Directorate of Postgraduate Studies

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Browsing Directorate of Postgraduate Studies by Subject "AIDS – acquired immunodeficiency syndrome"

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    Outcome of untreated depression among people living with HIV attending clinic at Mwananyamala regional referral hospital, Dar es salaam Tanzania.
    (Kairuki University, 2023) Mulokozi, Judith J.
    Background: Depression is prevalent among individuals living with HIV/AIDS and can have detrimental effects on treatment adherence, patient stability and overall well being. However, at Mwananyamala Regional Referral Hospital, routine diagnosis and care for depression among this population are lacking. Objective: The study sought to determine the association of untreated depression on treatment outcome, patient stability, and engagement in risky behaviors among individuals living with HIV/AIDS attending CTC at Mwananyamala Hospital from July to August 2023. Materials and methods: An analytical cross-sectional study design was employed. The study population consisted of people living with HIV/AIDS who attended the CTC at Mwananyamala Hospital. A structured questionnaire was used to collect data on socio-demographic characteristics, depression status, HIV treatment history, clinical presentation variables, and other relevant factors. Patient Health Questionnaire (PHQ-9) Quick Depression Assessment which has been developed by Pfizer Inc. was administered by the Principal Investigator to all participants to determine presence of depression and the severity. During data analysis Descriptive statistics was used to summarize socio-demographic characteristics and clinical parameters; while Chi-squared test was used to assess the association between untreated depression and treatment outcomes, patient stability, and engagement in risky behaviors. Logistic regression analysis was conducted to identify factors associated with untreated depression among people living with HIV/AIDS. The significance level was set at p-value < 0.05. Results: During the study period a total of 596 eligible study participants above 18 years of age attending HIV Care and Treatment Clinic at Mwananyamala Regional Referral Hospital were screened for eligibility criteria to participate in the study and were enrolled into the study. Out of this number a total of 149 were determined to have depression based on PHQ 9 score results and were in the final data analysis. The prevalence of depression among the study participants was 25% (149/596 participants). Study participants with depression who received treatment for depression were 25%; while the rest did not receive treatment for depression. Not getting treatment for depression had adverse outcome for comprehensive care and treatment for HIV. Among the 149 study participants with depression virological non-response was quite high with more than 50 copies in 118 participants (79.19%). Conclusions: The study offers a comprehensive analysis of the socio-demographic and clinical parameters of HIV patients, focusing on the critical influence of depression on patient stability. The socio-demographic data underscores the need for tailored interventions, especially for younger individuals, women, and those with low level of education and marital instability, as these factors interact adversely with HIV outcome. The clinical parameters show the pressing need for early diagnosis, timely HIV management, and mental health support to improve the overall well being of individuals living with HIV. Recommendations: There are four recommendations which are shown below: 1. Integrated Mental Health Services: Health care facilities should integrate mental health services into routine HIV care. Screening for depression and providing timely treatment is crucial for improving patient stability and overall well-being. Multidisciplinary teams that include mental health professionals can ensure a holistic approach to patient care. 2. Early diagnosis and interventions: Given the high prevalence of severe depression and its impact on HIV patients, health care providers should prioritize early diagnosis of depression, particularly among newly diagnosed individuals. Offering psychological support and counseling immediately after an HIV diagnosis can help mitigate distress and improve mental health outcome. 3. Special attention - Focus on vulnerable sub-groups: Tailored interventions should be developed to address the unique needs of vulnerable subgroups, including younger individuals, women, and those with lower education levels. These subgroups may face specific challenges in managing their HIV diagnosis, and targeted support programs can help mitigate these challenges. 4. Comprehensive education and support: Health care facilities should provide comprehensive education and support to patients regarding HIV management and the importance of treatment adherence. Patients with higher education levels tend to have better access to information and healthcare resources, but efforts should be made to bridge educational disparities to ensure all patients have equal access to essential information and support.