Relationship between depression and who clinical stage of HIV in patients attending AMPATH clinic at Webuye County Hospital, Kenya

Abstract

Background: The Sub Saharan Africa prevalence of depression in HIV/AIDS is estimated at between 39 to 47 %, which is nearly two times higher than in HIV negative group. Depressive symptoms have been associated with risky behavior, non-adherence to medications, and shortened survival. Not much is known about the risk factors of depression in HIV/AIDS in Kenya. Thus the study was undertaken to find out the relation between depression and WHO clinical stage of HIV at Webuye county Hospital AMPATH clinic. Broad objective: To establish the relationship between depression and WHO clinical stage of HIV among patients attending Webuye County Hospital comprehensive care clinic. Setting: Webuye County Hospital AMPATH Clinic. Method: This was a descriptive cross-sectional study in which 345 randomly selected HIV positive patients enrolled at AMPATH clinic Webuye were studied. A pre-structured questionnaire was used to collect social and demographic data, CD4 count and WHO clinical stage of HIV. Frequency and severity of depression was assessed using the patient health questionnaire (PHQ-9), which is a widely used validated tool for assessing and measuring depression. Chi-square test was employed in the analysis. Data analysis was done using software for data analysis and statistical computing known as R. P<0.05 was considered significant. Results: Out of 345 analyzed, the median age was forty one years, males compromised 39.1% and 59.7% were married. The median CD4 count was 217. The prevalence of depression was 44.1%, among those with depression 88.2% had mild while 11.8% had moderate to severe depression. Higher initial CD4 count was found to lower the odds of depression, p=0.031. None of the other factors studied were associated with occurrence and severity of depression. Conclusions: Depression is common among the HIV infected patients attending AMPATH clinic Webuye. Higher initial CD4 count was found to reduce the odds of depression. WHO clinical stage of HIV was not associated with depression. Recommendations: All HIV positive patients should be screened for depression. People with lower CD4 at enrolment should be followed up closely and offered psycho-social and other support to prevent depression.