Postnatal depression by HIV status among women in Zimbabwe

Dixon Chibanda, Walter Mangezi, Mufuta Tshimanga, Godfrey Woelk, Simbarashe Rusakaniko, Lynda Stranix-Chibanda, Stanley Midzi, Avinash K. Shetty

Research output: Contribution to journalArticle

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Abstract

Background: Postnatal depression (PND) is a serious public health problem in resource-limited countries. Research is limited on PND affecting HIV-infected women in sub-Saharan Africa. Zimbabwe has one of the highest antenatal HIV infection rates in the world. We determined the prevalence and risk factors of PND among women attending urban primary care clinics in Zimbabwe. Methods: Using trained peer counselors, a simple random sample of postpartum women (n=210) attending the 6-week postnatal visit at two urban primary care clinics were screened for PND using the Shona version of the Edinburgh Postnatal Depression Scale (EPDS). All women were subsequently subjected to mental status examination using the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for major depression by two psychiatrists who had no knowledge of the EPDS test results. Results: Of the 210 mothers (31 HIV positive, 148 HIV negative, 31 unknown status) enrolled during the postpartum period, 64 (33%) met DSM-IV criteria for depression. The HIV prevalence was 14.8%. Of the 31 HIV-infected mothers, 17(54%) met DSM-IV criteria for depression. Univariate analysis showed that multiparity (prevalent odds ratio [OR] 2.22, 95% confidence intervals [CI] 1.15-4.31), both parents deceased (OR 2.35, 95% CI 1.01-5.45), and having experienced a recent adverse life event (OR 8.34, CI 3.77-19.07) were significantly associated with PND. Multivariate analysis showed that PND was significantly associated with adverse life event (OR 7.04, 95% CI 3.15-15.76), being unemployed (OR 3.12, 95% CI 1.23-7.88), and multiparity (OR 2.50, 95% CI 1.00-6.24). Conclusions: Our data indicate a high burden of PND among women in Zimbabwe. It is feasible to screen for PND in primary care clinics using peer counselors. Screening for PND and access to mental health interventions should be part of routine antenatal care for all women in Zimbabwe.

Original languageEnglish
Pages (from-to)2071-2077
Number of pages7
JournalJournal of Women's Health
Volume19
Issue number11
DOIs
Publication statusPublished - 01-11-2010
Externally publishedYes

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Postpartum Depression
Zimbabwe
Women's Rights
HIV
Odds Ratio
Confidence Intervals
Diagnostic and Statistical Manual of Mental Disorders
Primary Health Care
Depression
Parity
Postpartum Period
Mothers
Prenatal Care
Africa South of the Sahara
HIV Infections
Psychiatry
Mental Health
Multivariate Analysis
Public Health
Parents

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Chibanda, D., Mangezi, W., Tshimanga, M., Woelk, G., Rusakaniko, S., Stranix-Chibanda, L., ... Shetty, A. K. (2010). Postnatal depression by HIV status among women in Zimbabwe. Journal of Women's Health, 19(11), 2071-2077. https://doi.org/10.1089/jwh.2010.2012
Chibanda, Dixon ; Mangezi, Walter ; Tshimanga, Mufuta ; Woelk, Godfrey ; Rusakaniko, Simbarashe ; Stranix-Chibanda, Lynda ; Midzi, Stanley ; Shetty, Avinash K. / Postnatal depression by HIV status among women in Zimbabwe. In: Journal of Women's Health. 2010 ; Vol. 19, No. 11. pp. 2071-2077.
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Chibanda, D, Mangezi, W, Tshimanga, M, Woelk, G, Rusakaniko, S, Stranix-Chibanda, L, Midzi, S & Shetty, AK 2010, 'Postnatal depression by HIV status among women in Zimbabwe', Journal of Women's Health, vol. 19, no. 11, pp. 2071-2077. https://doi.org/10.1089/jwh.2010.2012

Postnatal depression by HIV status among women in Zimbabwe. / Chibanda, Dixon; Mangezi, Walter; Tshimanga, Mufuta; Woelk, Godfrey; Rusakaniko, Simbarashe; Stranix-Chibanda, Lynda; Midzi, Stanley; Shetty, Avinash K.

In: Journal of Women's Health, Vol. 19, No. 11, 01.11.2010, p. 2071-2077.

Research output: Contribution to journalArticle

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AU - Chibanda, Dixon

AU - Mangezi, Walter

AU - Tshimanga, Mufuta

AU - Woelk, Godfrey

AU - Rusakaniko, Simbarashe

AU - Stranix-Chibanda, Lynda

AU - Midzi, Stanley

AU - Shetty, Avinash K.

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Y1 - 2010/11/1

N2 - Background: Postnatal depression (PND) is a serious public health problem in resource-limited countries. Research is limited on PND affecting HIV-infected women in sub-Saharan Africa. Zimbabwe has one of the highest antenatal HIV infection rates in the world. We determined the prevalence and risk factors of PND among women attending urban primary care clinics in Zimbabwe. Methods: Using trained peer counselors, a simple random sample of postpartum women (n=210) attending the 6-week postnatal visit at two urban primary care clinics were screened for PND using the Shona version of the Edinburgh Postnatal Depression Scale (EPDS). All women were subsequently subjected to mental status examination using the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for major depression by two psychiatrists who had no knowledge of the EPDS test results. Results: Of the 210 mothers (31 HIV positive, 148 HIV negative, 31 unknown status) enrolled during the postpartum period, 64 (33%) met DSM-IV criteria for depression. The HIV prevalence was 14.8%. Of the 31 HIV-infected mothers, 17(54%) met DSM-IV criteria for depression. Univariate analysis showed that multiparity (prevalent odds ratio [OR] 2.22, 95% confidence intervals [CI] 1.15-4.31), both parents deceased (OR 2.35, 95% CI 1.01-5.45), and having experienced a recent adverse life event (OR 8.34, CI 3.77-19.07) were significantly associated with PND. Multivariate analysis showed that PND was significantly associated with adverse life event (OR 7.04, 95% CI 3.15-15.76), being unemployed (OR 3.12, 95% CI 1.23-7.88), and multiparity (OR 2.50, 95% CI 1.00-6.24). Conclusions: Our data indicate a high burden of PND among women in Zimbabwe. It is feasible to screen for PND in primary care clinics using peer counselors. Screening for PND and access to mental health interventions should be part of routine antenatal care for all women in Zimbabwe.

AB - Background: Postnatal depression (PND) is a serious public health problem in resource-limited countries. Research is limited on PND affecting HIV-infected women in sub-Saharan Africa. Zimbabwe has one of the highest antenatal HIV infection rates in the world. We determined the prevalence and risk factors of PND among women attending urban primary care clinics in Zimbabwe. Methods: Using trained peer counselors, a simple random sample of postpartum women (n=210) attending the 6-week postnatal visit at two urban primary care clinics were screened for PND using the Shona version of the Edinburgh Postnatal Depression Scale (EPDS). All women were subsequently subjected to mental status examination using the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for major depression by two psychiatrists who had no knowledge of the EPDS test results. Results: Of the 210 mothers (31 HIV positive, 148 HIV negative, 31 unknown status) enrolled during the postpartum period, 64 (33%) met DSM-IV criteria for depression. The HIV prevalence was 14.8%. Of the 31 HIV-infected mothers, 17(54%) met DSM-IV criteria for depression. Univariate analysis showed that multiparity (prevalent odds ratio [OR] 2.22, 95% confidence intervals [CI] 1.15-4.31), both parents deceased (OR 2.35, 95% CI 1.01-5.45), and having experienced a recent adverse life event (OR 8.34, CI 3.77-19.07) were significantly associated with PND. Multivariate analysis showed that PND was significantly associated with adverse life event (OR 7.04, 95% CI 3.15-15.76), being unemployed (OR 3.12, 95% CI 1.23-7.88), and multiparity (OR 2.50, 95% CI 1.00-6.24). Conclusions: Our data indicate a high burden of PND among women in Zimbabwe. It is feasible to screen for PND in primary care clinics using peer counselors. Screening for PND and access to mental health interventions should be part of routine antenatal care for all women in Zimbabwe.

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Chibanda D, Mangezi W, Tshimanga M, Woelk G, Rusakaniko S, Stranix-Chibanda L et al. Postnatal depression by HIV status among women in Zimbabwe. Journal of Women's Health. 2010 Nov 1;19(11):2071-2077. https://doi.org/10.1089/jwh.2010.2012