Ngum Pleasure Atoh, Fon Peter Nde, Ngu Roland Cheofor, Verla Vincent Siysi, Luma Henri Namme
Faculty of Health Sciences, University of Buea, Buea, Cameroon.
Mboppi Baptist Hospital Douala, Douala, Cameroon.
Neurol Ther. 2017 Jun;6(1):103-114. doi: 10.1007/s40120-017-0065-9. Epub 2017 Mar 18.
HIV patients are now having longer life expectancies with the use of antiretroviral therapy (ART). However, the issue of mental illness has surfaced with depression being the most common in these patients, which has markedly reduced patient adherence to ART. In Cameroon, the management of HIV/AIDS does not incorporate psychiatric manifestations and depression is therefore underdiagnosed. The aim of our study was to determine the prevalence and determinants of depressive symptoms and their association with adherence to ART among HIV/AIDS patients on HAART in the Southwest Regional Hospitals of Cameroon.
This was a cross-sectional hospital-based study carried out in the BRH and LRH over a 3-month period. Three hundred HIV patients aged 21 and above were recruited. Depression and adherence to treatment were assessed using the nine-item Patient Health Questionnaire (PHQ-9) and eight-item Morisky Medication Adherence Scale questionnaires, respectively. Data were analysed using Epi-info version 3.4.5.
The prevalence of depression was 26.7% (95% CI 20.6-33.7%); 75.0% of those with depression were non-adherent to HAART compared to 37.3% of those without depression (p value <0.001). The statistically significant risk factors associated with depression were unemployment (OR 2.38; 95% CI 1.26-4.50), age ≤40 years (OR 2.13; 95% CI 1.20-3.70) and CD4 counts ≤200 cells/µl (OR 3.70; 95% CI 1.45-9.09).
The prevalence of depression was high and depression was significantly associated with non-adherence to HAART. Interventions to enhance early identification and treatment of depression in patients with HIV/AIDS are needed. Depression screening should be included as part of the routine consultation of HIV/AIDS patients to ensure early detection and treatment.
随着抗逆转录病毒疗法(ART)的使用,HIV患者的预期寿命现在更长了。然而,精神疾病问题已经出现,抑郁症是这些患者中最常见的,这显著降低了患者对ART的依从性。在喀麦隆,HIV/AIDS的管理并未纳入精神科表现,因此抑郁症诊断不足。我们研究的目的是确定喀麦隆西南地区医院接受高效抗逆转录病毒治疗(HAART)的HIV/AIDS患者中抑郁症状的患病率、决定因素及其与ART依从性的关联。
这是一项在布埃亚地区医院(BRH)和利姆贝地区医院(LRH)进行的为期3个月的基于医院的横断面研究。招募了300名年龄在21岁及以上的HIV患者。分别使用九项患者健康问卷(PHQ-9)和八项莫氏 Medication 依从性量表问卷评估抑郁症和治疗依从性。使用Epi-info 3.4.5版进行数据分析。
抑郁症的患病率为26.7%(95%可信区间20.6 - 33.7%);75.0%的抑郁症患者未坚持HAART,而无抑郁症患者的这一比例为37.3%(p值<0.001)。与抑郁症相关的具有统计学意义的危险因素为失业(比值比2.38;95%可信区间1.26 - 4.50)、年龄≤40岁(比值比2.13;95%可信区间1.20 - 3.70)和CD4细胞计数≤200个/微升(比值比3.70;95%可信区间1.45 - 9.09)。
抑郁症患病率很高,且抑郁症与不坚持HAART显著相关。需要采取干预措施来加强对HIV/AIDS患者抑郁症的早期识别和治疗。抑郁症筛查应纳入HIV/AIDS患者常规咨询的一部分,以确保早期发现和治疗。