scholarly journals Child Dietary Diversity, Household Food Insecurity, Child Stunting and Maternal Mental Health Symptoms in Vakinankaratra, Madagascar

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 295-295
Author(s):  
Christine Walters ◽  
Joel Komakech ◽  
Hasina Rakotomanana ◽  
Barbara Stoecker

Abstract Objectives This study aimed to determine the association between child dietary diversity, household food insecurity, child stunting, and maternal mental health symptoms in the Vakinankaratra region of Madagascar. Methods This cross-sectional study included 391 mother-child dyads. The World Health Organization (WHO) standards were used for defining child dietary diversity and child stunting and the Household Food Insecurity Access Scale (HFIAS) was used for food insecurity scores. Maternal symptoms of common mental disorders were assessed using the WHO Self-Reporting Questionnaire (SRQ), which was translated into Malagasy and pre-tested; a cutoff of seven was used to indicate the occurrence of symptoms of common mental disorders. Multivariate linear and logistic regression models adjusted for strata, cluster, and confounding variables were conducted with statistical significance set at P < 0.05. Results More than half (56.8%) of the mothers reported symptoms of common mental disorders and more than half of the children (69.4%) were stunted. The mean HFIAS score was 10.3 (±5.6) and mean child dietary diversity score was 3.0 (±1.31). Symptoms of common mental disorders were significantly associated with child dietary diversity score in the bivariate analysis but became nonsignificant in the final adjusted model (β = –0.22, P = 0.06, R2 = 0.07). In the adjusted model, having symptoms of common mental disorders was significantly associated with higher HFIAS score (β = 3.45, P < 0.0001, R2 = 0.13) and HFIAS scores were significantly associated with having symptoms of common mental disorders (AOR = 1.31 [1.09–1.17], P < 0.0001). Maternal symptoms of common mental disorders were significantly associated with stunting (AOR = 1.68 [1.02–2.78], P < 0.05). Conclusions Maternal mental health and household food insecurity were significantly associated in this rural area of the Vakinankaratra region in Madagascar. Furthermore, assessing maternal symptoms of common mental disorders and referring mothers for mental health care appears to be an important consideration for improving child stunting in the region. Funding Sources Oklahoma State University.

2021 ◽  
Author(s):  
Zulfa Abrahams ◽  
Crick Lund

Abstract Objective: Common mental disorders (CMDs) such as depression and anxiety are highly prevalent during the perinatal period, and are associated with food insecurity, domestic violence and lack of social support. This study explores the relationship between household food insecurity, mental health status and several adverse social and economic factors experienced by perinatal women during the COVID-19 pandemic.Design: Cohort study, using telephonic interviews at two time-points, three months apart. Logistic regression analysis was used to model the associations of several baseline risk factors with the occurrence of household food insecurity at follow-up as the outcome.Setting: Midwife obstetric units or basic antenatal care units in Cape Town, South Africa.Participants: The sample comprised of 880 perinatal women at baseline and 660 women at follow-up. Results: At baseline 23% were pregnant, 54% were unemployed, 13% had a probable CMD, 43% were severely food insecure and 21% experienced domestic abuse in the past year. Of the 660 women interviewed at follow-up, 71% were unemployment, 3.5% were pregnant, 7% had a probable CMD, and 32% were severely food insecure. In the multivariate regression model, after controlling for ethnicity, number of children, being HIV-infected, and having a planned pregnancy, the odds of being food insecure were greater in women who were unemployed (OR=1.88; p=0.001) or had probable CMD (OR=2.20; p=0.019) at baseline. Conclusions: This study highlights a range of socio-demographic and mental health related variables that predict food insecurity among perinatal women during the COVID-19 pandemic.


2020 ◽  
pp. 1-9
Author(s):  
Qiao Wang ◽  
Mbatshi Dima ◽  
Ari Ho-Foster ◽  
Keneilwe Molebatsi ◽  
Chawangwa Modongo ◽  
...  

Abstract Objective: To determine the association between food insecurity and HIV infection with depression and anxiety among new tuberculosis (TB) patients. Design: Our cross-sectional study assessed depression, anxiety and food insecurity with Patient Health Questionnaire (PHQ-9), Zung Anxiety Self-Assessment Scale (ZUNG) and Household Food Insecurity Access Scale, respectively. Poisson regression models with robust variance were used to examine correlates of depression (PHQ-9 ≥ 10) and anxiety (ZUNG ≥ 36). Setting: Gaborone, Botswana. Participants: Patients who were newly diagnosed with TB. Results: Between January and December 2019, we enrolled 180 TB patients from primary health clinics in Botswana. Overall, 99 (55·0 %) were HIV positive, 47 (26·1 %), 85 (47·2 %) and 69 (38·5 %) indicated depression, anxiety and moderate to severe food insecurity, respectively. After adjusting for potential confounders, food insecurity was associated with a higher prevalence of depression (adjusted prevalence ratio (aPR) = 2·30; 95 % CI 1·40, 3·78) and anxiety (aPR = 1·41; 95 % CI 1·05, 1·91). Prevalence of depression and anxiety was similar between HIV-infected and HIV-uninfected participants. Estimates remained comparable when restricted to HIV-infected participants. Conclusions: Mental disorders may be affected by food insecurity among new TB patients, regardless of HIV status.


2016 ◽  
Vol 19 (16) ◽  
pp. 2965-2974 ◽  
Author(s):  
Claudia Leite de Moraes ◽  
Emanuele Souza Marques ◽  
Michael Eduardo Reichenheim ◽  
Marcela de Freitas Ferreira ◽  
Rosana Salles-Costa

AbstractObjectiveTo investigate the direct and indirect associations between psychological and physical intimate partner violence and the occurrence of common mental disorders (CMD) and how they relate to the occurrence of household food insecurity (HFI).DesignThis was a population-based cross-sectional study. Intimate partner violence was assessed using the Brazilian version of the Revised Conflict Tactics Scale (CTS2) and HFI was assessed using the Brazilian Food Insecurity Scale. The propositional analytical model was based on a review of the literature and was tested using path analysis.SettingDuque de Caxias, Greater Rio de Janeiro, Brazil (April–December 2010).SubjectsWomen (n 849) who had been in a relationship in the 12 months preceding the interview.ResultsBoth psychological and physical violence were found to be major risk factors of HFI. Psychological violence was associated with HFI indirectly via physical violence and CMD, and directly by an unidentified path. The effects of physical violence seemed to be manifested exclusively through CMD. Most of the variables in the propositional model related to socio-economic position, demographic characteristics, degree of women’s social support and partner alcohol misuse were retained in the ‘final’ model, indicating that these factors contribute significantly to the increased likelihood of HFI.ConclusionsThe results reinforce the importance of considering domestic violence and other psychosocial aspects of family life when implementing interventions designed to reduce/eradicate HFI.


2020 ◽  
Author(s):  
Qiao Wang ◽  
Mbatshi Dima ◽  
Ari Ho-Foster ◽  
Keneilwe Molebatsi ◽  
Chawangwa Modongo ◽  
...  

Objective: To determine the association between food insecurity and HIV-infection with depression and anxiety among new tuberculosis patients. Design: Our cross-sectional study assessed depression, anxiety, and food insecurity with Patient Health Questionnaire (PHQ9), Zung Anxiety Self-Assessment Scale (ZUNG), and Household Food Insecurity Access Scale, respectively. Poisson regression models with robust variance were used to examine correlates of depression (PHQ9 ≥ 10) and anxiety (ZUNG ≥ 36). Setting: Gaborone, Botswana. Participants: Patients who were newly diagnosed with tuberculosis. Results: Between January and December 2019, we enrolled 180 TB patients from primary health clinics in Botswana. Overall, 99 (55.0%) were HIV-positive, 47 (26.1%), 85 (47.2%), and 69 (38.5%) indicated depression, anxiety, and moderate to severe food insecurity, respectively. After adjusting for potential confounders, food insecurity was associated with a higher prevalence of depression (adjusted prevalence ratio [aPR] = 2.30; 95% confidence interval [CI] = 1.40, 3.78) and anxiety (aPR = 1.41; 95% CI = 1.05, 1.91). Prevalence of depression and anxiety were similar between HIV-infected and -uninfected participants. Estimates remained comparable when restricted to HIV-infected participants. Conclusions: Mental disorders may be affected by food insecurity among new tuberculosis patients, regardless of HIV status.


2020 ◽  
Author(s):  
bilal shikur endris ◽  
Seifu Hagos Gebreyesus ◽  
Girmay Medhin ◽  
Martin Prince ◽  
Atalay Alem ◽  
...  

Abstract Background: There is a growing body of evidence for an association between common mental disorders and food insecurity. However, since most studies have been cross-sectional, it has not been possible to differentiate the direction of the association. The aim of this study was to determine the effect of common mental disorders on food insecurity using a prospective cohort study design. Methods: The study was carried out in Butajira, south-central Ethiopia among mothers who were enrolled in the CMaMiE cohort. A total of 1815 enrolled women were evaluated for symptoms of CMD using the Self-Reporting Questionnaire-20 (SRQ-20) at two time points; August 2012 (time 1, T1) and in August 2014 (time 2, T2). Probable CMD was defined when mothers reported six or more affirmative (yes) responses to the SRQ-20. Household food insecurity was measured using the Household Food Insecurity Access Scale (HFIAS) in December 2017 (time 3, T3). Zero inflated negative binomial regression was used to determine the independent effects of CMDs at T1 and T2 on food insecurity score at T3. A Poisson working model was used to determine the risk of being severely food insecure associated with CMD. Results : About two thirds of women (67.0%) were living in food insecure households.The prevalence of CMD was 4.8% at T1 and 10.0% at T2 and only 1.2 % (n=22) women had CMD at both time points. After controlling for potential confounders, women with CMD at T2 only (RR=1.14; 95%CI: 1.02, 1,29) had higher HFIAS scores at T3; Women with CMD at T1 only were not significantly associated with HFIAS score at T3. Women with CMD at T1 only had 4 times higher risk of severe food insecurity (RR=3.96, 95% CI: 2.15-7.27) and women with CMD at T2 only had 2.2 times higher risk of severe food insecurity (RR=2.24, 95% CI: 1.27-3.95) at follow-up. Conclusion : Common mental disorders among mothers were prospectively associated with increased risk of household food insecurity in this rural Ethiopian population. Possible mechanisms such as increased cost for health care, lost productivity and decreased self-efficacy warrant further investigation for their potential to prevent future food insecurity.


2021 ◽  
Vol 27 (4) ◽  
pp. 344-352
Author(s):  
Eman Mahfouz ◽  
Eman Mohammed ◽  
Shaza Alkilany ◽  
Tarek Abdel Rahman

Background: Food insecurity leads to disturbed eating patterns, hunger or poor nutrition and is strongly correlated with poor mental health. Aims: To determine the impact of household food insecurity on maternal mental health in a rural population in Egypt. Methods: This community-based cross-sectional study was conducted in Qulubba Village in Minia Governorate. We interviewed 497 mothers with at least one child, using the Household Food Insecurity Access Scale and Hopkins Symptom Check List-25. Results: Nearly 70% of women resided in food-insecure households. Symptoms of anxiety and depression were significantly more common among food-insecure mothers. By logistic regression analysis, household food insecurity, socioeconomic status, husband working abroad and number of children were significant predictors of maternal distress. Mothers with severe food insecurity were approximately 13 times more likely to experience mental distress than were food secure-mothers. Conclusions: Household food insecurity was associated with an increased likelihood of poor maternal mental health. The study highlights the need for policies to decrease poverty and programmes for screening and addressing food insecurity. Integrating mental health into programmes addressing food insecurity and providing counselling are recommended.


2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 280-280
Author(s):  
Jessica Silva ◽  
Fernando José Herkrath ◽  
Gabriela Buccini ◽  
Sonia Isoyama Venancio ◽  
Rafael Pérez-Escamilla ◽  
...  

Abstract Objectives The aim of the study was to evaluate whether maternal mental health and infant's diet mediate the association between Household Food Insecurity (HFI) and Early Child Development (ECD) using Structural Equation Modeling (SEM). We hypothesized a priori that both maternal mental health and infant's diet would mediate the association between HFI and ECD. Methods A cross-sectional study was carried out with 474 mother-infant dyads at Primary Health Centers in the Federal District, Brazil. Mothers answered a questionnaire that evaluated variables through validated instruments. SEM analyses were conducted including the following observed variables: HFI, ECD, consumption of a healthy and diverse diet, presence of a partner in the household, wanted pregnancy and current breastfeeding. Latent variables were included to evaluate mental health (created from maternal depression, trait anxiety and state anxiety), poverty (created from maternal educational level, household per capita income and participation in the Brazilian cash transfer program) and infant health (created from preterm birth, hospitalization after birth and Neonatal Intensive Care Unit needed after birth). Results Poor maternal mental health mediated the relationship between HFI and ECD (β = –0.05), but a healthy and diverse diet was not a mediator in this relationship. Poverty was related to lower ECD scores directly (β = 0.21) and indirectly (β = 0.02). Not having a partner (β = 0.05) and having an unwanted pregnancy (β = 0.02) predicted indirectly lower ECD scores. Conclusions Poor maternal mental health mediates the relationship between HFI and ECD, and ECD is influenced by poverty, single motherhood and unwanted pregnancy through different pathways. Therefore, it is necessary that public policies and interventions that aim to promote an optimal ECD also approach these aspects. Longitudinal cohort studies are needed to determine causality and identify promising approaches to improve parenting skills and ECD outcomes in the context of HFI. Funding Sources This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) (Finance Code 001, CAPES scholarship Programa Doutorado Sanduíche no Exterior Process number 88,881.189710/2018–01).


2020 ◽  
Vol 17 (3) ◽  
pp. 56-59 ◽  
Author(s):  
Mwawi Ng'oma ◽  
Tesera Bitew ◽  
Malinda Kaiyo-Utete ◽  
Charlotte Hanlon ◽  
Simone Honikman ◽  
...  

Africa is a diverse and changing continent with a rapidly growing population, and the mental health of mothers is a key health priority. Recent studies have shown that: perinatal common mental disorders (depression and anxiety) are at least as prevalent in Africa as in high-income and other low- and middle-income regions; key risk factors include intimate partner violence, food insecurity and physical illness; and poor maternal mental health is associated with impairment of infant health and development. Psychological interventions can be integrated into routine maternal and child healthcare in the African context, although the optimal model and intensity of intervention remain unclear and are likely to vary across settings. Future priorities include: extension of research to include neglected psychiatric conditions; large-scale mixed-method studies of the causes and consequences of perinatal common mental disorders; scaling up of locally appropriate evidence-based interventions, including prevention; and advocacy for the right of all women in Africa to safe holistic maternity care.


2021 ◽  
Author(s):  
Zulfa Abrahams ◽  
Crick Lund

Abstract Background Common mental disorders (CMDs) such as depression and anxiety are highly prevalent during the perinatal period, and are associated with poverty, food insecurity and domestic violence. We used data collected from perinatal women at two time-points during the COVID-19 pandemic to test the hypotheses that (1) socio-economic adversities at baseline would be associated with higher CMD prevalence at follow-up and (2) worse mental health at baseline would be associated with higher food insecurity prevalence at follow-up. Methods Telephonic interviews were conducted with perinatal women attending healthcare facilities in Cape Town, South Africa. Multivariable logistic regression analysis was used to model the associations of baseline risk factors with the prevalence of household food insecurity and CMD at 3 months follow-up. Results At baseline 859 women were recruited, of whom 217 (25%) were pregnant, 106 (12%) had probable CMD, and 375 (44%) were severely food insecure. At follow-up (n=634), 22 (4%) were still pregnant, 44 (7%) had probable CMD, and 207 (33%) were severely food insecure. In the multivariable regression model, after controlling for confounders, the odds of being food insecure at follow-up were greater in women who were unemployed [OR=2.05 (1.46-2.87); p<0.001] or had probable CMD [OR=2.37 (1.35-4.18); p=0.003] at baseline; and the odds of probable CMD at follow-up were greater in women with psychological distress [OR=2.81 (1.47-5.39); p=0.002] and abuse [OR=2.47 (1.47-4.39); p=0.007] at baseline. Conclusions This study highlights the complex bidirectional relationship between mental health and socioeconomic adversity among perinatal women during the COVID-19 pandemic.


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