Prevalence and Factors Associated With Depression Among Patients With Hypertension and Diabetes in Kiambu County, Kenya

Abstract

Background: Mental illnesses have been on the rise with depression being one of the prevalent mental health conditions. Depression is one of the prognostic indicators for non-communicable diseases including diabetes mellitus and hypertension. Most of these non-communicable diseases are diagnosed and managed in lower level hospitals while complex cases are managed in tertiary hospitals. However, there has been limited focus on depression among patients with hypertension and diabetes in lower tier hospitals which present the gap this study seeks to explore. Study objective: To determine the prevalence and factors associated with Depression Among Patients with Hypertension and/or Diabetes in Kiambu County, Kenya. Study design: This was a hospital based cross-sectional study. Study setting: The study included five selected level 4 sub county hospitals in Kiambu County. Namely: Kihara level 4 hospital, Wangige subcounty hospital, Ruiru subcounty hospital, Lari level 4 hospital, Tigoni level 4 hospital. A total of 360 patients with hypertension or diabetes or both were randomly selected in each of the hospitals where 72 patients were recruited in each facility. Data collection and analysis: A structured questionnaire (Demographic and clinical characteristics) and a validated PHQ9 to assess depression. Data was collected using google form. Descriptive statistics were employed to summarize participant characteristics and clinical factors. Depression was calculated as a proportion of total sample size and expressed as a percentage. Univariate and multivariable analysis was done using binary logistic regression. Results were presented as odds ratios alongside a 95% confidence interval. Data analysis was performed using Stata version 16 software. Results: The average age was 58.1(SD±13) years, 65.6% were female, 65.8% were married, 66.7% had primary level education while 76.1% had a monthly household income of less than Ksh.20,000.The prevalence of depression was 22.8%, 95%CI:18.5% to 27.1%. Mild, moderate and severe depression among respondents was 10.6%, 8.9% and 3.3% respectively. Being single, primary level of education, unemployed, earning ≤20,000 ksh, family history of mental illness, and feeling of emotional effect from disease diagnosis were independently associated with depression. Conclusion and recommendations: A significant portion of the population studied suffers from depression, with nearly one in four individuals affected. Mild depression is the most common, but there are also notable cases of moderate and severe depression. Various factors such as being single, low educational attainment, unemployment, low income, family history of mental illness, and emotional impact from illness are important contributors to the risk of depression.