Prevalence, Correlates and Under-Diagnosis of Clinical Depression among Adults on Highly Active Antiretroviral Therapy in a Tertiary Health Institution in Northeastern Nigeria.

Journal: Journal of public health in Africa

Volume: 5

Issue: 2

Year of Publication: 

Affiliated Institutions:  Mental Health Department, Federal Neuropsychiatric Hospital, Maiduguri, Nigeria; Mental Health Department, University of Maiduguri, Borno state, Nigeria. Mental Health Department, University of Maiduguri, Borno state, Nigeria; Department of Research and Training, Federal Neuropsychiatric Hospital, Maiduguri, Nigeria. Mental Health Department, University of Maiduguri , Borno state, Nigeria. Clinical Services Department, Federal Neuropsychiatric Hospital , Maiduguri, Nigeria. Mental Health Department, Federal Neuropsychiatric Hospital , Maiduguri, Nigeria. Infectious Disease Unit, Internal Medicine Department, University of Maiduguri , Aro-Abeokuta, Nigeria. Clinical Services Department, Neuropsychiatric Hospital , Aro-Abeokuta, Nigeria. Clinical Psychology Unit, Federal Medical Centre , Nguru-Yobe State, Nigeria.

Abstract summary 

Clinical depression is a highly debilitating illness, which is often under-diagnosed and negatively impacts on the quality of life of its sufferers. When it co-exists with other medical conditions, its effect is even more incapacitating. Undiagnosed depression in the context of HIV infection leads to accelerated decline in CD4+ cell counts with concomitant increase in the viral load and poor adherence to the antiretroviral medications which lead to viral mutation and the evolution of resistant strains. This study examined the prevalence of depression, its correlates and the frequency of the diagnosis of the condition among HIV+ subjects on highly active antiretroviral therapy (HAART) by the internists and general physicians at the University of Maiduguri Teaching Hospital in Northeastern Nigeria. Three hundred and fifty representative samples of HIV+ adults on HAART were drawn from the Antiretroviral Therapy Clinic of the Institution. Diagnosis of depression was made using the International Classification of Diseases-10 criteria based on Composite International Diagnostic Interview generated data. Socio-demographic and clinical variables were also analyzed for their correlation with depression in the subjects. About 20% of the respondents were diagnosed with clinical depression and no diagnosis of the condition was hitherto entertained in all the respondents. The independent determinants of depression in the participants were: female gender [odds ratio (OR)=3.87 (95% confidence interval, CI: 2.089-7.183)], past history of psychiatric illness [OR=43.81 (95% CI: 9.731-197.30)] and family history of psychiatric illness in first-degree relatives of the subjects [OR=14.364 (95% CI=5.327-38.729)]. Depression is a relatively common psychiatric condition among adults on HAART, there is therefore the need for routine screening of this condition among HIV+ subjects in order to optimize patient care and improve clinical outcomes.

Authors & Co-authors:  Ibrahim Abdu Wakawa AW Jidda Mohammed Said MS Wakil Musa Abba MA Rabbebe Isa Bukar IB Omeiza Asuku Beida AB Yusuph Haruna H Ogunlesi Adegboyega A Suleiman Umar Garba UG

Study Outcome 

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Citations :  Regier DA, Narrow WE, Rae DS, et al. The De facto US mental and addictive disorders service system: epidemiologic catchment area prospective 1-year prevalence rates of disorders and services. Archiv General Psychiat 1993;50:85-94.
Authors :  8
Identifiers
Doi : 342
SSN : 2038-9922
Study Population
Female
Mesh Terms
Other Terms
depression;highly active antiretroviral therapy;northeastern Nigeria
Study Design
Cross Sectional Study
Study Approach
Country of Study
Niger
Publication Country
Italy