Prevalence of Depression Among Caregivers of Hiv Infected Children Aged 10 Years and Below, on Follow Up at Comprehensive Care Clinic at Kenyatta National Hospital.

Abstract

Background: Mental health morbidities such as depression are well described consequences associated with chronic illnesses and are exacerbated when offspring are suffering from chronic illnesses such as HIV. Caregivers own health and quality of care is impacted over time in such situations. Objectives The primary objective was to determine the prevalence and factors associated with depression among caregivers of HIV infected children using the PHQ-9. Study Design: Descriptive cross-sectional study Study methods Study participants were recruited from the Comprehensive Care Clinic, where HIV infected patients are followed up, at Kenyatta National Hospital(KNH). KNH is Kenya’s largest referral hospital. Depression was assessed using the PHQ-9 questionnaire. Pill count record was used to assess for ART adherence among children. Children’s viral load and clinic attendance were abstracted from the electronic records. Results A total of 116 caregivers-child dyads were enrolled. The prevalence of depression among caregivers of HIV infected children was 54%, of whom 62% were mildly depressed, 35% moderately depressed and 3% moderately-severely depressed. None of the caregivers had severe depression. PHQ-9 scores ≥10 was associated with 31 times increased likelihood of having children who were not virally suppressed AOR 31(6.5,150.9) p=0.000, additionally, it was associated with lower likelihood of achieving good ART adherence among children AOR 0.008(0.02,0.29) p=0.000. Being a married caregiver was associated with a lower likelihood of being depressed AOR 0.13(0.03, 0.59) (p=0.009) whereas being HIV-infected was associated with a higher likelihood of being depressed AOR17.1(1.2,24.9) P=0.03. Severity of depression was significantly associated with poorer outcomes. Conclusions There is a high prevalence of depression among the caregivers of HIV infected children. Caregivers’ depression is significantly associated with children’s level of adherence and viral suppression. Recommendations Assessment of caregivers’ depression should be done routinely