Abstract:
The prevalence of diabetes in sub-Saharan Africa is rising, but its relationship
to depression is not well-characterized. This report describes depressive symptom
prevalence and associations with adherence and outcomes among patients with diabetes
in a rural, resource-constrained setting.
Methods: In the Webuye, Kenya diabetes clinic, we conducted a chart review, analyzing
data including medication adherence, hemoglobin A1c (HbA1c), clinic attendance, and
PHQ-2 depression screening results.
Results: Among 253 patients, 20.9% screened positive for depression. Prevalence in
females was higher than in males; 27% vs 15% (p=0.023). Glycemic control trends were
better in those screening negative; at 24 months post-enrollment mean HbA1c was 7.5 for
those screening negative and 9.5 for those screening positive (p=0.0025). There was a
nonsignificant (p=0.269) trend toward loss to follow-up among those screening positive.
Conclusions: These findings suggest that depression is common among people with
diabetes in rural western Kenya, which may profoundly impact diabetes control and
treatment adherence.