Prevalence and factors associated with depressive symptoms among adults receiving outpatient care at primary health care facilities in Ilala district -Dar es salaam.

Abstract

ABSTRACT Background: Depression and depressive symptoms (DS) are common among patients attending primary health care (PHC). They significantly affect an individual's well-being and daily functioning, impacting their quality of life. Globally, nearly one in four people who visit a PHC are affected, making depression a serious public health concern that warrants attention. However, the reported prevalence rates are often lower than the actual rates because depression frequently co-occurs with other physical symptoms and conditions. Objective: - The study aimed to determine the prevalence and factors associated with depressive symptoms among adults receiving outpatient care at primary health care in Ilala District - Dar es Salaam. Methodology: This was a facility-based cross-sectional study with a quantitative approach. The study population comprised adults aged 18 and above who received outpatient primary health care at Ilala District, Dar es Salaam. Data collection was from September to October 2023. Data collection was done using the semi-structured questionnaire, which comprised of social demographic characteristics and clinical diagnosis PHQ-9 to assess depressive symptoms at the cutoff point of 9 or more, and a semi-structured questionnaire with a modified questionnaire used to collect the necessary information. Captured data was analyzed using SPSS version 23. Descriptive analysis was used for summarizing data, bivariate and multivariate logistic regression analyses were performed to test the association between dependent and independent variables. Ethical clearance was obtained from the MUHAS Senate Research and Publications Committee, and permission to collect data was obtained from the Regional and District Medical Office. Results: Data was collected from 350 participants, aged 18-39 years (70%, n=245), with a mean age of 34.6 years (SD ±13.18). The overall prevalence of depressive symptoms was 28% (n= 99). Factors such as female gender(AOR=1.87, 95%Cl 1.05-3.32, p=0.024), are shown to be associated with, a family history of mental illness (AOR= 2.54, 95% CI: 1.40-4.61, P=0.002), xii alcohol consumption (AOR=2.53, 95% CI: 1.41-4.55, P = 0.005), and presence of chronic illness.(AOR=4.29, 95% CI: 2.08-8.88, P < 0.001) Were associated with depressive symptoms. Residence area showed no statistically significant association with depressive symptoms (AOR=0.47, 95%Cl 1.40-4.61, p=0.023) Conclusion: the prevalence of depressive symptoms is high among adults receiving outpatient care at PHC facilities. It's associated with female gender, familial mental health history, alcohol use, and chronic illnesses like HTN, DM, and HIV while residing in the urban area is shown to be a protective factor Recommendations: Effective interventions on mitigating the impact of identified factors associated with depressive symptoms. Findings from these studies suggest a pressing need to integrate mental health training into the curricula for healthcare workers and to implement structured programs aimed at improving their knowledge and skills regarding depression by developing care models that address both mental and physical health. Scaling up mental health services by ensuring mental health services are available within other clinics in primary health care facilities. Finally, promoting research on depression, and the biological, psychological, and social factors associated better for practice in PHC systems