Depression in mothers of children with severe acute malnutrition admitted in Kenyatta National Hospital Peadiatric Wards.
Abstract
BACKGROUND
Depression is the leading cause of disability worldwide. In women it is a significant cause of
disease related disability. Globally, an estimated 350 million people suffer from depression. The
prevalence of maternal depression in developing countries varies from 15-57%. Maternal
depression is associated with adverse outcomes for both mothers and their children. Worldwide,
nearly 20 million children under the age of five are severely wasted, 90% of whom are in LMIC
countries. South Asian studies have shown maternal depression as a risk factor for poorer infant
growth. Little is known about the situation in Sub-Saharan Africa.
OBJECTIVE
The study objective was to examine the association of maternal depression and severe acute
malnutrition in children aged 6 – 60 months admitted in the general paediatric wards of Kenyatta
National hospital.
DESIGN
The study design was a matched case control study.
METHODS
The study was conducted in KNH general paediatric wards. Subjects were recruited through
convenience sampling. The cases were children aged 6-60months admitted with severe acute
malnutrition as determined by W.H.O criteria. The controls were children (6-60months) with
normal weight admitted in the same wards with acute ailments. Mothers of the cases and controls
who consented were enrolled in the study and assessed for depression using a PHQ-9
questionnaire. Anthropometric and socio-demographic data of the children and mothers were
captured using the study proforma. The data was entered in coded proforma, and analyzed using
SPSS version 17. Continuous and categorical variables were analyzed using descriptive statistics.
Odds ratio were presented to estimate the risk of depression among the cases compared to the
controls. Depression as a factor in severe malnutrition was determined by controlling for other
risk factors of malnutrition in logistic regression model.
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RESULTS
The mean age of mothers of the cases and controls were similar (28.7 vs 27.2 years). Most
mothers were literate (97.4%) and married (76%). unemployment was similar at 73.4% vs 61.5
% while mothers of cases had significantly lower income than mothers of controls. The
prevalence of depression among mothers of malnourished children was high (64.1%), and was
associated with malnutrition (OR33.0 95%CI 6.9-152), as compared to 5.1% among mothers of
normal weight children. In univariate analysis income and employment status was associated
with malnutrition while in multivariate only depression was significantly associated with
malnutrition.
CONCLUSION
Depression is common among mothers of malnourished children and is significantly associated
with malnutrition. Maternal education, income, family size and employment status does not
correlate significantly with child malnutrition.
Publisher
University of Nairobi