scholarly journals Clinical and Obstetric Risk Factors for Postnatal Depression in HIV Positive Women: A Cross Sectional Study in Health Facilities in Rural KwaZulu-Natal

Author(s):  
Nontokozo Lilian Mbatha ◽  
Kebogile Elizabeth Mokwena ◽  
Sphiwe Madiba

Postnatal depression (PND) remains underdiagnosed and undertreated in different socio-economic backgrounds in South Africa. This study determined the prevalence of and clinical and obstetric risk factors for PND symptoms among HIV positive women in health facilities in a rural health district in South Africa. The Edinburgh Postnatal Depression Scale was used to measure PND from 386 women who had delivered a live infant. More than half (58.5%) tested HIV positive during the current pregnancy. The prevalence of PND symptoms was 42.5%. Logistic regression analysis yielded significant associations between clinical and obstetric variables of pre-term baby (p-value < 0.01), baby health status p-value < 0.01), baby hospitalization, (p-value < 0.01), and knowing the baby’s HIV status (p-value = 0.047). Maternal variables associated with PND were level of education (p-value < 0.01), monthly income (p-value < 0.01), and source of income (p-value = 0.05). At multivariate analysis, none of the clinical and obstetrical risk factors were independently associated with the PND. The high prevalence of PND symptoms underscore the need to integrate routine screening for PND in prevention of mother to child transmission of HIV programmes to enable early diagnosing and treatment of PND.

Healthcare ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 65
Author(s):  
Kebogile Elizabeth Mokwena ◽  
Nontokozo Lilian Mbatha

Background: Mothers living with HIV are at risk for mental health problems, which may have a negative impact on the management of their HIV condition and care of their children. Although South Africa has a high prevalence of HIV, there is a dearth of studies on sociodemographic predictors of postnatal depression (PND) among HIV-positive women in South Africa, even in KwaZulu Natal, a province with the highest prevalence of HIV in the country. Objective: The objective of the study was to determine sociodemographic factors associated with the prevalence of postnatal depression symptoms among a sample of HIV-positive women attending health services from primary healthcare facilities in Umhlathuze District, KwaZulu Natal. Methods: A quantitative cross-sectional survey was used to collect data from 386 HIV-positive women who had infants aged between 1 and 12 weeks. The Edinburgh Postnatal Depression Scale (EPNDS), to which sociodemographic questions were added, was used to collect data. Results: The prevalence of PND symptoms among this sample of 386 HIV-positive women was 42.5%. The age of the mothers ranged from 16 to 42 years, with a mean of 29 years. The majority of the mothers were single or never married (85.5%; n = 330), living in a rural setting (81.9%; n = 316%), with a household income of less than R 2000 (estimated 125 USD) per month (64.9%; n = 120). The government child support grant was the main source of income for most of the mothers (53%; n = 183). PND symptoms were significantly associated with the participant’s partner having other sexual partners (p-value < 0.001), adverse life events (p-value = 0.001), low monthly income (p-value = 0.015), and being financially dependent on others (p-value = 0.023). Conclusion: The prevalence of PND symptoms among the sample is high, with a number of social and demographic factors found to be significantly associated with PND. This requires the consideration of sociodemographic information in the overall management of both HIV and postnatal depression. Addressing the impact of these factors can positively influence the health outcomes of both the mother and the baby.


2020 ◽  
Author(s):  
Maria Carmina Lorenzana Santiago ◽  
Maria Antonia Esteban Habana

Abstract Background Postpartum depression (PPD) occurs in 10-15% of deliveries worldwide. Unfortunately there is a dearth of local studies on its exact prevalence. Method This cross-sectional study aimed to determine the prevalence of and risk factors for PPD among postpartum patients at a tertiary government hospital using the Edinburgh Postnatal Depression Scale-Filipino Translation (EPDS-F), a 10-point questionnaire translated into Filipino and previously validated. Four hundred patients within 8 weeks postpartum were recruited and their EPDS-F scores and sociodemographic, medical and personal history, and delivery and perinatal outcome data were obtained. Results The overall prevalence of PPD was 14.5%, which is within the known worldwide prevalence. Among those that had family incomes below PhP10,000, the proportion that had high EPDS-F scores was 68.8%, while those that had low EPDS-F scores was 48.8% (significant at p=0.001). Among those that finished below tertiary education, the proportion that had high EPDS-F scores was 81%, while those that had low EPDS-F scores was 59.9% (significant at p=0.002). Among those who delivered vaginally, 62.1% had high EPDS-F scores vs 44.2% low EPDS-F (p=0.03). Of those that had epidural anesthesia (106 or 26.5%), 44.8% had high EPDS scores and 26.0% had low EPDS-F scores (p=0.04). Regression analysis showed that having an abdominal delivery is correlated with a lower EPDS-F score by 0.87% by logistic regression and 0.46 % by probit regression. Having a higher educational attainment and monthly income are associated with a lower EPDS-F score by regression analysis. Conclusions The prevalence may be skewed because a tertiary government institution caters to delicate pregnancies and those in low socioeconomic brackets. It may be worthwhile to compare responses from a public versus a private institution, also urban versus rural areas. It would be interesting also to evaluate the mode of delivery variable and how exactly it correlates with the development of postpartum depression.


2021 ◽  
Vol 3 (1) ◽  
pp. 18-23
Author(s):  
Sapana Karki ◽  
Shila Gurung

Background: Postpartum depression(PPD)can be defined as non-psychotic depression occurring within a year after childbirth, characterized by low mood, unusual thoughts, feeling of guilt, unexplained anxiety, worthlessness, and other depressive symptoms. Objective: This study aims to assess the prevalence, knowledge and risk factors of postpartum disorder. Methods: A cross-sectional descriptive study was conducted among 217 postpartum mothers in the outpatient department of psychiatry of a tertiary care hospital using the Edinburgh postnatal depression scale(EPDS). All the patients enrolled were directly interviewed using a structured questionnaire to identify the associated risk factors of postpartum depression. The data collected were checked for validity and analyzed using S.P.S. version 16.0. Results: Out of 217 patients, five women were found to have an EPDS(Edinburgh postnatal depression scale) score greater than 10. The prevalence of postpartum depression was found to be 2.3%.Upon evaluation of knowledge about postpartum depression, 90.3% of women were found to have a poor level of knowledge and 8.8% had a good knowledge level. The statistically significant factors associated with postpartum depression were the lack of support from family and partners (p<0.005). Conclusion: There was a comparatively low prevalence of P.P.D. in Western Nepal. Majority of the mothers (90.3%) were found not aware of P.P.D. The present study concluded on the need for educational intervention among the mothers regarding P.P.D. in Western Nepal.


2020 ◽  
Vol 27 (05) ◽  
pp. 1017-1021
Author(s):  
Muhammad Umar Ghafoor ◽  
Rabia Arshed Usmani ◽  
Zaidan Idrees Choudhary ◽  
Shahbaz Ahmad ◽  
Aftab Nazir ◽  
...  

Objectives: This study was designed to evaluate the frequency of postpartum depression in new mothers at a tertiary care hospital in Faisalabad and identify the factors associated with the condition. Study Design: Cross-sectional study. Setting: Obstetrics and Gynecology Department of Independent University Hospital, Faisalabad. Period: Over a period of three months from February 2018 to May 2018. Material & Methods: Included 213 subjects selected through nonprobability purposive sampling patients who had given birth in the last six months were included in the study. The Punjabi version of Edinburgh Postnatal Depression Scale was used to assess for depression. Socio-demographic and medical information was collected on a pre-designed proforma. Data was analyzed using SPSS version 23. Chi square test was applied to ascertain association. Results: Out of the total 213 participants, 33.8% (n=72) of the study sample were suffering from postnatal depression. The socio-demographic profile of the depressed patients showed that most of them were uneducated (84.72%), housewives (77.78%) living with extended families (68.06%). The difference in the number of depressed women among extended and nuclear families was found to be statistically significant (p-value of 0.004). The study also showed that women suffering from postpartum depression were less likely to breastfeed their babies (p-value 0.046). Conclusion: Postpartum depression was identified in more than one thirds of the females included in this study. This high number should raise an alarm for all health professionals. Detection through mandatory screening and early intervention can prevent the adverse consequences this disorder carries for the mother and the child.


2020 ◽  
Vol 16 ◽  
Author(s):  
Salman Khazaei ◽  
Erfan Ayubi ◽  
Saeid Bashirian ◽  
Ronak Hamzehei ◽  
Ensiyeh Jenabi

Background: The relationship between gestational diabetes and postpartum depression (PPD) is poorly understood and seldom studied. Objective: In an effort to explore this issue, the present study investigated the relationship between gestational diabetes and PPD. Methods: The present cross-sectional study was performed with 342 women who were referred to four urban health centers of Hamadan city, west of Iran. We used convenience sampling as a method to recruit women in each health center. We used a researcher-made checklist for gathering data on socio-demographic characteristics and potential risk factors of PPD. The Persian validated version of the Edinburgh Postnatal Depression Scale (EPDS) was used to assess PPD. Univariate and multivariable binary logistic regression was applied to estimate the odds ratio (OR) (95% confidence interval [CI]). Results: Gestational diabetes was identified as the most important risk factor for PPD with OR (95% CI) of 2.19 (1.11, 4.31); P-value=0.02 after adjusting for other variables. Moreover, the adjusted odds ratio showed that PPD among lesseducated women (primary school) was 3.5 times higher compared to women with a university education (OR=3.54, 95% CI: 1.27, 9.84; P-value=0.01). Conclusion: Our findings suggested that PPD is more likely among women with gestational diabetes and those who were less educated. Interventional and educational activities for reducing the risk of PPD can be targeted for use with this population.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Dhokotera Tafadzwa ◽  
Riou Julien ◽  
Bartels Lina ◽  
Rohner Eliane ◽  
Chammartin Frederique ◽  
...  

Abstract Background Disparities in invasive cervical cancer (ICC) incidence exist globally, particularly in HIV positive women who are at elevated risk compared to HIV negative women. We aimed to determine the spatial, temporal, and spatiotemporal incidence of ICC and the potential risk factors among HIV positive women in South Africa. Methods We included ICC cases in women diagnosed with HIV from the South African HIV cancer match study during 2004–2014. We used the Thembisa model, a mathematical model of the South African HIV epidemic to estimate women diagnosed with HIV per municipality, age group and calendar year. We fitted Bayesian hierarchical models, using a reparameterization of the Besag-York-Mollié to capture spatial autocorrelation, to estimate the spatiotemporal distribution of ICC incidence among women diagnosed with HIV. We also examined the association of deprivation, access to health (using the number of health facilities per municipality) and urbanicity with ICC incidence. We corrected our estimates to account for ICC case underascertainment, missing data and data errors. Results We included 17,821 ICC cases and demonstrated a decreasing trend in ICC incidence, from 306 to 312 in 2004 and from 160 to 191 in 2014 per 100,000 person-years across all municipalities and corrections. The spatial relative rate (RR) ranged from 0.27 to 4.43 in the model without any covariates. In the model adjusting for covariates, the most affluent municipalities had a RR of 3.18 (95% Credible Interval 1.82, 5.57) compared to the least affluent ones, and municipalities with better access to health care had a RR of 1.52 (1.03, 2.27) compared to municipalities with worse access to health. Conclusions The results show an increased incidence of cervical cancer in affluent municipalities and in those with more health facilities. This is likely driven by better access to health care in more affluent areas. More efforts should be made to ensure equitable access to health services, including mitigating physical barriers, such as transportation to health centres and strengthening of screening programmes.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Abiyu Ayalew Assefa ◽  
Feleke Hailemichael Astawesegn ◽  
Bethlehem Eshetu

Abstract Background In Ethiopia, cervical cancer is a public health concern, as it is the second most cause of cancer deaths among reproductive age women and it affects the country’s most vulnerable groups like; rural, poor, and HIV-positive women. Despite the strong evidence that cervical cancer screening results in decreased mortality from this disease, its utilization remains low. Methods An institution-based cross-sectional study was conducted from March 2 to April 1/2019 to assess the level and factors affecting utilization of cervical cancer screening among HIV positive women in Hawassa town. Quantitative data collection methods were used. Data were gathered using a structured and pretested questionnaire. Epi-Info version 7 and SPSS version 23 were used for data entry and analysis respectively. Statistically significant association of variables was determined based on Adjusted Odds ratio with its 95% confidence interval and p-value of ≤0.05. Results Of the 342 women interviewed, 40.1% (95% CI: 35.00, 45.33%) of them were screened. Having a post primary education (AOR = 5.1, 95% CI: 1.8, 14.5), less than 500 cell/mm3 CD4 count (AOR = 2.7, 95% CI: 1.2, 5.9); duration since HIV diagnosis (AOR = 4.2, 95% CI: 2.1, 8.5), partner support (AOR = 4.7, 95% CI: 2.3, 9.4), having knowledge about risk factors (AOR = 2.9 (95% CI: 1.2, 6.9) and having favorable attitude towards cervical cancer and its screening (AOR = 3.7 (95% CI: 1.8, 7.5) were associated with cervical cancer screening utilization. Conclusions The study revealed utilization of cervical cancer screening service was low among HIV positive women. Educational status, duration of HIV diagnosis, partner support, knowledge status about risk factor, CD4 count and attitude towards cervical cancer and its screening were associated with cervical cancer screening utilization. Health care workers need to provide intensive counseling services for all ART care attendants to increase utilization.


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