© 2013 Texas Children’s Hospital. All rights reserved.

Prevalence of Depression amongst HIV Infected Adolescents in Malawi

M.H. Kim, A.C. Mazenga, A. Devendra, S. Ahmed. C. Sharp, J.K. Mhango, M.

Bvumbwe, M. Machika, W. Kamiyango, A. Munthali, P.N. Kazembe

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Background and Study Aims•As countries scale up pediatric services in Southern Africa, the number of Adolescents Living with HIV (ALHA) is rising

•Depression in HIV-infected persons is the most commonly occurring psychiatric disorder and is associated with poor treatment outcomes (HIV Clinical Resource, 2010, AVERT, 2011 Do et al, 2010; Gonzalez et al, 2011; Holzemer et al, 1999 & Reda & Biadgiligin, 2012, Carrico et al, 2011; Holzemer et al 1999

•Scarcity of data regarding depression in youth in Malawi hinders the development of appropriate interventions.

•Study Aim: To estimate the prevalence of depression amongst adolescents aged 12 to 18 years old vertically infected with HIV in Malawi

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Methods•Study Design: quantitative cross-sectional study

•Study population: convenience sample of adolescents 12 – 18 years vertically infected with HIV presenting to care at the Baylor Clinic (Central Malawi), and Zomba Central Hospital ART clinic (Southern Malawi)

•Data collection:‐Depression Screening Tools

• Beck’s Depression Inventory (BDI) – II (Beck et al, 2006).• Children’s Depression Inventory (CDI) II-Short (Kovacs, 2004).*Gold Standard: Children’s Depression Rating Scale-revised

(CDRS-r)

‐Socio-demographic, Behavioral & Adherence Questionnaire (SDBAQ)

‐Medical Data Extraction Form (MDEF)

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Results

•Recruited 562; 56% (315) female; 44% (247) male

•Mean age was 14.5 yrs

•Suicidal symptoms expressed in 7.2% (40) of the participants

• 1.1% (6) actively suicidal at the time of interview

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Results

Prevalence of Depression by Screening Tool

Depression Screening Tool

Total %(n), N=562

Female %(n), N=315

Male %(n), N=247

P-

value

BDI-II (cut-off = 17)

25.6%(144) 28.9%(91) 21.5%(53) <0.05

CDI-2 short (cut-off = 65)

20.8%(117) 19.7%(62) 22.3%(55) =0.45

CDRS – R Clinical assessment (cut-off = 55)

18.9%(106) 21.6(68) 15.4%(38) =0.06

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Closing Remarks

High prevalence of depression amongst Malawian adolescents vertically infected with HIV in this setting, highlights the need for screening and availability of treatment services for adolescents living with HIV & AIDS

•Convenience sample of adolescents at two metropolitan clinics, not necessarily representative of adolescents throughout Malawi

•Currently analyzing the psychometric properties of the screening tools for use in ALHA in Malawi

•Research on factors associated with depression in ALHA is needed

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Many thanks to•Study participants/caregivers

•Research Team

•Texas Children’s Hospital Global Health program

•The Executive Director BCM-CFM, Dr P. Kazembe

•The Hospital Director ZCH, Dr Joshua

•The Medical Program Manager and staff, Dignitas International – Zomba

•Center for AIDS research (CFAR), Houston, USA

•COE Clinicians/doctors/nurses/social workers/psychotherapist

•Teen Club Teams from Zomba Central Hospital ART Clinic and Baylor Clinical Centre of Excellence

•All Baylor Malawi staff and Zomba Central ART Clinic staff.

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Thank you for your Attention!