Pascal Geldsetzer1, Maria Vaikath1, Ryan Wagner2, Julia K Rohr3, Livia Montana3, Francesc X Gómez-Olivé2, Molly S Rosenberg4, Jennifer Manne-Goehler1,5, Farrah J Mateen6,7, Collin F Payne8, Kathleen Kahn2,9,10, Stephen M Tollman2,9,10, Joshua A Salomon1,11, Thomas A Gaziano12,13, Till Bärnighausen1,14,15, Lisa F Berkman2,3. 1. Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts. 2. MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. 3. Center for Population and Development Studies, Harvard University, Cambridge, Massachusetts. 4. Department of Epidemiology and Biostatistics, Indiana University School of Public Health - Bloomington. 5. Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts. 6. Department of Neurology, Massachusetts General Hospital, Boston. 7. Department of Neurology, Harvard Medical School, Boston, Massachusetts. 8. School of Demography, Australian National University, Canberra, Australian Capital Territory, Australia. 9. INDEPTH Network, Accra, Ghana. 10. Umeå Centre for Global Health Research, Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Sweden. 11. Center for Health Policy and Center for Primary Care Outcomes and Research, Stanford Medicine, Stanford University, Palo Alto, California. 12. Department of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. 13. Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, Massachusetts. 14. Institute of Public Health, Heidelberg University, Germany. 15. Africa Health Research Institute (AHRI), Mtubatuba, South Africa.
Abstract
BACKGROUND: Understanding how depression is associated with chronic conditions and sociodemographic characteristics can inform the design and effective targeting of depression screening and care interventions. In this study, we present some of the first evidence from sub-Saharan Africa on the association between depressive symptoms and a range of chronic conditions (diabetes, HIV, hypertension, and obesity) as well as sociodemographic characteristics. METHODS: A questionnaire was administered to a population-based simple random sample of 5,059 adults aged 40 years and older in Agincourt, South Africa. Depressive symptoms were measured using a modified version of the eight-item Center for Epidemiological Studies-Depression screening tool. Diabetes was assessed using a capillary blood glucose measurement and HIV using a dried blood spot. RESULTS: 17.0% (95% confidence interval: 15.9%-18.1%) of participants had at least three depressive symptoms. None of the chronic conditions were significantly associated with depressive symptoms in multivariable regressions. Older age was the strongest correlate of depressive symptoms with those aged 80 years and older having on average 0.63 (95% confidence interval: 0.40-0.86; p < .001) more depressive symptoms than those aged 40-49 years. Household wealth quintile and education were not significant correlates. CONCLUSIONS: This study provides some evidence that the positive associations of depression with diabetes, HIV, hypertension, and obesity that are commonly reported in high-income settings might not exist in rural South Africa. Our finding that increasing age is strongly associated with depressive symptoms suggests that there is a particularly high need for depression screening and treatment among the elderly adults in rural South Africa.
BACKGROUND: Understanding how depression is associated with chronic conditions and sociodemographic characteristics can inform the design and effective targeting of depression screening and care interventions. In this study, we present some of the first evidence from sub-Saharan Africa on the association between depressive symptoms and a range of chronic conditions (diabetes, HIV, hypertension, and obesity) as well as sociodemographic characteristics. METHODS: A questionnaire was administered to a population-based simple random sample of 5,059 adults aged 40 years and older in Agincourt, South Africa. Depressive symptoms were measured using a modified version of the eight-item Center for Epidemiological Studies-Depression screening tool. Diabetes was assessed using a capillary blood glucose measurement and HIV using a dried blood spot. RESULTS: 17.0% (95% confidence interval: 15.9%-18.1%) of participants had at least three depressive symptoms. None of the chronic conditions were significantly associated with depressive symptoms in multivariable regressions. Older age was the strongest correlate of depressive symptoms with those aged 80 years and older having on average 0.63 (95% confidence interval: 0.40-0.86; p < .001) more depressive symptoms than those aged 40-49 years. Household wealth quintile and education were not significant correlates. CONCLUSIONS: This study provides some evidence that the positive associations of depression with diabetes, HIV, hypertension, and obesity that are commonly reported in high-income settings might not exist in rural South Africa. Our finding that increasing age is strongly associated with depressive symptoms suggests that there is a particularly high need for depression screening and treatment among the elderly adults in rural South Africa.
Authors: Jeffrey S Gonzalez; Mark Peyrot; Lauren A McCarl; Erin Marie Collins; Luis Serpa; Matthew J Mimiaga; Steven A Safren Journal: Diabetes Care Date: 2008-12 Impact factor: 17.152
Authors: Patrick Nzivo Mwangala; Adam Mabrouk; Ryan Wagner; Charles R J C Newton; Amina A Abubakar Journal: BMJ Open Date: 2021-09-22 Impact factor: 3.006
Authors: Ben Brinkmann; Collin F Payne; Iliana Kohler; Guy Harling; Justine Davies; Miles Witham; Mark J Siedner; Ali Sie; Mamadou Bountogo; Lucienne Ouermi; Boubacar Coulibaly; Till Bärnighausen Journal: BMJ Open Date: 2020-12-22 Impact factor: 2.692
Authors: Eva van Empel; Rebecca A de Vlieg; Livia Montana; F Xavier Gómez-Olivé; Kathleen Kahn; Stephen Tollman; Lisa Berkman; Till W Bärnighausen; Jennifer Manne-Goehler Journal: Arch Sex Behav Date: 2021-10-01