Prevalence and Correlates of Probable Depression and Post-Traumatic Stress Disorder Among Female Sex Workers in Lilongwe, Malawi

MacLean, Sarah A.; Lancaster, Kathryn E.; Lungu, Thandie; Mmodzi, Pearson; Hosseinipour, Mina C.; Pence, Brian W.; Hoffman, Irving; Miller, William C.

doi:10.1007/s11469-017-9829-9

Cited by 21 publications

(29 citation statements)

References 47 publications

(102 reference statements)

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“…The PHQ-9 was translated into the local language (Chichewa) and the same version was utilised in recently published studies examining postnatal depression in Malawi. 17,18 This version of the PHQ-9 was found to be in concordance with the Edinburgh Postnatal Depression Scale in our setting.…”

Section: Study Proceduressupporting

confidence: 63%

“…Any woman with a PHQ‐9 score of ≥10, or who reported any suicidal ideation on the PHQ‐9, were referred for local mental health services. The PHQ‐9 was translated into the local language (Chichewa) and the same version was utilised in recently published studies examining postnatal depression in Malawi . This version of the PHQ‐9 was found to be in concordance with the Edinburgh Postnatal Depression Scale in our setting.…”

Section: Methodsmentioning

confidence: 89%

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Continence, quality of life and depression following surgical repair of obstetric vesicovaginal fistula: a cohort study

Kopp

Tang

Bengtson

et al. 2018

BJOG

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Objective We evaluated residual incontinence, depression, and quality of life among Malawian women who had undergone vesicovaginal fistula (VVF) repair 12 or more months previously. Design Prospective cohort study. Setting Fistula Care Centre in Lilongwe, Malawi. Population Women who had undergone VVF repair in Lilongwe, Malawi at least 12 months prior to enrolment. Methods Self‐report of urinary leakage was used to evaluate for residual urinary incontinence; depression was evaluated with the Patient Health Questionnaire‐9; quality of life was evaluated with the King's Health Questionnaire. Main outcome measures Prevalence and predictors of residual incontinence, quality of life scores, and prevalence of depression and suicidal ideation. Results Fifty‐six women (19.3%) reported residual urinary incontinence. In multivariable analyses, predictors of residual urinary incontinence included: pre‐operative Goh type 3 [adjusted risk ratio (aRR) 2.82; 95% confidence interval (CI) 1.61–5.27) or Goh type 4 1.08–2.78), positive postoperative cough stress test (aRR = 2.42; 95% CI 1.24–4.71) and the positive 1‐hour postoperative pad test (aRR = 2.20; 95% CI 1.08–4.48). Women with Goh types 3 and 4 VVF reported lower quality of life scores. Depressive symptoms were reported in 3.5% of women; all reported residual urinary incontinence. Conclusions While the majority of women reported improved outcomes in the years following surgical VVF repair, those with residual urinary incontinence had a poorer quality of life. Services are needed to identify and treat this at‐risk group. Tweetable abstract Nearly one in five women reported residual urinary incontinence at follow up, 12 or months after vesicovaginal fistula repair.

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Section: Study Proceduressupporting

confidence: 63%

Section: Methodsmentioning

confidence: 89%

Continence, quality of life and depression following surgical repair of obstetric vesicovaginal fistula: a cohort study

Kopp

Tang

Bengtson

et al. 2018

BJOG

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“…The pooled prevalence of anxiety among FSWs from LMICs is 21.0% (95% CI 4.8%-58.4%). PTSD symptomology was reported in 8 studies [9,10,23,40,43,46,47,50] with 4 studies included in the meta-analysis (Fig 4). The…”

Section: Plos Medicinementioning

confidence: 99%

“…Seventeen studies reported on suicidal ideation [10,36,39,46,47,55,57,58,61,69,71,[75][76][77][78][79][80]. Most assessed suicidal ideation by asking about suicidal thoughts, for example, "have you thought about killing yourself?"…”

Section: Plos Medicinementioning

confidence: 99%

“…and "have you ever felt like you wanted to end your life?" For the meta-analysis, we divided studies based on timeframe into 'recent' or 'ever' suicidal ideation and removed 3 studies due to limitations in how questions were operationalized [46,47], including one study that combined suicidal thoughts with attempting suicide [65]. The pooled prevalence of recent (past 3 months, 6 months, or year) suicide ideation is 22.8% (95% CI 13.2%-36.5%) (n = 6 studies from 7 countries) ( Fig 6).…”

Section: Plos Medicinementioning

confidence: 99%

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Mental health problems among female sex workers in low- and middle-income countries: A systematic review and meta-analysis

et al. 2020

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Background The psychological health of female sex workers (FSWs) has emerged as a major public health concern in many low-and middle-income countries (LMICs). Key risk factors include poverty, low education, violence, alcohol and drug use, human immunodeficiency virus (HIV), and stigma and discrimination. This systematic review and meta-analysis aimed to quantify the prevalence of mental health problems among FSWs in LMICs, and to examine associations with common risk factors. Method and findings The review protocol was registered with PROSPERO, number CRD42016049179. We searched 6 electronic databases for peer-reviewed, quantitative studies from inception to 26 April 2020. Study quality was assessed with the Centre for Evidence-Based Management (CEBM) Critical Appraisal Tool. Pooled prevalence estimates were calculated for depression, anxiety, post-traumatic stress disorder (PTSD), and suicidal behaviour. Meta-analyses examined associations between these disorders and violence, alcohol/drug use, condom use, and HIV/sexually transmitted infection (STI). A total of 1,046 studies were identified, and 68 papers reporting on 56 unique studies were eligible for inclusion. These were geographically diverse (26 countries), representing all LMIC regions, and included 24,940 participants. All studies were cross-sectional and used a range of measurement tools; none reported a mental health intervention. Of the 56 studies, 14 scored as strong quality, 34 scored as moderate, and 8 scored as weak. The average age of participants was 28.9 years (age range: 11-64 years), with just under half (46%) having up to primary education or less. The pooled prevalence rates for mental disorders among FSWs in LMICs were as follows: depression 41.8% (95% CI 35.8%-48.0%), anxiety 21.0% (95% CI: 4.8%-58.4%), PTSD 19.7% (95% CI 3.2%-64.6%), psychological distress 40.8% (95% CI 20.7%-64.4%), recent suicide ideation 22.8% (95% CI 13.2%-36.5%), and recent suicide attempt 6.3% (95% CI 3.4%-11.4%). Meta-analyses found significant associations between violence experience

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Prevalence and co‐occurrence of symptoms of mental and substance use disorders among people with HIV age 40 and older in low‐ and middle‐income countries: a cross‐sectional study

Parcesepe,

Stockton,

Bernard

et al. 2024

J Int AIDS Soc.

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IntroductionDue to the increased effectiveness of and access to antiretroviral therapy (ART), people with HIV (PWH) are living longer. As a result, the population of older PWH has increased. Mental and substance use disorders (MSDs) are common and frequently co‐occurring among PWH and are associated with poor HIV care outcomes. Research into the prevalence and co‐occurrence of MSDs among ageing PWH remains limited, particularly in low‐ and middle‐income countries (LMICs).MethodsWe analysed data collected between 2020 and 2022 from the International epidemiology Databases to Evaluate AIDS (IeDEA) Sentinel Research Network cohort of PWH aged 40 years or older on ART at 11 HIV clinics in Brazil, Côte d'Ivoire, India, Kenya, Mexico, Uganda, Rwanda, Togo, Vietnam, Zambia and Zimbabwe. We estimated the prevalence and co‐occurrence of unhealthy alcohol use (AUDIT‐C ≥3 for women, ≥4 for men), unhealthy drug use (ASSIST >3 for cannabis, cocaine, amphetamines, inhalants, sedatives, hallucinogens and/or opioids), and moderate to severe symptoms of depression (PHQ‐9 ≥10), anxiety (GAD‐7 ≥10) and post‐traumatic stress disorder (PTSD) (PCL‐5 ≥33). Psychiatric multimorbidity was defined as having symptoms of two or more disorders assessed. Log binomial models assessed the association between socio‐demographic and HIV care characteristics and symptoms of anxiety, depression, PTSD or unhealthy substance use.ResultsOf 2821 participants, the prevalence of unhealthy alcohol and drug use was 21% and 5%, respectively. The prevalence of moderate to severe symptoms of depression, anxiety and PTSD was 14%, 9% and 6%, respectively. Overall, the prevalence of psychiatric multimorbidity was 11%. Among those with symptoms of at least one mental health or substance use outcome assessed (n = 1036), the prevalence of psychiatric multimorbidity was 31%. In binomial models, the prevalence of symptoms of depression and anxiety was higher, while the prevalence of unhealthy alcohol and drug use was lower among women than men.ConclusionsUnhealthy alcohol use and symptoms of depression were most commonly reported, among this cohort of PWH aged 40 or older across 11 LMICs. Integration of MSD screening and treatment into HIV care should be prioritized. The effectiveness and implementation of transdiagnostic or multi‐focus mental health treatment approaches in HIV care settings should be examined.

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Prevalence and Correlates of Probable Depression and Post-Traumatic Stress Disorder Among Female Sex Workers in Lilongwe, Malawi

Cited by 21 publications

References 47 publications

Continence, quality of life and depression following surgical repair of obstetric vesicovaginal fistula: a cohort study

Continence, quality of life and depression following surgical repair of obstetric vesicovaginal fistula: a cohort study

Mental health problems among female sex workers in low- and middle-income countries: A systematic review and meta-analysis

Prevalence and co‐occurrence of symptoms of mental and substance use disorders among people with HIV age 40 and older in low‐ and middle‐income countries: a cross‐sectional study

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