Predictors of depression among patients on art in a rural health district in North West Cameroon

ABSTRACT

Depression in people living with HIV/AIDS (acquired immune-deficiency syndrome) (PLWHA) increases risky HIV transmission behaviour, disease progression to AIDS, negatively affects drug adherence and is thus a risk for the development of drug-resistant strains. This study sought to identify predictors of depression in rural Cameroon. A cross-sectional analytic study was carried out from September 2013 to November 2013 in the Mbengwi district hospital of the North West region. We measured depression (PHQ-9 (nine-item Patient Health Questionnaire)), clinical and demographic characteristics of patients on antiretroviral therapy (ART). Means, proportions and a stepwise logistic regression model were fit to describe participants’ characteristics and predictors of depression in the study population. Of the 202 recruited patients, 58(28.7%) had a positive depression screen. Independent predictors of depression included monthly income less than 20,000 FCFA (US$40), (adjusted odds ratio (aOR) = 2.47; 95% CI = 1.18–5.18), CD4 count <200 cls/µl (aOR = 7.56; 95% CI = 2.46–23.30) and presence of AIDS symptoms (aOR = 4.29; 95% CI = 2.09–8.81). There was no significant correlation between duration on ART, marital status, age, gender and depression. Early diagnosis and treatment of depressed patients need to be incorporated into intervention programmes, which might improve patient outcomes. More research is needed to investigate the impact of antidepressant therapy in PLWHA on the evolution of treatment.

KEYWORDS:

• Depression
• HIV/AIDS
• ART
• CD4 count
• income

Acknowledgements

We heartily thank the health personnel of the Mbengwi Health District, especially the District Chief of Service for Public Health (for granting authorisation for this study to be carried out), and those of the HIV/AIDS unit, for their assistance during the data collection process. We also thank all participants for their remarkable cooperation in the course of the study.

Disclosure statement

No potential conflict of interest was reported by the authors.