scholarly journals Validity and utility of instruments for screening of depression in women attending antenatal clinics in Blantyre district in Malawi

2018 ◽  
Vol 60 (4) ◽  
pp. 55
Author(s):  
G. Chorwe-Sungania ◽  
J. Chipps

Introduction: Screening instruments should be brief, valid and easy to use if they are to be useful in a busy antenatal clinic in low-resource settings. A short instrument can be used in a busy antenatal clinic in combination with a more detailed instrument once referred. This study aimed at assessing the validity of a range of depression screening instruments and to test the utility of combining these instruments for use in antenatal clinics in Blantyre district, Malawi.Methods: This was a sensitivity analysis study using a sub-sample of 97 pregnant women drawn from a cross-sectional study (sample size = 480) that was screening for depression in eight antenatal clinics. Data from the cross-sectional study for the 97 pregnant women on the 3-item screener, Edinburgh Postnatal Depression Scale (EPDS), Hopkins Symptoms Checklist-15 (HSCL-15) and Self-Reporting Questionnaire (SRQ), was compared with a gold standard, the Mini International Neuropsychiatric Interview (MINI). Sensitivity, specificity and area under curve (AUC) were calculated to test for validity of the instruments. The utility of various combinations of the instruments was tested using the compensatory, conjunctive, probability and sequential rules.Results: The 3-item screener, EPDS, HSCL-15 and SRQ were valid instruments for screening antenatal depression. Sequential combination of the 3-item screener and SRQ had superior discriminant ability over similar combinations of the 3-item screener and either EPDS or HSCL-15 (sensitivity = 78%, specificity = 88%, AUC = 0.885).Discussion: The 3-item screener, EPDS, HSCL-15 and SRQ are valid instruments for screening depression in local antenatal clinics. The sequential combination of the 3-item screener and SRQ may be a practical, accurate and suitable method for multistage screening of depression in antenatal clinics in Blantyre district, Malawi.

Author(s):  
Genesis Chorwe-Sungani ◽  
Jennifer Chipps

Background: Pregnancy is a period associated with major psychological and social changes in the life of a woman and can be associated with anxiety and depression.Aim: To describe demographic, clinical and risk profile of antenatal depression among pregnant women attending antenatal clinics in Blantyre district, Malawi.Setting: The study was conducted in eight antenatal clinics in Blantyre district, Malawi.Methods: A cross-sectional study of 480 randomly selected pregnant women attending antenatal clinics was conducted. Prevalence was determined using the Edinburgh Postnatal Depression Scale (EPDS) which was validated against a sub-sample using the Mini International Neuropsychiatric Interview. The risk factors of depression were assessed using the Pregnancy Risk Questionnaire. Data were analysed using descriptive statistics, Pearson chi-square test and binary logistic regression.Results: Prevalence of antenatal depression using the EPDS was 19% (95% CI 15.5% – 22.5%, n = 91) and was comparable to the Mini International Neuropsychiatric Interview (25.8% [95% CI = 17.5–34], n = 25). The key risk factors that predicted antenatal depression were: ‘being distressed by anxiety or depression for more than 2 weeks during this pregnancy’ (OR = 4.1 [2.1–7.9], p≤ 0.001); ‘feeling that a relationship with partner is not an emotionally supportive one’ (OR = 3.5 [1.4–8.4], p = 0.01); ‘having major stresses, changes or losses in the course of this pregnancy’ (OR = 3.2 [1.7–6.2], p = 0.01); ‘feeling that father was critical of her when growing up’ (OR = 3.2 [1.4–7.6], p = 0.01); and ‘having history of feeling miserable or depressed for ≥2 weeks before this pregnancy’ (OR = 2.4 [1.3–4.4], p = 0.01).Conclusion: This study confirmed the high-prevalence rate of depression in this group and illustrated that antenatal depression was associated with being distressed by anxiety or depression; support from partner; major stresses during pregnancy; and history of feeling miserable or depressed before pregnancy. This study also found a history of poor relationship between pregnant women and their fathers during childhood.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saran Tenzin Tamang ◽  
Thinley Dorji ◽  
Sonam Yoezer ◽  
Thinley Phuntsho ◽  
Phurb Dorji

Abstract Background The third Sustainable Development Goal for 2030 development agenda aims to reduce maternal and newborn deaths. Pregnant women’s understanding of danger signs is an important factor in seeking timely care during emergencies. We assessed knowledge of obstetric danger signs using both recall and understanding of appropriate action required during obstetric emergencies. Methods This was a cross-sectional study among pregnant women attending antenatal clinic at Bhutan’s largest hospital in Thimphu. Recall was assessed against seven obstetric danger signs outlined in the Mother and Child Health Handbook (7 points). Understanding of danger signs was tested using 13 multiple choice questions (13 points). Knowledge was scored out of 20 points and reported as ‘good’ (≥80%), ‘satisfactory’ (60–79%) and ‘poor’ (< 60%). Correlation between participant characteristics and knowledge score as well as number of danger signs recalled was tested using Pearson’s correlation coefficient. Association between knowledge score and participant characteristics was tested using t-tests (and Kruskal-Wallis test) for numeric variables. Socio-demographic and clinical characteristics associated with the level of knowledge ('good’ versus ‘satisfactory’ and ‘poor’ combined) were assessed with odds ratios using a log-binomial regression model. All results with p < 0.05 were considered significant. Results Four hundred and twenty-two women responded to the survey (response rate = 96.0%). Mean (±SD) knowledge score was 12 (±2.5). Twenty women (4.7%) had ‘good’ knowledge, 245 (58.1%) had ‘satisfactory’ knowledge and 157 (37.2%) had ‘poor’ knowledge. The median number of danger signs recalled was 2 (IQR 1, 3) while 68 women (20.3%) could not recall any danger signs. Most women were knowledgeable about pre-labour rupture of membranes (96.0%) while very few women were knowledgeable about spotting during pregnancy (19.9%). Both knowledge score and number of danger signs recalled had significant correlation with the period of gestation. Women with previous surgery on the reproductive tract had higher odds of having ‘good’ level of knowledge. Conclusions Most pregnant women had ‘satisfactory’ knowledge score with poor explicit recall of danger signs. However, women recognized obstetric emergencies and identified the appropriate action warranted.


2019 ◽  
Author(s):  
Samson Udho ◽  
Joyce Nankumbi ◽  
Mariam Namutebi ◽  
Grace Ndeezi ◽  
Joshua Epuitai ◽  
...  

Abstract Background Iron deficiency is a leading cause of anemia among pregnant women in Uganda. However, due to the high cost of biochemical tests required to determine iron deficiency, the prevalence and factors associated with iron deficiency remain largely unstudied in our setting. Therefore, this study aimed at determining the prevalence of iron deficiency and its associated factors among pregnant women attending an antenatal clinic, Lira District-Uganda.Methods A cross-sectional study was conducted among 320 pregnant women attending an antenatal clinic at Lira Regional Referral Hospital. Maternal serum ferritin was used as a measure of iron deficiency and was determined using a Cobas 6000 Automated Analyzer. Iron deficiency was based on serum ferritin of <30 μg/L. A semi-structured questionnaire was used to obtain the characteristics of the study participants. Binary and multivariate logistic regression were performed to identify the associated factors.Results The prevalence of iron deficiency was 45%. Non-adherence to iron supplements (AOR: 2.05 95% CI: 1.02-4.12) & third trimester pregnancy (AOR: 1.88 95% CI: 1.20-2.94) were significantly associated with iron deficiency during pregnancy.Conclusion Nearly 5 in 10 of the participants had iron deficiency. Iron deficiency during pregnancy was associated with non-adherence to iron supplements and being in the third trimester of pregnancy. Midwives should encourage pregnant women to adhere to iron supplements during pregnancy especially pregnant women who are in the third trimester.


2015 ◽  
Vol 3 (1) ◽  
pp. 239-244
Author(s):  
Abah MG ◽  
Umoh AV

Background: Aversion towards Caesarean section and its outright rejection by parturient have been widely reported in Nigeria. Objective: This study was conducted with the objective of assessing the perception and attitude towards Caesarean section by pregnant women attending antenatal clinic in a Niger Delta tertiary facility. Methods: It was a cross-sectional study involving 500 women interviewed using selfadministered semi-structured, pre-tested questionnaires with open and close ended questions. Their socio-demographic characteristics, knowledge, perception and attitude towards Caesarean section were inquired Results: The mean age of the women was 29.1years


BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e017745 ◽  
Author(s):  
Munas M Muzrif ◽  
Dinusha Perera ◽  
Kumudu Wijewardena ◽  
Berit Schei ◽  
Katarina Swahnberg

ObjectivesThe aims of this study were to assess the regional differences in domestic violence among pregnant women in the capital district and in the tea plantation sector of Sri Lanka, to explore potential contributory factors and to assess whether healthcare workers addressed domestic violence and disclosure among survivors.DesignA cross-sectional study was carried out using interviewer-administered Abuse Assessment Screen.SettingFifty-seven antenatal clinic centres in the capital district and 30 in the tea plantation sector.ParticipantsPregnant women between 6 and 40 weeks of gestational age. In the capital district, 1375 women were recruited from antenatal clinic centres in the urban (n=25) and in the rural areas (n=32), and 800 women from 30 centres in the tea plantation sector. The response rate in the capital district was 95.6% and 96.7% in the tea plantation sector.ResultsAmong the total sample of pregnant women (n=2088), the prevalence of ‘ever abused’ was 38.6%, and the prevalence of ‘currently abused’ was 15.9%. ‘Ever abused’ (31.5% vs 50.8%) and ‘currently abused’ (10% vs 25.8%) were significantly higher (P<0.001) among the women living in the tea plantation sector. ‘Ever abused’ was associated with living in the tea plantation sector, being employed, living far from gender-based violence care centre and of Muslim ethnicity, after adjusting for age, education and family income. Only 38.8% of all participants had been asked by healthcare workers about abuse. Living in the tea plantation sector and lower level of education were associated with not being asked. Among those who reported ‘ever abused’, only 8.7% had disclosed the experience to a healthcare worker.ConclusionDomestic violence was prevalent and highest among women in the tea plantation sector compared with the capital district. The capacity of healthcare workers in addressing domestic violence should be increased.


2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Melaku Desta ◽  
Mohammed Akibu ◽  
Mesfin Tadese ◽  
Meskerem Tesfaye

Background. Maternal dietary diversity is a proxy indicator of maternal nutrient adequacy and improves health outcomes for both mothers and babies. However, little is documented on dietary diversity among pregnant mothers. Therefore, this study assessed diet diversity and associated factors among pregnant mothers attending the antenatal clinic in Shashemane, Oromia, Central Ethiopia.Methods. An institution-based cross-sectional study was conducted on 315 systematically selected pregnant women attending antenatal clinic of Shashemane town in April 2017. Dietary diversity was assessed using a 24 h dietary recall method, and the dietary diversity score was computed for ten food groups. Bivariate and multivariate logistic regressions were computed to identify associated factors of dietary diversity.Result. In this study, only a quarter (25.4%) of pregnant mothers consumed adequate dietary diversity. Mother’s tertiary (AOR 3.18; 95% CI: 1.8, 6.35) and secondary (AOR 2.13; 95% CI: 2.32, 8.72) education, household monthly income above 3500 ETB (AOR = 2.24; 95% CI: 1.47, 7.78), livestock ownership (AOR = 4.15; 95% CI: 2.07, 9.86), women who got emotional support from the husband (AOR = 3.49; 95% CI: 1.12, 8.23), and women who participated in the shooping (AOR = 2.54; 95% CI: 3.27, 9.83) were more likely to attain the adequate dietary diversity.Conclusion. The study revealed that the overall consumption of adequate dietary diversity was found to be low. Developing the educational level of women, increasing household income and owning of livestock, increasing husbands’ support, and improving women’s participation in the shopping are recommended to improve women’s adequate dietary diversity.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Willy Kiboi ◽  
Judith Kimiywe ◽  
Peter Chege

Abstract Objectives To determine the health morbidity profile of pregnant women attending antenatal clinic in Nanyuki Teaching and Referral hospital, Kenya. Methods A cross-sectional study was conducted among pregnant women where data on maternal morbidity profile was collected. A total of 254 pregnant women attending antenatal clinic were recruited. Results More than half (57.5%) of the women recruited in this study reported to be unwell in the immediate two weeks preceding the day of the interviews. The common diseases/disorders reported were heartburn (42.9%), anemia (16.9%) anorexia (15.4%), vomiting (14.2%) and constipation (11.4%) with most of them having a duration of more than 7 days. Other morbidities such as fever, abdominal pain, upper respiratory infection, diarhoea and headache were also reported. Further, out of all those who reported being sick, only 40.4% who sought medical attention. Conclusions Morbidity among the pregnant women was notably high. Public health awareness campaigns among pregnant women on prevention, early identification and timely treatment of diseases/disorders during pregnancy should be up-scaled. Funding Sources None.


2020 ◽  
Vol 18 (1) ◽  
pp. 10-15
Author(s):  
Stepan Feduniw ◽  
◽  
Olga Płaza ◽  
Dominika Paździor ◽  
Katarzyna Kosińska-Kaczyńska ◽  
...  

Introduction. It was established that intragestational depression is a common disease, with the estimated average prevalence of 10–25% in all expectant mothers worldwide. Aim of the study. The aim of the study was to evaluate the frequency of depressive symptoms in pregnant women in Poland and to identify which factors may be related to a higher risk of depressive symptoms during pregnancy. Material and methods. A prospective cross-sectional study was performed. Depressive symptoms were assessed with the validated Edinburgh Postnatal Depression Scale (EPDS). 346 women were enrolled in the study. Results. 130 women (37.6%) scored 13 or more points and were considered as presenting with depressive symptoms. Independent risk factors of depressive symptoms during pregnancy including mood disorders diagnosed before the current pregnancy (aOR=2.68, 95%CI 1.37-5.22), mental disorders confirmed in family members (aOR=2.72, 95%CI 1.24-5.98), unhappiness in their current relationship (aOR=4.0, 95%CI 1.77-9.01), lack of support from family members (aOR=2.73, 95%CI 1.51-4.96) increased the risk of DS and good financial status decreased the risk of DS occurrence (aOR=0.45, 95%CI: 0.25-0.80). Conclusions. Pregnant women commonly report depressive symptoms. The evaluation of relations with the family members, socio-economic status, former depressive symptoms and possible prenatal depression are essential for proper screening of depression in pregnant women.


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