Long-term effects on depressive symptoms among Ugandan mothers - Findings from a follow-up of a cluster-randomized education trial in a rural low-resource setting.

Autor: Kakwangire P; Department of Nutrition, IMB, University of Oslo, Oslo, Norway., Atukunda P; Center for Crisis Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway., Ngari M; KEMRI Wellcome Trust Research Programme, Kilifi, Kenya and Department of Public Health, School of Health & Human Sciences, Pwani University, Kilifi, Kenya., Westerberg AC; Division of Obstetrics and Gynecology, Department of Obstetrics, Oslo University Hospital - Rikshospitalet, Oslo, Norway; School of Health Sciences, Kristiania University College, Oslo, Norway., Iversen PO; Department of Nutrition, IMB, University of Oslo, Oslo, Norway; Department of Haematology, Oslo University Hospital, Oslo, Norway; Division of Human Nutrition, Stellenbosch University, Tygerberg, South Africa., Muhoozi G; Department of Family Life and Consumer Studies (Home Economics), Kyambogo University, Kampala, Uganda. Electronic address: gmuhoozi@kyu.ac.ug.
Jazyk: angličtina
Zdroj: Journal of affective disorders [J Affect Disord] 2024 Apr 15; Vol. 351, pp. 598-606. Date of Electronic Publication: 2024 Feb 01.
DOI: 10.1016/j.jad.2024.01.263
Abstrakt: Introduction: Depression is increasingly affecting mothers in poor countries such as Uganda. Various interventions have been implemented to tackle this problem, but their sustainability is under-researched. Here we present follow-up data on maternal depression six years after a cluster-randomized controlled maternal education trial in rural Uganda.
Methods: The intervention lasted six months and consisted of nutrition, hygiene, sanitation and child stimulation education, delivered to 511 mothers of 6 to 8 months' old children. Six years later we assessed maternal depressive symptoms using two psychometric tools; the Beck Depression Inventory II (BDI-II) and Center for Epidemiologic Studies Depression scale (CESD).
Results: For this follow-up study, data was available from 307/511 (60 %) mothers. Intention-to-treat analyses adjusting for clustering showed that the intervention mothers had non-significantly less depression symptoms (absolute score difference - 2; 95 % CI -5 to 0; p = 0.07) on BDI-II, and borderline significantly less depression symptoms (absolute score difference - 3; 95 % CI -5 to 0; p = 0.05) on CES-D compared to the controls. For categorized depression scores, the control mothers had significantly higher proportion of women classified in the worse depression categories for both BDI-II and CESD. We did not find any baseline characteristics associated with maternal depression.
Limitations: The BDI-II and CES-D tools are both self-reported and we cannot rule out the possibility of social desirability bias in reporting of depression symptoms.
Conclusion: Six years after the maternal education trial, some benefits on maternal mental health were sustained. More studies are warranted on sustainability and scale-up of such interventions.
Competing Interests: Declaration of competing interest None of the authors declare any competing interests.
(Copyright © 2024 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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