COVID-19 pandemic and factors influencing depression in residents of the Democratic Republic of Congo

Background: The COVID-19 outbreak caused the border closure, martial law declaration, and lockdown to prevent the spread of the disease. These policies caused reduced interaction among people,social isolation, and higher levels of anxiety and depression. Objectives: This study aimed to examine changes in depressive symptoms of residents of the Democratic Republic of Congo (DRC) that may have arisen due to the COVID-19 and lockdown measures and to identify relevant influencing factors. Methods: This cross-sectional study involved 300 residents of the DRC. An online survey tool investigated general and public health characteristics and included the Patient Health Questionnaire-9 for measuring depressive symptoms. The study was conducted from April 7­30, 2020. Results: The average depression score was low at 2.74±3.33. Factors influencing depression were the number of family members, probability of death due to COVID-19, knowledge of COVID-19, and time at home. The factor that most significantly influenced depression and these variables accounted for 26.9% of the influence of COVID-19 on depression (F= 9.936, p<.001). Conclusion: This study investigated the influence of COVID-19 outbreak on depression in DRC. Levels of depression increased for individuals who were living alone, had low levels of knowledge of COVID-19 and awareness of the disease severity, and spent a long time at home.

Évaluation de la prescription et de l'utilisation des benzodiazépines dans la ville de Sidi Bel-Abbès / Evaluation of the prescription and use of benzodiazepines in Sidi Bel-Abbes city

Introduction :Une forte consommation des benzodiazépines (BZDs) a été remarquée en dehors parfois des règles de recommandations de prescription, ce qui rend leur consommation un problème majeur de santé publique. La présente étude a eu pour objectif d'évaluer la prescription et l'usage des BZDs dans la ville de Sidi Bel-Abbès. Méthodes-Il s'agissait d'une étude descriptive transversale réalisée du 01 Février 2018 au 30 Juin 2018 évaluant la prescription et l'usage des BZDs dans la ville de Sidi Bel-Abbès au moyen d'un questionnaire distribué aux patients de l'hôpital psychiatrique, du service de psychiatrie du CHU et aux pharmaciens d'officine.Le critère de jugement principal était l'évaluation de la prescription et de l'utilisation des BZDs dans cette ville. La saisie et l'analyse des données ont été réalisées par le logiciel SPSS. Résultats-Au total, 353 patients traités au moins par une BZD ont été inclus dont 178 hommes. Le taux de prescription des BZDs était de 1.10, des jeunes (59,77 %) et des personnes mariées (60,34%) constituaient les consommateurs privilégiés. La prescription était l'apanage des psychiatres, en monothérapie (07,42%), la molé cule la plus fréquemment prescrite était le Bromazépam (31,07%) et la prise noc turne était la plus importante (49,01%). Les BZDs étaient utilisées pour combattre l'insomnie (25,21%), l'anxiété (16,43%), pour une durée de plus d'une année (57,79 %). Conclusion-La prescription et l'utilisation des BZDs dans la ville de Sidi Bel-Abbès s'est avérée importante. L'insomnie et l'anxiété constituaient les principales raisons de leur utilisation, et le Bromazépam était la molécule la plus fréquemment utilisée .

Introduction-A high consumption of benzodiazepines (BZDs) has been noticed so metimes outside the rules of prescription recommendations, which makes their consumption a major public health problem. The present study aimed to evaluate the prescription and use of BZDs in Sidi Bel-Abbès city. Methods-: This was a descriptive cross-sectional study carried out from February 01st, 2018 to June 30th, 2018 evaluating the prescription and use of BZDs in of Sidi Bel-Abbès by means of a questionnaire distributed to patients from the psychiatric hospital, the CHU psychiatry department and community pharmacists. The primary endpoint was the assessment of the prescription and use of BZDs in this city. Data entry and analysis were performed using SPSS software. Results-A total of 353 patients treated with at least one BZD were included, including 178 men. The prescription rate of BZDs was 1.10, young people (59.77%) and married people (60.34%) were the privileged consumers. The prescription was the prerogative of psychiatrists, in monotherapy (07.42%), the molecule most frequent ly prescribed was Bromazepam (31.07%) and night intake was the most important (49.01%). BZDs were used to combat insomnia (25.21%), anxiety (16.43%), for a period of more than a year (57.79%). Conclusion-The prescription and use of BZDs in Sidi Bel-Abbès has proven to be important. Insomnia and anxiety were the main reasons for their use, and Bromazepam was the most molecule frequently used.

The impacts of COVID-19 pandemic on mental health: A scoping review

Background: This scoping review assessed the COVID-19 impacts on mental health and associated risk factors. Methods: A literature search for relevant articles published between March 2020 and July 2022, was conducted in the APA PsychInfo, JBI Evidence Synthesis, Epistemonikos, PubMed, and Cochrane databases. Results: The article inclusion criteria were met by 72 studies. The commonly used mental health assessment tools were the Patient Health Questionnaire (41.7%), Generalized Anxiety Disorder Scale (36%), 21-item Depression, Anxiety, and Stress (13.9%), Impact of Event Scale (12.5%), Pittsburgh Sleep Quality Index (9.7%), Symptom Checklist and the General Health Questionnaire (6.9% each). The prevalence rate of depression ranged from 5-76.5%, 5.6-80.5% for anxiety, 9.1- 65% for Post-Traumatic Stress Disorder, 8.3-61.7% for sleep disorders, 4.9-70.1% for stress, 7-71.5% for psychological distress, and 21.4-69.3% for general mental health conditions. The risks included female gender, healthcare related/frontline jobs, isolation/quarantine, poverty, lower education, COVID-19 risk, age, commodities, mental illness history, negative psychology, and higher social media exposure. The incidence of mental disorders increased along with the increasing cases of COVID-19 and the corresponding government restrictions. Conclusion: Standard mental health assessment tools were used in these studies conducted during COVID-19. Mental health disorders like depression, anxiety, and stress increased during the COVID-19 pandemic and lockdowns. Various factors impacted the prevalence of mental health disorders. Policymakers need to provide social protective measures to improve coping in critical health events. Further studies should investigate the effectiveness of interventions for reducing the prevalence and risk factors for mental health conditions during a public health emergency.

Psychological impact of the COVID-19 pandemic on anaesthetists in an academic institution in South Africa

Background: Anaesthesiology is considered to be a medical speciality that can result in high levels of stress. The COVID-19 pandemic required anaesthetists to rapidly adopt additional challenging roles. This study describes the psychological impact of the pandemic on anaesthetists and identified and compared factors associated with depression, anxiety, stress, and post-traumatic stress disorder (PTSD). Methods: A cross-sectional study design was used. An anonymous questionnaire was used to collect data utilising convenience sampling and results were reported using descriptive statistics and logistic regression analysis. The order of importance for the sources of stress and organisational support was determined by calculating the median rank. Results: The majority of the participants were between ages 31­40 (62.6%), male (59.8%), registrars (47.6%), had no comorbidities (73.8%), and had no known mental illness (79.9%). Having a previous diagnosis of a mental health illness was linked with greater levels of depression (OR [95% CI] = 4.50 [2.02­10.24], p < 0.001), anxiety(OR [95% CI] = 3.9 [1.7­9.0], p = 0.001), stress (OR [95% CI] = 3.8 [1.6­9.2], p = 0.002), and PTSD (OR [95% CI] = 5.4 [2.2­13.5], p < 0.001). Sources of stress identified included: insecure access to appropriate personal protective equipment, being exposed to COVID-19 at work, and taking the infection home to family. Conclusion: Participants with a history of mental illness were predisposed to developing negative psychological symptoms as a result of the pandemic. The main source of stress identified was insecure access to appropriate personal protective equipment.

Menstrual hygiene management in public high schools in Ghana

in the ten (10) regions of Ghana. The findings showed that most girls in Public Senior High Schools in Ghana had prior knowledge about menstruation from their mothers and sisters prior to menarche. It was revealed that majority of the girls mentioned hormones as the cause of menstruation, whilst others mentioned the uterus, bladder, vagina, and other parts of the female reproductive system. A few of them had no idea what causes menstruation. The findings again revealed that most girls use sanitary pads, while some use other materials during menstruation. Less than half of the sample of girls in this study were able to change their pads twice daily or more. About half of the girls cleansed their genital parts only when bathing during menstruation using soup and water mostly. Half of the schools used public tap/standpipe as their main source of water and the rest used other sources of water. Also, most schools have toilet facilities. Some useful recommendations are proffered with the aim of improving MHM in public high schools in Ghana

Effect of video-based information on preoperative State trait anxiety inventory scores in adult patients presenting for elective caesarean section: a randomized controlled trial

Background: Preoperative anxiety is a common occurrence in patients presenting for surgery with a reported incidence of up to 80%. Increased preoperative anxiety has been associated with increased morbidity. Provision of information relating to surgery and anesthesia to patients has been proven to have benefit in allaying anxiety. However, the best format of information dissemination remains unknown. Objective: To determine the effect of video information in addition to the pre-anesthetic review on the mean preoperative State anxiety inventory (STAI-S) score in adult patients presenting for elective caesarean section under spinal anesthesia at Aga Khan University Hospital, Nairobi (AKUHN), and to determine the prevalence of preoperative anxiety in the obstetric population presenting for elective caesarean section at AKUHN. Methods: Thirty-seven adult patients booked for elective caesarean section under spinal anesthesia were randomly assigned to one of two groups. In the study arm, a video was shown to the participants in addition to the standard pre-anesthetic review. In the control arm the participants only had a standard pre-anesthetic review. Results: The mean STAI-T score in the sampled population was 45.64 (SD 5.625). The mean baseline STAI-S score was 46.32 (SD 4.911). There was no statistically significant difference in change in STAI score between the video and control arms (p>0.05). Conclusion: On the basis of this study among this population, there was no benefit demonstrated from the use of an information video about spinal anesthesia on anxiety levels in obstetric patients presenting for a first time spinal

Comorbid anxiety and depression among women receiving care for breast cancer: analysis of prevalence and associated factors

Background: Living with breast cancer has been associated with increased risk for common mental health problems including depression and anxiety. However, the prevalence of comorbid anxiety and depression (CAD) and their associated factors have received little attention especially in low- and middle-income countries (LMICs) including Ghana. Objectives: This study examined the prevalence of CAD and its correlates in the context of breast cancer. Methods: Participants were 205 women receiving care for breast cancer at a Tertiary Hospital in Ghana. The Hospital Anxiety and Depression Scale (HADS) and socio-demographic questionnaires were administered to the participants. Results: Findings from the study showed that the prevalence of CAD, anxiety and depression was 29.4%, 48.5% and 37.3% respectively. CAD was significantly predicted by patients' English language reading ability, shared decision making and good doctor-patient relationship. Anxiety was significantly predicted by shared decision making and good doctor-patient relationship whereas depression was significantly predicted educational status, patients' English language reading ability, shared decision making and good doctor-patient relationship. Conclusion: The findings suggest relatively high prevalence of comorbid anxiety and depression which could negatively impact breast cancer treatment outcomes and therefore, improved interpersonal relationships between doctors and their patients as well as literacy skills are warranted

Impact of COVID-19 ­ experiences of 5th year medical students at the university of KwaZulu-natal

Background: The global pandemic associated with coronavirus disease 2019 (COVID-19) had a considerable effect on higher education in South Africa, with online instruction replacing traditional lectures for many students. Medical students were required to vacate their residences in March 2020 but returned to campus in July 2020 to enable them to continue with clinical teaching and learning. The aim of this study was to understand the learning experiences of 5th year medical students at the University of KwaZulu-Natal (UKZN) during 2020. Methods: This was a qualitative study conducted via Zoom in December 2020 with 18 students in four focus group discussions and four semi-structured interviews. These were all facilitated by an independent researcher with experience in qualitative research. All the interviews were recorded, transcribed verbatim and analysed qualitatively through the identification of codes, categories and themes. Results: The following major themes emerged: A stressful and at times an overwhelming year, mental health issues, developing strategies to cope, and issues that related to teaching and learning. Conclusion: The disruptions caused by COVID-19, the lockdown, a condensed academic programme and uncertainty about their competency resulted in high levels of anxiety and stress among medical students. Participants highlighted strategies that had helped them to cope with the isolation and academic pressures. Given the large volume of work, careful thought needs to be given to what should be taught and how it should be taught to ensure that graduates have the competencies they need to practise.

Contemporary prevalence and predictors of anxiety among patients living with HIVAIDS in Ghana

Objectives: To identify the prevalence and associated factors of anxiety in people living with HIV/AIDS in a tertiary centre in Ghana. Design: The study employed a cross-sectional design. Setting: The study was conducted in the outpatient HIV clinic of a tertiary hospital. Participants: Participants were adult PLWHA receiving OPD care, including those established on combined antiretroviral therapy (cART) and newer patients who were not on cART. Four hundred ninety-five participants aged ≥30 years were consecutively enrolled on the study. Interventions: Demographic and clinical data were collected using standard questionnaires and patient files. Anxiety was assessed using the Hospital Anxiety and Depression Scale (HADS). Multivariate logistic regression analysis was done to identify associated factors. Main outcome measure: Proportion of PLWHA who had HADS score of ≥8 Results: Overall prevalence of anxiety was 61.0% (95%CI: 56.6 ­ 65.3), with no significant difference between recently diagnosed (≤ 6 months, 64.3%) and those with established diagnoses (>6 months, 59.1%). Urban residence (aOR: 1.67, 95%CI: 1.12 ­ 2.51), alcohol use (aOR: 1.64, 95%CI: 1.13 ­ 2.38) and depression (aOR: 13.62, 95%CI: 7.91 ­ 23.45) were independently associated with anxiety. Conclusion: In this sample, 6 in 10 Ghanaian PLWHA had evidence of anxiety. Liaison with the national mental health service for more comprehensive and integrated care and further research into the mental health of PLWHA is recommended to reduce this high burden of anxiety

The prevalence and correlates of anxiety and depression amongst essential workers during the COVID-19 lockdown in Ekiti State, Nigeria

Background: Essential workers are imperative in the fight against the coronavirus disease (COVID-19) pandemic. Aim: To assess the prevalence and factors associated with anxiety and depression among essential workers during the COVID-19 pandemic and lockdown. Setting: This study was set in Ekiti State, Nigeria. Method: This was a cross-sectional study involving essential workers in Ekiti State Nigeria, during the COVID-19 pandemic and lockdown. A total of 588 essential workers were sampled. Online socio-demographic variables and the Hospital Anxiety and Depression Scale, a 14 item self-reported questionnaire were used. Results: The prevalence of anxiety and depression among the respondents was 93.4% (CI = 91.2­95.2) and 64.3% (CI = 60.4­68.4) respectively. Among the health workers, the prevalence of anxiety and depression were 96.5% (CI =94.8­98.1) and 66.5% (CI = 60.5­69.8) respectively while the prevalence of anxiety and depressive symptoms among non- health workers were 84.6% (CI = 78.7­90.1) and 61.5% (CI = 54.2­69.4) respectively. The odds ratio (OR) of depressive symptoms was increased among, respondents who were not satisfied with the support they received from the government during the pandemic (AOR = 2.071, CI = 1.350­2.213), respondents that were 35 years and younger (AOR = 1.512, CI = 1.033­2.213) and reduced amongst Christians (AOR = 0.501, CI = 0.286­0.879). The odd of anxiety was increased among health workers compared to non-health workers (AOR = 3.700, CI = 1.744­7.851) and the odds of anxiety was reduced among respondents with previous history of mental illness (AOR = 0.215, CI = 0.049­0.943). Conclusion: Anxiety and depressive symptoms were common mental illness among essential workers working during the COVID-19 lockdown, therefore their mental health should be adequately considered to sustain the fight against the virus.

Stress, anxiété, dépression et qualité de vie des patients tuberculeux pharmacorésistants à Kinshasa, République Démocratique du Congo / Stress, anxiety, depression and quality of life of drug-resistant tuberculosis patients in Kinshasa, Democratic Republic of the Congo

Contexte & objectif. La prise en charge médicale de la tuberculose pharmacorésistante connaît des progrès dans le monde. Mais, le volet psychosocial a été peu exploré en République Démocratique du Congo. La présente étude a évalué la qualité de vie des patients tuberculeux pharmacorésistants (PTP) suivis au Centre d'Excellence Damien (CEDA) à Kinshasa. Méthodes. L'échelle de stress perçu (PSS), l'Hospital Anxiety and Depression Scale (HADS) et l'Indicateur de Santé Perceptuelle de NOTTINGHAM (ISPN) ont été utilisés dans une étude transversale réalisée du 1er avril au 31 décembre 2018 sur 81 PTP hospitalisés au CEDA de Kinshasa. La méthode de régression logistique a recherché les déterminants de la qualité de vie. Résultats. Au cours de la période de l'étude, 81 PTP étaient reçus dont 62 TB multirésistants (TB MR, 76,5%) contre 19 TB ultrarésistants (TBUR, 23,5%), constituant les deux groupes d'étude. L'âge moyen des sujets était de 34,7±14,3 ans. Les hommes étaient légèrement prépondérants (53 %) avec un sex ratio H/F de 1,1. La tranche d'âge de 21 à 30 ans était plus représentée (35%). Trois-quarts des sujets étaient solitaires (75%), plus de deuxtiers avaient un niveau secondaire (69%), plus de la moitié n'avait pas d'occupation (56%), près de deux-tiers fréquentaient les Eglises indépendantes (60%). Trente-cinq pourcents des patients avaient une mauvaise qualité de vie. Celle-ci était liée à l'âge >40 ans, au type TBMR, au retard d'accompagnement psychosocial, au niveau d'étude primaire, à la présence de la co-infection tuberculose- VIH/SIDA, au stress perçu et à l'anxiété-dépression. Conclusion. Les patients tuberculeux pharmacorésistants à Kinshasa ont une qualité de vie altérée. Cette situation est favorisée par l'âge >40 ans, le type de tuberculose pharmacorésistante, le retard d'accompagnement psychosocial, le faible niveau d'étude, la présence de la coinfection tuberculose-VIH/SIDA, le stress perçu, l'anxiété et la dépression.

Context and objective. Despite many progress in the treatment of drug-resistant tuberculosis, psychosocial aspects remain poorly adressed in the Democratic Republic of Congo. This study aimed to evaluate the quality of life of drugresistant tuberculosis patients. Methods. A crosssectional survey was conducted in hospitalized drug-resistant tuberculosis patients at CEDA Kinshasa, during the period from April 1 to December 31th, 2018, through the perceived stress scale (PSS), the Hospital Anxiety and Depression Scale (HADS) and the NOTTINGHAM Health Profil (NHP) tools. Data from 62 multdrug rerestitant TB patients (MDR TB, 76,5%) were compared with 19 ultraresistant (PXDR, 23.5 %) and analyzed, using a multivariate logistic regression analysis to assess the determinants of quality of life. Results. Among a total of 81 pharmaco-resistant TB patients, average age 34.7 ± 14.3 years, with a slight man preponderance (53 %), 35% had a poor quality of life. This was linked to age > 40 years, MDRTB type, delayed psychosocial support, primary education, the presence of TBHIV co-infection, and perceived stress and anxiety-depression. Conclusion.The study reveals an impaired quality of life in Drug-resistant tuberculosis patients in Kinshasa, with some identified correlates. Targeted measures are needed to improve the management of these patients

The effect of clinical simulation assessment on stress and anxiety measures in emergency care students

Background: Clinical simulation has become widespread as a training and assessment tool across a range of health professions, including emergency care. As with any form of assessment, simulations may be associated with stress and anxiety ("distress") which may have a negative effect on student performance if demands required by the simulation outweigh the available resources. This study aimed to assess the effect of participation by students in an emergency care simulation on an objective measure of stress and a subjective measure of anxiety. Methods: Heart rate variability (HRV) and scores from a validated state anxiety instrument (the State-Trait Anxiety Inventory) were assessed in 36 emergency medical care students participating in scheduled simulation assessments. Data recorded during a resting control period were used for comparison. Results: HRV variables showed changes in the simulation assessment group suggesting decreased variability and parasympathetic withdrawal, however these were not significantly different to control. Heart rate in the simulation assessment group increased significantly (73.5/min vs. 107.3/min, p < 0.001). State anxiety scores increased significantly both before (33.5 vs. 49.1, p < 0.001) and after (33.5 vs. 60, p < 0.001) the simulation assessment, compared to control. No linear relationship was found between any HRV variables and anxiety scores. Conclusion: Participating in an emergency care simulation assessment significantly elevated levels of anxiety in a group of 36 students, however an objective measure of stress did not identify changes significantly different to those at rest, with the exception of heart rate. The high levels of anxiety documented before and after simulation assessments may have a negative effect on performance and require further investigation

Burden, psychological well-being and quality of life of caregivers of end stage renal disease patients

BACKGROUND: Caregivers of chronic kidney disease (CKD) patients play an important role in the management of the patients. Their psychological needs are often overlooked and unmet by the managing team. This study assessed the psychosocial well-being and quality of life (QoL) of caregivers of CKD patients in two hospitals in Southern Nigeria. METHODS: Burden of caregiving, QoL, depression, and anxiety were assessed using standardized instruments; modified Zarit questionnaire, modified SF-12 questionnaire and Hospital Anxiety and Depression Scale (HADS) respectively among caregivers of CKD patients on maintenance haemodialysis and controls. RESULTS: Fifty-seven caregivers of CKD patients and aged and sex-matched controls participated in the study. Anxiety was significantly higher in caregivers compared to control (31.6% vs 5.3%, p = 0.004). Also, depression was significantly higher in caregivers (31.6% vs 3.5%, p= <0.001). Twenty-eight (49.1%) of the caregivers had mild to moderate burden and 19 (33.3%) had a high burden. The mean Zarit burden score was higher in female caregivers compared to male caregivers (18.30±8.11 vs 14.83±6.70, p = 0.09). The mean depression score was higher in female caregivers compared to male caregivers (8.58±3.83 vs 6.75±3.80, p= 0.08). There was significant positive correlation between Zarit burden and hospital anxiety score (r = 0.539, p= < 0.001) and depression score (r = 0.472, p = 0.005). CONCLUSION: Depression, anxiety and burden were common among caregivers of CKD patients especially females compared to controls. Supportive interventions for these caregivers should be included in treatment guidelines in order to improve overall patients' outcome

Depression, anxiety and stress symptoms in patients presenting with dyspepsia at a regional hospital in KwaZulu-Natal province

Background: Depression, anxiety and stress (DAS) have been shown to be co-morbid with dyspepsia. Local data on the factors associated with these co-morbidities could inform the role of psychiatric intervention in affected patients.Aim: The aim of this study was to describe the frequency of undiagnosed DAS and their associated protective and risk correlates in a sample of patients undergoing endoscopies for dyspepsia.Setting: The study was conducted at a regional hospital's gastro-intestinal unit in KwaZulu-Natal province.Method: A cross-sectional survey was conducted on 201 in- and outpatients with symptoms of dyspepsia awaiting endoscopy. Information on DAS symptomatology (using the DASS-21 screening questionnaire, as well as socio-demographic and clinical data) were collected.Analyses: Following a descriptive analysis of the participants' socio-demographic and clinical details, linear regression models were fitted to identify potential risk and protective correlates linked to DAS symptomatology.Results: The mean age of participants (N = 201) was 48.89 years, of whom approximately two-thirds (n = 133; 66.17%) were women, 97% (n = 195) were African and 64.68% (n = 130) resided in rural areas. Anxiety was the most prevalent symptom category (n = 149; 74.13%) versus depression (n = 96; 47.76%) and stress (n = 68; 33.83%) in each category of symptom (mild to extremely) severity. In the severe and extremely severe range, anxiety existed without co-morbid depression or stress in 61.19% of anxious patients. Alcohol use was significantly associated with all three symptom categories (p < 0.01).Conclusions: Given high frequencies of depression and anxiety in patients undergoing endoscopies for dyspepsia, screening for common mental disorders is essential

The impact of 6-month micronutrient supplementation on viral, immunological, and mental health profile of a cohort of highly active antiretroviral therapy-naive HIV-positive patients in Northern Nigeria

Background: HIV is a chronic disease with inflammatory reactions involving numerous elements of the immune system, resulting in an increased risk for other physical and psychiatric morbidities. Micronutrients, some of which possess anti-inflammatory properties, may help prevent the development of psychological disorders such as anxiety and depression in people living with HIV disease. Objectives: This study examined the profile of viral load, CD4 cell count, C-reactive protein, anxiety, and depression among highly active antiretroviral therapy (HAART)-naive HIV-positive patients receiving micronutrient supplementation over a 6-month period. Materials and Methods: A total of ninety HAART-naïve HIV-infected patients completed the Hospital Anxiety Depression Scale. Their blood samples were taken for serum viral load, CD4 cell count, and C-reactive protein at baseline. They all received a micronutrient supplement for 6 months, and 68 participants who remained in treatment at 6 months were reassessed with the same parameters. Results: After 6 months of micronutrient supplementation, the participants were found to have statistically significantly lower mean scores on the anxiety (t-test = 2.970,P = 0.003) and depression (t-test = 3.843,P = 0.001) subscales. They also had statistically significantly lower median CD4 cell count (P = 0.00) and C-reactive protein serum measures (P = 0.04). The median viral load decreased although the difference was not statistically significant. Conclusion: Micronutrient supplementation may reduce inflammatory reactions, anxiety, and depression in HAART-naive HIV-infected persons

Post-partum depression, anxiety and marital satisfaction: A perspective from Southeastern Nigeria

Background: Many studies have noted the high prevalence of post-partum depression (PPD) and anxiety associated with poor marital satisfaction, albeit amidst a dearth of literature on comorbid PPD and anxiety among women in Nigeria. Objective: The study was aimed to assess the prevalence of PPD and anxiety, and to investigate their relationship with marital satisfaction in low-risk women in Enugu, Southeastern Nigeria. Method: A cross-sectional study of 309 randomly selected nursing mothers at two tertiary health institutions. Socio-demographic Questionnaire, Hospital Anxiety and Depression Scale, and Index of Marital Satisfaction (IMS) were used to collect data on demography, anxiety and depression and marital relationship respectively. All statistical tests were performed at a significant level of 0.05. Results: The age range of the respondents was 20­46 years; mean and s.d. was 29.65 and ±4.87, respectively, and most of them were graduates of tertiary educational institutions (74.1%). The prevalence of post-partum anxiety was 31.1% and of PPD was 33.3%. Marital dissatisfaction was observed in 39.5% (122) of the respondents who were mothers. Those with co-morbid depression and anxiety (22.0%) had worse marital dissatisfaction. The strongest correlation with depression and anxiety was item 12 of IMS ('feel that my partner doesn't confide in me').Conclusion: There was a high prevalence of marital dissatisfaction, PPD and anxiety among nursing mothers in Enugu, but with low detection rate. The effects of PPD and anxiety on the mother, her marital relationship and her infant make them essential conditions for early diagnosis, prevention and treatments

Level of awareness and treatment of anxiety and depression during pregnancy in southeast Nigeria

Background: Anxiety and depressive disorders are somewhat masked by features of pregnancy; hence many women are ignorant of them and are untreated. Aim: To determine the level of awareness and treatment of anxiety and depression in pregnancy. Setting: The study was carried out at the antenatal clinic of Enugu State University Teaching Hospital, Enugu, Nigeria. Method: This was a cross-sectional and descriptive study of 200 pregnant women in consecutive attendance of the antenatal clinic using the Hospital Anxiety and Depression Scale (HADS) and a sociodemographic questionnaire. Results: Of the participants, 23.5% had anxiety and/or depression, 7.5% of them were aware of their condition and only 0.5% of all the participants or 6.7% of those who were aware of their problem received treatment. Conclusion: Anxiety and depression are prevalent among pregnant women. Because of overlap of symptoms of anxiety and depression with those of pregnancy, the awareness is very low; hence many of them suffer immensely without treatment

A cross-sectional study of depression among women attending antenatal clinics in Blantyre district, Malawi

Background: Pregnancy is a period associated with major psychological and social changes in the life of a woman and can be associated with anxiety and depression. Aim: To describe demographic, clinical and risk profile of antenatal depression among pregnant women attending antenatal clinics in Blantyre district, Malawi. Setting: The study was conducted in eight antenatal clinics in Blantyre district, Malawi. Methods: A cross-sectional study of 480 randomly selected pregnant women attending antenatal clinics was conducted. Prevalence was determined using the Edinburgh Postnatal Depression Scale (EPDS) which was validated against a sub-sample using the Mini International Neuropsychiatric Interview. The risk factors of depression were assessed using the Pregnancy Risk Questionnaire. Data were analysed using descriptive statistics, Pearson chi-square test and binary logistic regression. Results: Prevalence of antenatal depression using the EPDS was 19% (95% CI 15.5% ­ 22.5%, n= 91) and was comparable to the Mini International Neuropsychiatric Interview (25.8%[95%CI=17.5­34], n=25). The key risk factors that predicted antenatal depression were: 'being distressed by anxiety or depression for more than 2 weeks during this pregnancy'(OR=4.1 [2.1­7.9], p≤ 0.001); 'feeling that a relationship with partner is not an emotionally supportive one' (OR=3.5 [1.4­8.4], p=0.01); 'having major stresses, changes or losses in the course of this pregnancy' (OR=3.2 [1.7­6.2], p=0.01); 'feeling that father was critical of her when growing up' (OR=3.2 [1.4­7.6], p=0.01); and 'having history of feeling miserable or depressed for ≥ 2 weeks before this pregnancy' (OR=2.4 [1.3­4.4], p=0.01). Conclusion: This study confirmed the high-prevalence rate of depression in this group and illustrated that antenatal depression was associated with being distressed by anxiety or depression; support from partner; major stresses during pregnancy; and history of feeling miserable or depressed before pregnancy. This study also found a history of poor relationship between pregnant women and their fathers during childhood

Anxiety experience and preoperative nursing care evaluation among postoperative emergency caesarian section patients in two selected hospitals, Nairobi, Kenya

Emergency caesarean section poses obstetric, anesthetic and surgical risks to the mother and the unborn baby and exacerbates anxiety which is deleterious. Preoperative nursing care rendered during this period greatly influence patient's care perception, a concept underpinned in this study. Patients' pre-and postoperative anxiety levels and demographics informed by literature reviewed were evaluated. Demographics included age, the level of education, mode of hospital bill payment, history of major illness, previous surgeries, current medication, smoking and the condition of the newborn. A descriptive cross-sectional survey was conducted in a private and a public hospital among patients undergoing emergency caesarean section. Sixty participants were purposively and systematically sampled from the postnatal ward admission registers using inclusion criteria. A structured questionnaire was used to assess participants' demographics and care satisfaction. Anxiety levels were evaluated using Form Y-6. Ethical approval was obtained from the respective ethical review boards. Multivariate nonparametric statistical analyses using Statistical Package for Social Sciences (SPSS) version 17 computer software was used to analyze data Alongside descriptive statistics. Significant finding observed regarding demographics were on the level of education and mode of hospital hill payment. The highest level of education attained was tertiary 22(73.3%) in private compared to secondary level 14 (46.7%) in the public hospital. The mode of hospital bill payment was through companies' medical schemes 24(80%) in private hospital and through National Health Insurance Fund (NHIF) 22(73.3%) in public. Mann-Whitney U test showed statistically significant differences in only two out of the six anxiety defining statements assessed postoperatively. Participants at the public hospital felt calmer (z=-2.071, p=0.038<0.05) and more relaxed (z=-2.85, p=0.004<0.05) than those at the private hospital. Wilcoxon rank test yielded significant results for only one out of the six care satisfaction defining statements. Participants at the public hospital were more satisfied with the information given by the nurse about what is expected before and after surgery (z=-2.61, p=0.009<0.05) compared to private. This study evidences nurses' ability to render satisfactory care to patients in emergency situations regardless of socio-patients' demographic profile and type of hospital. There is need to initiate and sustain such care surveillance for quality auditing