Assessment of and associated factors among diabetic patients at Mnazi Mmoja Referral Hospital in Zanzibar, Tanzania

Abstract

Background: Depression is a common chronic mental disorder which affects individuals worldwide. Many patients with a chronic physical disease such as diabetes mellitus are estimated to suffer from depression. Depression remains undetected or undiagnosed in patients with diabetes mellitus due to lack of knowledge, skills to diagnose and lack of tools that can be used to diagnose the disease. Objectives: To determine the prevalence and factors associated with depression among patients attending Diabetic clinics at Mnazi Mmoja Referral Hospital in Zanzibar. Method: A descriptive cross-sectional design employing a quantitative approach was used. Simple random sampling technique was used to select the participants in a diabetic clinic at Mnazi Mmoja Referral Hospital. The study participants were diabetic patients aged 18 years and above and accessible during the study period. A structured questionnaire was used to collect data. Data were coded and analyzed using SPSS version 23.0, and Chi-square test was done to find the association between independent variable and depression. Moreover, bivariate and multiple logistic regression analysis were used to identify the statistically significant variables. P-value of <0.05 was considered as statistically significant. Results: A total of 267 diabetic patients were interviewed with a response rate of 100%. Of 267 respondents, 142 (53.2%) and 125 (46.8%) were male and female respectively with a mean age of 50 years and standard deviation ±14. The overall prevalence in this study was 73%. 0f 267 diabetic patients; most 30% had mild depression, 23% had minimal depression, 12% had moderate depression, 8% had severe and 27% had no depression. After controlling for confounding factors, a logistic regression model showed those who had difficulties in adhering to treatment regime (AOR=5.7: 95% CI, 2.11;15.18, p<0.05), experiences of recently feeling angry or stressed (AOR=4.4: 95% CI, 2.44;8.10, p<0.05), and diabetic retinopathy were more likely to be depressed (AOR=2.8: 95% CI, 1.45;5.28, p<0.05), while those who had diabetic foot (AOR=0.1: 95% CI, 0.04; 0.49, p<0.05) and impotence for male patients (AOR=0.4: 95% CI, 0.20; 0.68, p<0.05) were less likely be depressed Conclusions and recommendations: In the present study, the prevalence of depression was higher than reported in other studies. Our results demonstrate that many patients with diabetic mellitus attending Mnazi Mmoja clinic experience unrecognized symptoms of depression, and this affects their quality of life in diverse ways. Given the high prevalence of depression in diabetic patients, screening diabetic clients for co-morbid depression and its relevant associated factors is highly recommended.