Anxiety during active TB and enduring post-TB anxiety-related sequelae

Background: TB remains the leading cause of death by a single infectious agent globally. Experiencing TB disease also has profound psychological impacts that persist beyond treatment. Anxiety is increasingly recognised as a significant component of TB disease burden, but it is under-studied and the evidence is fragmented. We aimed to address this fragmentation by synthesising the literature on TB, post-TB sequelae, and anxiety.

Methods: We conducted a scoping review for literature published between January 2000 and May 2025 across PubMed, Scopus, Google Scholar, and ClinicalTrials.gov. Eligible studies examined anxiety in active TB or post-TB populations, including quantitative, qualitative, and mixed-methods data, published in English.

Results: From 612 records screened, 90 studies met the inclusion criteria. Although 87 reported on anxiety during a TB disease episode, only 3 studies addressed post-TB anxiety. Common risk factors included stigma, social isolation, financial strain, comorbid illness, and fear of recurrence. Findings suggested that anxiety often persists post-treatment, particularly among those with lasting physical limitations and socio-economic disadvantages. Challenges were observed across both low- and high-income countries.

Conclusion: Anxiety in TB and post-TB populations is widespread, multifactorial, and frequently unresolved after treatment. Additional data to inform intervention development are urgently needed.