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. 8 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.