Prevalence and incidence of probable perinatal depression among women enrolled in Option B+ antenatal HIV care in Malawi

Harrington, Bryna J.; Hosseinipour, Mina C.; Maliwichi, Madalitso; Phulusa, Jacob; Jumbe, Allan; Wallie, Shaphil D; Maselko, Joanna; Miller, William C.; Pence, Brian W.

doi:10.1016/j.jad.2018.06.001

Cited by 16 publications

(14 citation statements)

References 63 publications

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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: 69%

“…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%

“…Our findings may reflect the low rate of depressive disorders observed among Malawian women in the general population (3-15%). 17,[33][34][35] Further research is needed in this field, including further validation of survey instruments among women with VVF.…”

Section: Limitationsmentioning

confidence: 99%

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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: 69%

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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“…In Kenya and Uganda, greater depressive symptom severity was associated with greater likelihood of ART initiation during the study period among sero-converted partners of previously sero-discordant couples [54]. Studies of depression and retention in care conducted in Malawi and the Democratic Republic of the Congo found no difference between 12-month retention or viral suppression among pregnant women with and without depression at ART initiation [20,55]. One explanation for the differences in the literature relating depression and ART adherence versus relating depression and retention is that depression may not affect engagement in care in the same way it impacts ART adherence; different skills sets are required for adherence to daily ART than maintaining monthly clinic visits [53].…”

Section: Discussionmentioning

confidence: 86%

“…Depression is a major contributor to the burden of disease and disability and is highly prevalent among people living with HIV in Malawi and elsewhere in SSA, a region where mental health care is often limited [15,16]. Depression affects 18 to 30% of patients receiving HIV care in Africa [17], and estimates from Malawi range from 1 to 19% [18][19][20][21]. The high prevalence of depression among people living with HIV is thought to be due to coping with the HIV diagnosis, disease symptoms, bereavement, relationship crises, stigma and discrimination, co-existing poverty, ART side effects, fear of death, and infection-related inflammatory processes [22,23].…”

Section: Introductionmentioning

confidence: 99%

Association Between Depression and HIV Care Engagement Outcomes Among Patients Newly Initiating ART in Lilongwe, Malawi

et al. 2020

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As in other sub-Saharan countries, the burden of depression is high among people living with HIV in Malawi. However, the association between depression at ART initiation and two critical outcomes—retention in HIV care and viral suppression—is not well understood. Prior to the launch of an integrated depression treatment program, adult patients were screened for depression at ART initiation at two clinics in Lilongwe, Malawi. We compared retention in HIV care and viral suppression at 6 months between patients with and without depression at ART initiation using tabular comparison and regression models. The prevalence of depression among this population of adults newly initiating ART was 27%. Those with depression had similar HIV care outcomes at 6 months to those without depression. Retention metrics were generally poor for those with and without depression. However, among those completing viral load testing, nearly all achieved viral suppression. Depression at ART initiation was not associated with either retention or viral suppression. Further investigation of the relationship between depression and HIV is needed to understand the ways depression impacts the different aspects of HIV care engagement.

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Global Systematic Review of Common Mental Health Disorders in Adults Living with HIV

et al. 2021

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Prevalence and incidence of probable perinatal depression among women enrolled in Option B+ antenatal HIV care in Malawi

Abstract: Probable depression was more common during the antenatal period than postpartum among our participants. Given the association between depression and negative HIV outcomes, screening for depression during pregnancy should be integrated into antenatal HIV care.

Cited by 16 publications

References 63 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

Association Between Depression and HIV Care Engagement Outcomes Among Patients Newly Initiating ART in Lilongwe, Malawi

Global Systematic Review of Common Mental Health Disorders in Adults Living with HIV

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