB services.<\/jats:p>","DOI":"10.1371\/journal.pgph.0007388","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T17:25:16Z","timestamp":1790616316000},"page":"e0007388","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Methodologies for studying depression in persons with tuberculosis: A scoping review"],"prefix":"10.1371","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2318-1783","authenticated-orcid":true,"given":"Amanda J.","family":"Gupta","sequence":"first","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health","place":["Baltimore, Maryland, United States of America"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Turimumahoro","sequence":"additional","affiliation":[{"name":"World Alliance for Lung and Intensive Care Medicine in Uganda (WALIMU)","place":["Kampala, Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fulera","family":"Salami","sequence":"additional","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health","place":["Baltimore, Maryland, United States of America"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayden","family":"Brennan","sequence":"additional","affiliation":[{"name":"Epidemiology of Microbial Diseases, Yale School of Public Health","place":["New Haven, Connecticut, United States of America"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Jacoby","sequence":"additional","affiliation":[{"name":"Epidemiology of Microbial Diseases, Yale School of Public Health","place":["New Haven, Connecticut, United States of America"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1039-293X","authenticated-orcid":true,"given":"Sheeba","family":"Ibidunni","sequence":"additional","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health","place":["Baltimore, Maryland, United States of America"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lori","family":"Rosman","sequence":"additional","affiliation":[{"name":"Welch Medical Library, School of Medicine, Johns Hopkins University","place":["Baltimore, Maryland, United States of America"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2398-3145","authenticated-orcid":true,"given":"Jonathan E.","family":"Golub","sequence":"additional","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health","place":["Baltimore, Maryland, United States of America"],"department":["Department of Epidemiology"]},{"name":"Johns Hopkins Bloomberg School of Public Health","place":["Baltimore, Maryland, United States of America"],"department":["Department of International Health"]},{"name":"Center for Tuberculosis Research, Johns Hopkins University School of Medicine","place":["Baltimore, Maryland, United States of America"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David W.","family":"Dowdy","sequence":"additional","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health","place":["Baltimore, Maryland, United States of America"],"department":["Department of Epidemiology"]},{"name":"Johns Hopkins Bloomberg School of Public Health","place":["Baltimore, Maryland, United States of America"],"department":["Department of International Health"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"pgph.0007388.ref001","volume-title":"Global tuberculosis report 2025","author":"World Health Organization","year":"2025"},{"issue":"1","key":"pgph.0007388.ref002","doi-asserted-by":"crossref","first-page":"010423","DOI":"10.7189\/jogh.09.010423","article-title":"Health systems performance in managing tuberculosis: analysis of tuberculosis care cascades among high-burden and non-high-burden countries","volume":"9","author":"J Kim","year":"2019","journal-title":"J Glob Health"},{"issue":"11","key":"pgph.0007388.ref003","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0187145","article-title":"Drop-out from the tuberculosis contact investigation cascade in a routine public health setting in urban Uganda: A prospective, multi-center study","volume":"12","author":"M Armstrong-Hough","year":"2017","journal-title":"PLoS One"},{"issue":"9","key":"pgph.0007388.ref004","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2022-060906","article-title":"Prevalence and risks of tuberculosis multimorbidity in low-income and middle-income countries: a meta-review","volume":"12","author":"A Jarde","year":"2022","journal-title":"BMJ Open"},{"issue":"1","key":"pgph.0007388.ref005","doi-asserted-by":"crossref","first-page":"4980","DOI":"10.1038\/s41598-018-23344-z","article-title":"Comorbidities and treatment outcomes in multidrug resistant tuberculosis: A systematic review and meta-analysis","volume":"8","author":"JP Samuels","year":"2018","journal-title":"Sci Rep"},{"issue":"1","key":"pgph.0007388.ref006","doi-asserted-by":"crossref","first-page":"2313683","DOI":"10.1080\/07853890.2024.2313683","article-title":"Tuberculosis (TB) treatment challenges in TB-diabetes comorbid patients: A systematic review and meta-analysis","volume":"56","author":"M Khattak","year":"2024","journal-title":"Ann Med"},{"key":"pgph.0007388.ref007","doi-asserted-by":"crossref","first-page":"1253615","DOI":"10.3389\/fpubh.2023.1253615","article-title":"The impact of comorbidities on tuberculosis treatment outcomes in Poland: A national cohort study","volume":"11","author":"A Nowi\u0144ski","year":"2023","journal-title":"Front Public Health"},{"issue":"2","key":"pgph.0007388.ref008","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1001\/jama.2024.5756","article-title":"Management of depression in adults: A review","volume":"332","author":"GE Simon","year":"2024","journal-title":"JAMA"},{"key":"pgph.0007388.ref009","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1186\/s12991-020-00281-8","article-title":"The prevalence of depression among patients with tuberculosis: A systematic review and meta-analysis","volume":"19","author":"B Duko","year":"2020","journal-title":"Ann Gen Psychiatry"},{"issue":"1","key":"pgph.0007388.ref010","doi-asserted-by":"crossref","first-page":"231","DOI":"10.4314\/ahs.v23i1.25","article-title":"Prevalence of depression in people with tuberculosis in East Africa: A systematic review and meta-analysis","volume":"23","author":"WG Alemu","year":"2023","journal-title":"Afr Health Sci"},{"issue":"1","key":"pgph.0007388.ref011","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1007\/s44192-025-00248-9","article-title":"Prevalence and predictors of depression in tuberculosis patients in india: A systematic review and meta-analysis","volume":"5","author":"J Samal","year":"2025","journal-title":"Discov Ment Health"},{"issue":"1","key":"pgph.0007388.ref012","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0227472","article-title":"Association between tuberculosis and depression on negative outcomes of tuberculosis treatment: A systematic review and meta-analysis","volume":"15","author":"P Ruiz-Grosso","year":"2020","journal-title":"PLoS One"},{"issue":"7","key":"pgph.0007388.ref013","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1080\/17441692.2020.1826049","article-title":"Depression and delayed tuberculosis treatment initiation among newly diagnosed patients in Botswana","volume":"16","author":"K Molebatsi","year":"2021","journal-title":"Glob Public Health"},{"issue":"3","key":"pgph.0007388.ref014","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/j.ijtb.2022.05.007","article-title":"Prevalence of depression and anxiety in pulmonary tuberculosis patients and its association with unsuccessful treatment outcome: A prospective cohort study","volume":"70","author":"S Kumpuangdee","year":"2023","journal-title":"Indian J Tuberc"},{"issue":"01","key":"pgph.0007388.ref015","doi-asserted-by":"crossref","first-page":"31","DOI":"10.4236\/jtr.2021.91003","article-title":"Psychiatric problems in pulmonary tuberculosis: Depression and anxiety","volume":"09","author":"JV Lara-Espinosa","year":"2021","journal-title":"J Tuberc Res"},{"key":"pgph.0007388.ref016","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1186\/1748-5908-5-69","article-title":"Scoping studies: Advancing the methodology","volume":"5","author":"D Levac","year":"2010","journal-title":"Implement Sci"},{"issue":"7","key":"pgph.0007388.ref017","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0322753","article-title":"Methodologies for studying depression in persons living with tuberculosis: Protocol for a scoping review","volume":"20","author":"AJ Gupta","year":"2025","journal-title":"PLoS One"},{"issue":"7","key":"pgph.0007388.ref018","doi-asserted-by":"crossref","first-page":"467","DOI":"10.7326\/M18-0850","article-title":"PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and explanation","volume":"169","author":"AC Tricco","year":"2018","journal-title":"Ann Intern Med"},{"issue":"7","key":"pgph.0007388.ref019","doi-asserted-by":"crossref","first-page":"804","DOI":"10.5588\/ijtld.17.0038","article-title":"Depression and risk of tuberculosis: a nationwide population-based cohort study","volume":"21","author":"KH Oh","year":"2017","journal-title":"Int J Tuberc Lung Dis"},{"key":"pgph.0007388.ref020","doi-asserted-by":"crossref","first-page":"235","DOI":"10.3389\/fpsyt.2017.00235","article-title":"Increased risk of pulmonary tuberculosis in patients with depression: A cohort study in Taiwan","volume":"8","author":"K-C Cheng","year":"2017","journal-title":"Front Psychiatry"},{"issue":"6","key":"pgph.0007388.ref021","doi-asserted-by":"crossref","first-page":"2385","DOI":"10.3390\/clinpract14060187","article-title":"Clinical strategies for identifying pediatric patients with tuberculosis at risk of developing depressive disorders","volume":"14","author":"OM Mihailov","year":"2024","journal-title":"Clin Pract"},{"issue":"7","key":"pgph.0007388.ref022","first-page":"1403","article-title":"Effect of pharmacist-led patient education on management of depression in drug resistance tuberculosis patients using cycloserine","volume":"34","author":"I Kaukab","year":"2015","journal-title":"A Propective Study"},{"key":"pgph.0007388.ref023","doi-asserted-by":"crossref","first-page":"3103","DOI":"10.2147\/NDT.S183039","article-title":"Vitamin D3 as adjunctive therapy in the treatment of depression in tuberculosis patients: a short-term pilot randomized double-blind controlled study","volume":"14","author":"L Zhang","year":"2018","journal-title":"Neuropsychiatr Dis Treat"},{"issue":"3","key":"pgph.0007388.ref024","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1080\/01973533.2019.1600519","article-title":"Comprehensive intervention for anxiety and depression among the community elderly with tuberculosis","volume":"41","author":"X Li","year":"2019","journal-title":"Basic and Appl Soc Psychol"},{"issue":"1","key":"pgph.0007388.ref025","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1186\/s12890-020-1141-y","article-title":"People-centred care versus clinic-based DOT for continuation phase TB treatment in Armenia: A cluster randomized trial","volume":"20","author":"V Khachadourian","year":"2020","journal-title":"BMC Pulm Med"},{"issue":"12","key":"pgph.0007388.ref026","first-page":"13950","article-title":"Effect of targeted nursing intervention plus psychological counseling on quality of life, negative emotions, and complications in patients with extensively drug-resistant tuberculosis","volume":"13","author":"Y Lu","year":"2021","journal-title":"Am J Transl Res"},{"issue":"1","key":"pgph.0007388.ref027","doi-asserted-by":"crossref","first-page":"2160","DOI":"10.1186\/s12889-022-14631-6","article-title":"Cognitive-behavioral therapy on psychological stress and quality of life in subjects with pulmonary tuberculosis: a community-based cluster randomized controlled trial","volume":"22","author":"X Zuo","year":"2022","journal-title":"BMC Public Health"},{"issue":"36","key":"pgph.0007388.ref028","article-title":"Development and evaluation of an early rehabilitation nursing program for patients with pulmonary tuberculosis","volume":"102","author":"L Xie","year":"2023","journal-title":"Medicine (Baltimore)"},{"issue":"12","key":"pgph.0007388.ref029","first-page":"274","article-title":"Integrated nursing and psychological intervention for tuberculosis complicated by lung cancer: clinical efficacy","volume":"30","author":"W Yuan","year":"2024","journal-title":"Altern Ther Health Med"},{"issue":"1","key":"pgph.0007388.ref030","article-title":"Depression care integration in tuberculosis services: A feasibility assessment in Pakistan","volume":"27","author":"Zala","year":"2024","journal-title":"Health Expect"},{"key":"pgph.0007388.ref031","article-title":"Screening and management of depression among patients on TB treatment in Papumpare district, Arunachal Pradesh, India","volume":"71","author":"O Apang","year":"2024","journal-title":"Indian J Tuberc"},{"issue":"1","key":"pgph.0007388.ref032","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1080\/02688690120114278","article-title":"Frontal lobe tuberculoma masquerading as postnatal depression","volume":"16","author":"P Stavrou","year":"2002","journal-title":"Br J Neurosurg"},{"issue":"7","key":"pgph.0007388.ref033","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0201163","article-title":"Implementation of a psychosocial support package for people receiving treatment for multidrug-resistant tuberculosis in Nepal: A feasibility and acceptability study","volume":"13","author":"IF Walker","year":"2018","journal-title":"PLoS One"}],"container-title":["PLOS Global Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pgph.0007388","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T17:25:21Z","timestamp":1790616321000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pgph.0007388"}},"subtitle":[],"editor":[{"given":"Julia","family":"Robinson","sequence":"first","affiliation":[{"name":"PLOS: Public Library of Science","place":["UNITED STATES OF AMERICA"]}],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,9,28]]},"references-count":33,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9,28]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pgph.0007388","relation":{},"ISSN":["2767-3375"],"issn-type":[{"value":"2767-3375","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,28]]}}}