Date of Award

2019

Document Type

Dissertation

Degree Name

Master of Medicine (MMed)

First Supervisor/Advisor

Dr. Nancy Kunyiha

Second Supervisor/Advisor

Dr. Anthony Ngugi

Third Supervisor/Advisor

Dr. Njeri Nyanja

Department

Family Medicine (East Africa)

Abstract

Introduction: Type 2 diabetes affects 500,000 people in Kenya and is a single cause of morbidity and mortality. It also co-exists with depression, increasing the disease severity and the likelihood of a lower quality of life.

Objectives: The primary aim of this study was to examine the depression prevalence as well as factors associated with depression among patients with Type 2 diabetes attending clinic at Aga Khan University Hospital Nairobi (AKUHN). The study also assessed the differences in depression severity with Type 2 diabetes alone and with Type 2 diabetes and other comorbid conditions.

Methodology: An analytic cross-sectional methodology was used. A closed-ended interviewer-administered questionnaire was used to collect data. The prevalence of depression was calculated using frequency distribution. Binary logistic regression was used to assess the association between the variables of interest and comorbid depression and Type 2 diabetes, at the bivariate and multivariate levels. Chi-square was used to assess the difference in depression severity between those with depression as the only comorbidity and those with multiple comorbidities.

Results: Prevalence of depression among patients with Type 2 diabetes attending clinic at AKUHN was 21.94%. There was no difference in the severity of depression between Type 2 diabetes patients with depression as the only co-morbidity and those with multiple co-morbidities (χ2=1.29, df=1, p=0.256). The type of hypoglycemic drug used was the only variable that was statistically significantly associated with depression among patients with Type 2 diabetes. Those who used injectable medication had a 2.20 higher odds of being depressed [CI: 1.10 – 4.39, p=0.026], compared to those using oral hypoglycemics.

Conclusion: No differences were captured in relation to the severity of depression between patients with depression as the only co-morbidity and those with multiple co-morbidities. Routine screening for and management of depression among patients with Type 2 diabetes should be instituted at AKUHN and across the country, to ensure early detection and intervention.

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