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May 25, 2026Open Access

Tuberculosis and co-existing common mental and substance-use disorders: a case for including mental healthcare and substance-use prevention as part of the tuberculosis treatment package in high-burden provinces

Key Points

The aim is to underscore the need for including mental healthcare and substance-use prevention in TB treatment protocols in high-burden areas.
Analysis of TB and HIV co-infection rates in South Africa
Review of health outcomes associated with mental health and substance use in TB patients
Approximately 60% of TB patients are co-infected with HIV.
Co-infected individuals have nearly double the risk of developing multi-drug resistant TB (MDR-TB) and extreme-drug resistant TB (XDR-TB).
High mortality rates are observed due to the HIV co-infection.

Abstract

South Africa has 0.7% of the world's population and 28% of the world's population of the human immunodeficiency virus (HIV) and tuberculosis (TB) co-infected individuals. It has been estimated that approximately 60% of people with TB are co-infected with HIV (WHO 2012). Co-infected individuals have almost double the chances of getting multi-drug resistant TB (MDR-TB) and extreme-drug resistant TB (XDR-TB). These individuals also have a high mortality rate due to co-infection with HIV (Department of Health, RSA 2007).

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