Symptoms of depression among patients attending a diabetes care clinic in rural western Kenya

Kristen Shirey; Simon M Manyara; Lukoye Atwoli; Ryan Tomlin; Benson Gakinya; Stephanie Cheng; Jemima Kamano; Jeremiah Laktabai; Sonak Pastakia

doi:10.1016/j.jcte.2015.02.002

Symptoms of depression among patients attending a diabetes care clinic in rural western Kenya

J Clin Transl Endocrinol. 2015 Feb 10;2(2):51-54. doi: 10.1016/j.jcte.2015.02.002. eCollection 2015 Jun.

Authors

Kristen Shirey^{1

2

3}, Simon M Manyara^{4

5}, Lukoye Atwoli^{4

5

6}, Ryan Tomlin⁷, Benson Gakinya^{4

5

6}, Stephanie Cheng⁷, Jemima Kamano^{4

5}, Jeremiah Laktabai^{5

6

8}, Sonak Pastakia^{4

5

7

6}

Affiliations

¹ Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, P.O. Box 3837 Med Ctr, Durham, NC 27710, USA.
² Department of Medicine, Duke University Medical Center, P.O. Box 3837 Med Ctr, Durham, NC 27710, USA.
³ Duke Global Health Institute, P.O. Box 90519, Durham, NC, USA.
⁴ Moi Teaching and Referral Hospital, P.O. Box 3, Eldoret 30100, Kenya.
⁵ Academic Model Providing Access to Healthcare (AMPATH), P.O. Box 4606, Eldoret 30100, Kenya.
⁶ Moi University School of Medicine, P.O. Box 4606, Eldoret 30100, Kenya.
⁷ Department of Pharmacy Practice, Purdue University College of Pharmacy, 575 Stadium Mall Drive, West Lafayette, IN, USA.
⁸ Webuye District Hospital, P.O. Box 25, Webuye 50525, Kenya.

Abstract

Objective: The prevalence of diabetes in sub-Saharan Africa is rising, but its relationship to depression is not well-characterized. This report describes depressive symptom prevalence and associations with adherence and outcomes among patients with diabetes in a rural, resource-constrained setting.

Methods: In the Webuye, Kenya diabetes clinic, we conducted a chart review, analyzing data including medication adherence, hemoglobin A1c (HbA1c), clinic attendance, and PHQ-2 depression screening results.

Results: Among 253 patients, 20.9% screened positive for depression. Prevalence in females was higher than in males; 27% vs 15% (p = 0.023). Glycemic control trends were better in those screening negative; at 24 months post-enrollment mean HbA1c was 7.5 for those screening negative and 9.5 for those screening positive (p = 0.0025). There was a nonsignificant (p = 0.269) trend toward loss to follow-up among those screening positive.

Conclusions: These findings suggest that depression is common among people with diabetes in rural western Kenya, which may profoundly impact diabetes control and treatment adherence.

Keywords: Depression; Diabetes; Kenya; Resource-constrained; Sub-Saharan Africa.

Publication types

Case Reports