Prevalence and Factors Associated With Depression Among Children and Adolescents Living with HIV Attending Care and Tretment Centre Clinic Mwanza Tanzania.
Jovita John Bhuki [Female]
Prevalence and Factors Associated With Depression Among Children and Adolescents Living with HIV Attending Care and Tretment Centre Clinic Mwanza Tanzania. - Mwanza, Tanzania: Catholic University of Health and Allied Sciences [CUHAS - Bugando] : 2019 - xiii; 59 Pages Includes References and Appendices
Abstract:
Background: An estimated 2.1 million adolescents (aged 10–19 years) are living with HIV worldwide, the majority being in sub-Saharan Africa, half of all new HIV infections occur in young people aged 15–24 years. The introduction of antiretroviral therapy (ART) has improved survival, reduced mortality in children and hence allowing them to grow to adolescence and adulthood which then may encounter stressors increasing the risks of developing mental health problems like depression. Depression have been reported to be higher in children and adolescents (CALHIV) compared to general population, however due to different culture, parenting, stigma, poverty, ability to seek health care and most of research done to assess the depression and immune status were done in adults hence there is a need to assess the situation in our setting.
Objectives: The study aimed to determine the prevalence and factors associated with depression among children and adolescents living with HIV attending Nyamagana, Sengerema and Sekou-toure regional hospital in Mwanza Region.
Methods: This was a cross sectional hospital based study involving 230 children and adolescents aged 7- 19yrs on ART attending from Jan 2018 to May 2019 at Nyamagana, Sengerema and Sekou-Toure Care and treatment center clinics. Formulated questionnaires for obtaining demographic data were given to participants, each participant was interviewed using MINI KID to determine depression. ART adherence was evaluated by either missed pills (self-report) or pill counting.CD4 count and viral load were taken from the medical files. Data was analyzed by STATA version 13 as per study objectives.
RESULTS: Out of 230 CALHIV 53.9% were female and median age 14(IQR: 12-16) years. Prevalence of depression among CALHIV was 60(26.1 %.). Among patients who experienced depression, 34(56.7%) experienced suicidal ideas in the past. In multivariate analysis, age 14-19years (OR: 5.2, 95% CI: 2.4-11.4; p-value< 0.003), Orphan hood (OR: 3.3; 95% CI: 1.1-10.1; p-value=0.003), stigmatization (OR: 11.9; 95% CI: 2.7-52.5; p-value=0.001), low CD4 count (OR: 6.7; 95% CI: 2.8-16 ; p-value<0.001),poor ART adherence (OR: 2.2; 95% CI: 1.0-5.1; p-value=0.04) were statistically significant associated with depression.
CONCLUSIONS. Depression is a common mental disorder in children and adolescents living with HIV. Poor ART adherence, low CD4 count, stigmatization, orphans and older adolescents are significantly associated with depression hence mental assessment should be evaluated thoroughly in this group of people.
= OPERATIONAL DEFINITIONS Depression is defined as depressed mood or a loss of interest or pleasure in daily activities for more than two week. Symptoms include significant weight change (5%) or change in appetite, Change in sleep patterns, Change in activity, Fatigue or loss of energy, Guilt/worthlessness, loss of Concentration and /or Suicidal ideation. According to Mini International Neuropsychiatric Interview (MINI-KID) screening tool (DSM-V), 5 or more of the above symptoms defined Depression. OPERATIONAL DEFINITIONS Children: Age group between 7-9years according to world health organization (WHO) OPERATIONAL DEFINITIONS Adolescents: Age group between 10-19 years according to World health organization (WHO). OPERATIONAL DEFINITIONS Recent CD4 count: CD4 count taken within 6months OPERATIONAL DEFINITIONS Recent HIV viral load: Viral load taken within 1 year. OPERATIONAL DEFINITIONS Clinics: care and treatment center clinics in Nyamagana district hospital ,Sekou- Toure regional hospital and Sengerema Designatated district hospital. = LIST OF ABBREVIATIONS AIDS Acute Immunodeficiency Syndrome ART Anti- Retro Viral Therapy CALHIV Children And Adolescents Living With HIV CTC Care And Treatment Centre HIV Human Immunodeficiency Virus HVL HIV Viral Load HPT Hypothalamus Pituitary Thyroid Axis MINI-KID Mini International Neuropsychiatric Interview CPS Counseling And Psychosocial Support SSA Sub Saharan Africa. SSRI Selective Serotonin Reuptake Inhibitor
Wurzburg Road 35, BMC Premises, Post Code: 33102: P. O Box 1464, Mwanza – Tanzania: Phone: +255 28 298 3384: Fax: +255 28 298 3386: Email: vc@bugando.ac.tz: www.bugando.ac.tz
--Pediatrics and Child Health
Prevalence and Factors Associated With Depression Among Children and Adolescents Living with HIV Attending Care and Tretment Centre Clinic Mwanza Tanzania. - Mwanza, Tanzania: Catholic University of Health and Allied Sciences [CUHAS - Bugando] : 2019 - xiii; 59 Pages Includes References and Appendices
Abstract:
Background: An estimated 2.1 million adolescents (aged 10–19 years) are living with HIV worldwide, the majority being in sub-Saharan Africa, half of all new HIV infections occur in young people aged 15–24 years. The introduction of antiretroviral therapy (ART) has improved survival, reduced mortality in children and hence allowing them to grow to adolescence and adulthood which then may encounter stressors increasing the risks of developing mental health problems like depression. Depression have been reported to be higher in children and adolescents (CALHIV) compared to general population, however due to different culture, parenting, stigma, poverty, ability to seek health care and most of research done to assess the depression and immune status were done in adults hence there is a need to assess the situation in our setting.
Objectives: The study aimed to determine the prevalence and factors associated with depression among children and adolescents living with HIV attending Nyamagana, Sengerema and Sekou-toure regional hospital in Mwanza Region.
Methods: This was a cross sectional hospital based study involving 230 children and adolescents aged 7- 19yrs on ART attending from Jan 2018 to May 2019 at Nyamagana, Sengerema and Sekou-Toure Care and treatment center clinics. Formulated questionnaires for obtaining demographic data were given to participants, each participant was interviewed using MINI KID to determine depression. ART adherence was evaluated by either missed pills (self-report) or pill counting.CD4 count and viral load were taken from the medical files. Data was analyzed by STATA version 13 as per study objectives.
RESULTS: Out of 230 CALHIV 53.9% were female and median age 14(IQR: 12-16) years. Prevalence of depression among CALHIV was 60(26.1 %.). Among patients who experienced depression, 34(56.7%) experienced suicidal ideas in the past. In multivariate analysis, age 14-19years (OR: 5.2, 95% CI: 2.4-11.4; p-value< 0.003), Orphan hood (OR: 3.3; 95% CI: 1.1-10.1; p-value=0.003), stigmatization (OR: 11.9; 95% CI: 2.7-52.5; p-value=0.001), low CD4 count (OR: 6.7; 95% CI: 2.8-16 ; p-value<0.001),poor ART adherence (OR: 2.2; 95% CI: 1.0-5.1; p-value=0.04) were statistically significant associated with depression.
CONCLUSIONS. Depression is a common mental disorder in children and adolescents living with HIV. Poor ART adherence, low CD4 count, stigmatization, orphans and older adolescents are significantly associated with depression hence mental assessment should be evaluated thoroughly in this group of people.
= OPERATIONAL DEFINITIONS Depression is defined as depressed mood or a loss of interest or pleasure in daily activities for more than two week. Symptoms include significant weight change (5%) or change in appetite, Change in sleep patterns, Change in activity, Fatigue or loss of energy, Guilt/worthlessness, loss of Concentration and /or Suicidal ideation. According to Mini International Neuropsychiatric Interview (MINI-KID) screening tool (DSM-V), 5 or more of the above symptoms defined Depression. OPERATIONAL DEFINITIONS Children: Age group between 7-9years according to world health organization (WHO) OPERATIONAL DEFINITIONS Adolescents: Age group between 10-19 years according to World health organization (WHO). OPERATIONAL DEFINITIONS Recent CD4 count: CD4 count taken within 6months OPERATIONAL DEFINITIONS Recent HIV viral load: Viral load taken within 1 year. OPERATIONAL DEFINITIONS Clinics: care and treatment center clinics in Nyamagana district hospital ,Sekou- Toure regional hospital and Sengerema Designatated district hospital. = LIST OF ABBREVIATIONS AIDS Acute Immunodeficiency Syndrome ART Anti- Retro Viral Therapy CALHIV Children And Adolescents Living With HIV CTC Care And Treatment Centre HIV Human Immunodeficiency Virus HVL HIV Viral Load HPT Hypothalamus Pituitary Thyroid Axis MINI-KID Mini International Neuropsychiatric Interview CPS Counseling And Psychosocial Support SSA Sub Saharan Africa. SSRI Selective Serotonin Reuptake Inhibitor
Wurzburg Road 35, BMC Premises, Post Code: 33102: P. O Box 1464, Mwanza – Tanzania: Phone: +255 28 298 3384: Fax: +255 28 298 3386: Email: vc@bugando.ac.tz: www.bugando.ac.tz
--Pediatrics and Child Health