Predictors of depression among patients on art in a rural health district in North West Cameroon

Depression in people living with HIV/AIDS (acquired immune-deficiency syndrome) (PLWHA) increases risky HIV transmission behaviour, disease progression to AIDS, negatively affects drug adherence and is thus a risk for the development of drug-resistant strains. This study sought to identify predictors of depression in rural Cameroon. A cross-sectional analytic study was carried out from September 2013 to November 2013 in the Mbengwi district hospital of the North West region. We measured depression (PHQ-9 (nine-item Patient Health Questionnaire)), clinical and demographic characteristics of patients on antiretroviral therapy (ART). Means, proportions and a stepwise logistic regression model were fit to describe participants characteristics and predictors of depression in the study population. Of the 202 recruited patients, 58(28.7%) had a positive depression screen. Independent predictors of depression included monthly income less than 20,000 FCFA (US$40), (adjusted odds ratio (aOR) = 2.47; 95% CI = 1.18-5.18), CD4 count <200cls/μl (aOR = 7.56; 95% CI = 2.46-23.30) and presence of AIDS symptoms (aOR = 4.29; 95% CI = 2.09-8.81). There was no significant correlation between duration on ART, marital status, age, gender and depression. Early diagnosis and treatment of depressed patients need to be incorporated into intervention programmes, which might improve patient outcomes. More research is needed to investigate the impact of antidepressant therapy in PLWHA on the evolution of treatment.