Cognitive Therapy for depression in Tuberculosis treatment: a programme of research to improve outcomes for depression and TB in Pakistan.

This project is led by colleagues in the Institute for Global Health.

NIHR logo Funding from the NIHR Research and Innovation for Global Health Transformation Grant has been secured by researchers on a 48-month project regarding Tuberculosis (TB) and mental health in low- and middle-income countries (LMICs).

butterfly logo Worldwide, TB is the 10th leading cause of death. Depression is a major multimorbidity with TB in most LMICs. Pakistan is ranked fifth among TB high-burden countries and has fourth highest prevalence of MDR-TB globally.

The CONTROL programme aims to develop and test psychological intervention for treating depression in Pakistani and Afghan refugee TB (and multi-drug resistant TB) patients and to improve their adherence with anti-TB treatment. The programme also aims to test the intervention’s effectiveness and cost effectiveness and examine how the intervention can be implemented in real-world settings.

Professor Saeed Farooq and Dr Zohaib Khan

"This will be the first study in which teams in the UK, Pakistan, Afghanistan and other countries will work together to develop a psychological treatment for depression in TB and then test its effectiveness."

Professor Saeed Farooq and Dr Zohaib Khan

CONTROL is jointly led by Professor Saeed Farooq from Keele University and Dr Zohaib Khan from Khyber Medical University (Pakistan). The programme will bring together the diverse experience of the other co-investigators from a variety of different organizations, as seen below:

Joint Lead Institutions






Keele University:

  • Professor Saeed Farooq
  • Professor Christian Mallen
  • Dr Martyn Lewis

Khyber Medical University:

  • Dr Zohaib Khan
  • Professor Zia Ul Haq
  • Professor Saadia Ashraf

University of Peshawar:

  • Dr Noor Sanauddin

Healthnet TPO:

  • Professor Ivan Komproe

University of Leeds:

  • Dr Ian Kellar

Lady Reading Hospital:

  • Dr Mian Mukhtar Ul Haq

Pakistan Association of Cognitive Therapy:

  • Professor Farooq Naeem



Dr Haroon Rashid Clinic:

  • Dr Mirrat Gul

TB control programme of Khyber Pakhtunkhwa


The CONTROL programme consists of four work packages:CONTROL voice logo

  • WP1 - Developing intervention using evidence synthesis based on ethnographic and qualitative methods for incorporating the perspectives of patients and care givers (family and health professionals).
  • WP2 - Inbuilt pilot RCT to test and refine intervention with a clear progression criterion to the definitive trial.
  • WP3 - A randomised controlled trial to test if the CONTROL intervention is successful in improving the outcomes both for depression and TB, and also whether the CONTROL intervention is cost-effective.
  • WP4 - A process evaluation to understand the challenges and scale-up in TB control programmes. We will interview patients, staff, and policy makers to explore acceptability and experiences. We will also see how the CONTROL intervention, if successful, could be modified for other chronic infections such as Hepatitis C.

Capacity building and community engagement are major components of the CONTROL programme. Five PhD studentships (joint supervision between Keele and KMU) and eight Masters in Public Health studentships (KMU) will be offered, alongside post-doctoral research fellow positions.

Community engagement

Community Engagement focuses on actively engaging with the local and Afghan refugee communities to spread awareness regarding the CONTROL project, TB and mental health outcomes, and to address any prevailing myths. There is active inclusion of and engagement with the typically under-represented group of women.

Study updates

Keele logo Leeds logo KMU logo LRH logo University of Peshawar logo
National TB programme logo Healthnet TPO logo PACT logo