Kamga Nkouli Steve Jacquier
Seventh-Day Adventist Health Center, Cameroon
General practitioner in charge of the Gynaecology/Obstetric wards and maternity at the Seventh-Day Adventist Health Center, Buea, Cameroon. I was born on the 28th of October 1989 and I obtained an M.D degree from the Faculty of Health Sciences of the University of Buea, Cameroon in 2016. I also received training on training on cervical cancer screening and managements such as cryotherapy and leep procedures. I have also given several health talks through numerous massive cervical cancer screening outreach campaigns nationwide to teenagers and all women of reproductive age. As a young physician; I have developed interest in sexual and reproductive health research particularly in the field of HIV-AIDS and I am in the process of writing few articles on HIV-AIDS. I speak and write 2 languages and I love swimming and playing football
Background: HIV-AIDS in pregnancy and postpartum remains a global public health burden and depression is a significant contributor to the global burden of this current pandemic. Current studies show there is an association between depressive symptoms and HIV during pregnant and postpartum, lower adherence Antiretroviral Therapy (ART). Depression during these periods jeopardizes effective care mostly in postpartum. However, there is lack of data regarding these associations in Cameroon. The aim of the study was to determine the prevalence, determinants of depression in pregnant and postpartum women living with HIV-AIDS in the South West Region of Cameroon.
Methods: A prospective study was conducted involving 107 HIV-positive women during pregnancy and postpartum aged 18-47 years in the Buea and Limbe Regional and Kumba District Hospitals from August 2016 to April 2017. Depression was diagnosed using the nine-item patient health questionnaire and classified as none, mild and moderate. Multivariate analysis was used to investigate determinants of depression in these patients.
Results: The mean age of the study population was 32.6±10 years and 59 (55.1%) were pregnant while 48 (44.9%) were in postpartum. The prevalence of depression was 71.9% (n=77). Stigmatization by health personnel (OR=2.85, 95% CI: 1.67-5.01) and partners in discordant couples with fear of divorce and rejection (OR=4.73, 95% CI: 2.64-6.03), ostracisms by the community (OR=4.01, 95% CI: 2.14-5.75), fear of transmission to the newborn (OR=6.71, 95% CI: 3.92-8.24), lower CD4 counts ≤ 200mm3 (OR=5.01, 95% CI: 2.44-7.75) and lower adherence to ART (OR=2.45, 95% CI: 1.14-4.75) were determinants of depression in these women.
Conclusion: Our study suggests there is a high prevalence of depression among HIV-positive
women during pregnancy and postpartum, with more than one in two women affected.
Multidisciplinary care for HIV-positive women during pregnancy and postpartum and screening for depression involving mental health practitioners is highly encouraged.