南非结核病患者抑郁症治疗的有效性和成本效益

其他：对照：照常加强治疗

新的成年结核病患者将接受抑郁症筛查，有明显症状（PHQ-9 > 15 和/或自杀意念）的患者将转诊给门诊护士进行评估，并根据需要转诊至专门的精神卫生保健机构。 抑郁症的常规筛查不是结核病患者的标准做法；因此，评估和转诊照常被视为“加强”治疗。 个人将在基线和治疗完成时接受采访。

行为的：照常加强治疗

抑郁症筛查和转诊（根据需要）

实验性的：Intervention: Interpersonal Counseling for Depression

New adult TB patients with depressive symptoms (PHQ-9 > 10) will be offered 4-5 sessions of Interpersonal Counseling delivered by a trained lay counsellor.

行为的：Interpersonal Counseling

Interpersonal Counseling is a brief (4-5 sessions) psychological intervention that was developed to treat depression in primary care. In IPC, counselors provide psychoeducation about the connection of depressive symptoms to social triggers and support patients in leveraging social networks to address these stressors and reduce depressive symptoms. Since depressive symptoms are often a transient reaction to life stress (e.g. TB diagnosis), many individuals are able to achieve significant alleviation of symptoms in as few as four sessions. IPC focuses on reducing interpersonal conflict and improving social cohesion in families, which may have the advantage of strengthening the ability of families to support TB patients in completing treatment to achieve cure. All individuals will be offered 4-5 sessions (weekly).

结核病治疗成功率

患者级别的结核病治疗成功（是/否）将从临床记录中提取并根据南非国家结核病控制指南定义为所有治愈的涂片阳性患者（上个月治疗的涂片阴性）和完成治疗的患者但不符合治愈或失败的标准。

抑郁症缓解率

将使用患者健康问卷 (PHQ-9) 评估患者水平的抑郁缓解（是/否），并将其定义为小于 10 分。