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Original research
Prevalence and correlates of depressive symptoms, and points of intervention, in rural central Uganda: results from a cross-sectional population-based survey of women and men
  1. Katelyn M Sileo1,
  2. Rhoda K Wanyenze2,3,
  3. Katherine Schmarje Crockett3,4,
  4. Rose Naigino2,3,4,
  5. Michael Ediau3,4,5,
  6. Haruna Lule6,
  7. Seth C Kalichman7,
  8. Chii-Dean Lin8,
  9. Nicolas Menzies9,
  10. Moses H Bateganya10,
  11. Susan M Kiene2,3
  1. 1Department of Public Health, The University of Texas at San Antonio, San Antonio, Texas, USA
  2. 2Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
  3. 3Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, California, USA
  4. 4Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
  5. 5Department of Health Policy, Planning and Management, Makerere University School of Public Health, Kampala, Uganda
  6. 6Division of Health Systems Strengthening, Global Centre of Excellence in Health (GLoCEH), Kampala, Uganda
  7. 7Institute for Collaboration on Health, Intervention and Policy, University of Connecticut, Storrs, Connecticut, USA
  8. 8Department of Mathematics and Statistics, San Diego State University, San Diego, California, USA
  9. 9Department of Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
  10. 10Infectious Diseases and Health Systems, FHI 360, Durham, North Carolina, USA
  1. Correspondence to Dr Susan M Kiene; skiene{at}sdsu.edu

Abstract

Objectives The present study aimed to identify the prevalence and correlates of depressive symptoms and potential intervention points among women and men from a population-based sample in rural central Uganda.

Design A cross-sectional study.

Setting Four districts in rural Uganda.

Participants Women and men aged 15–59 residing in four districts in rural Uganda accepting home-based HIV testing who completed a baseline survey at the time of testing.

Primary outcome measures Depressive symptoms measured by the 10-item Center for Epidemiological Studies Depression Scale using a cut-off score of 13 for significant depressive symptoms.

Results Among a sample of 9609 women and 6059 men, 1415 (14.7%) women and 727 (12.0%) men met criteria for significant depressive symptoms. Having ever received mental health services was associated with lower odds of significant depressive symptoms (women: adjusted OR (adjOR)=0.32, 95% CI=0.22 to 0.47; men: adjOR=0.36, 95% CI=0.18 to 0.62). Having received outpatient (women: adjOR=3.64, 95% CI=3.14 to 4.22; men: adjOR=3.37, 95% CI=2.78 to 4.07) or inpatient (women: adjOR=5.44, 95% CI=4.24 to 6.97; men: adjOR=3.42, 95% CI=2.21 to 5.28) care in the prior 6 months was associated with greater odds of significant depressive symptoms. For women only, known HIV positive status (adjOR=1.37, 95% CI=1.05 to 1.77), and for men only, alcohol misuse (adjOR=1.38, 95% CI=1.12 to 1.70), were associated with increased odds of significant depressive symptoms.

Conclusion Our findings suggest that depression screening within outpatient and inpatient settings may help to identify people in need of mental health services. Routine screening in outpatient or inpatient clinics along with the implementation of evidence-based interventions could ultimately help close the mental health gap for depression in this and similar settings.

  • Depression
  • Uganda
  • population-based study
  • cross-sectional study
  • CES-D-10

Data availability statement

Data are available upon reasonable request. De-identified data are available upon reasonable request for non-profit/NGO or academic research use from the parent study principal investigators.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Data availability statement

Data are available upon reasonable request. De-identified data are available upon reasonable request for non-profit/NGO or academic research use from the parent study principal investigators.

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Footnotes

  • Contributors SMK and KMS conceptualised the manuscript. SMK led data analysis with support from KMS. KMS led the writing of the manuscript. SMK and RKW were principal investigators on the original study, leading all aspects of study implementation, with support from the investigative team, HL, SCK, C-DL, NM and MHB. RN, ME and KSC were involved in the operational implementation of the study. All authors reviewed the manuscript and provided feedback and editorial support. SMK is the senior author and is acting as the guarantor.

  • Funding This study was supported by the National Institute of Mental Health: Grant R01MH106391 awarded to SMK and RKW. KMS was supported by a Mentored Research Scientist Career Development Award from the National Institute of Mental Health of the National Institutes of Health (K01MH121663). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

  • Provenance and peer review Not commissioned; externally peer reviewed.