Prevalence and risk factors of anxiety and depression among non-communicable diseases clinic attendees in rural Rwanda: a cross-sectional study.

OBJECTIVES

This study aimed to estimate the prevalence of depression and anxiety and associated risk factors among non-communicable diseases (NCD) clinic attendees in rural Rwanda.

DESIGN

Cross-sectional.

SETTING

44 health centres in three rural districts in Rwanda.

PARTICIPANTS

Adults aged 18 years and older with a clinical diagnosis of diabetes, hypertension and/or asthma, who were attending a follow-up appointment during the study period (n=595).

OUTCOME MEASURES

Primary outcome measures were depression (measured by Patient Health Questionnaire-9) and anxiety (measured by Generalised Anxiety Disorder-7). Explanatory measures included sociodemographic and behavioural risk factors associated with depression and anxiety.

RESULTS

Of 595 participants, 265 (44.5%) had depression (95% CI: 40.5% to 48.6%) and 202 (33.9%) had anxiety (95% CI: 30.1% to 37.9%). Comorbidity of depression and anxiety was found in 137 participants (23%). Participants with no formal education had significantly higher odds of reporting depression and anxiety compared with those with primary and secondary/higher education (adjusted OR (aOR)=2.08; 95% CI=1.27 to 3.33, p=0.004, aOR=5.00; 95% CI=1.12 to 25.00, p=0.035, respectively). In addition, participants who were unemployed were more likely to report depression and anxiety (aOR=3.03; 95% CI=1.62 to 5.67, p<0.001). Similarly, participants who had trauma in the past were more likely to report depression and anxiety than those who did not experience traumatic events in the past (aOR=1.67; 95% CI=1.09 to 2.56, p=0.019).

CONCLUSIONS

The overall prevalence of depression and anxiety was found to be significantly high among the study participants. The risk factors that were associated with depression and anxiety included level of education, district of residence, employment status and past trauma exposure. The findings emphasise the need for integrating mental health screening into NCD care, district-specific interventions, employment support services and trauma-focused care.