The Prevalence and Correlates of Probable Major Depressive Disorder among Patients Living with Cancer at Kamuzu Central Hospital in Malawi: Across-sectional Study
Jonathan Chiwanda Banda1,3*, Michael Udedi3,4,5, Leo Masamba6, Olive Liwimbi7, Chifundo Colleta Zimba4,5, Moses Kamzati8, Steve Mphonda4,5, Wingston Felix Ng’ambi2 and Adamson Sinjani Muula1,2
1Department of Community and Environmental Health, School of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Malawi
2The Africa Center of Excellence in Public Health and Herbal Medicine, Kamuzu University of Health Sciences Blantyre, Malawi
3Department of Curative and Medical Rehabilitation Services, Non-Communicable Diseases & Mental Health Unit, Ministry of Health, Lilongwe, Malawi
4Department of Epidemiology, University of North Carolina Project, Lilongwe, Malawi
5Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
6Oncology Unit, Department of Internal Medicine, Queen Elizabeth Central Hospital, Blantyre, Malawi
7Psychiatry and Behavioral Sciences, Zomba Mental Hospital, Zomba, Malawi
8International Training & Education Center for Health (I-TECH)- Malawi, Department of Global Health, University of Washington, City Centre, Lilongwe, Malawi
*Corresponding Author: Jonathan Chiwanda Banda, Non-Communicable Diseases and Mental Health Unit, Department of Curative and Medical Rehabilitation Services, Ministry of Health, P.O. Box 30377, Lilongwe 3, Malawi.
Published: July 23, 2024
Abstract
Background: Depression is one of the most common mental health disorders in patients living with cancer worldwide. An understanding of the prevalence of depressive disorders among this sub-group of patients should inform both its prevention and management. There is currently little evidence on correlates of depressive disorders amongst the persons living with cancer in Malawi. Therefore, we conducted this study to estimate prevalence and correlates of probable major depressive disorder among patients living with cancer at a National Cancer Center based at Kamuzu Central Hospital (KCH), Lilongwe in Malawi.
Methods: We utilized a cross-sectional design nested in a larger quasi-experimental study which was evaluating the effect of integrating depression screening and management on clinical outcomes among patients living with cancer who were attending oncology services at Kamuzu Central Hospital in Lilongwe. A validated PHQ-9 tool was used to estimate prevalence and correlates of probable major depressive disorder. A total of 399 consented participants were enrolled from August to December, 2021.
Results: The study comprised more females (64%). Cervical cancer (33%), Kaposi’s Sarcoma (16%), breast cancer (9%) and esophageal cancer (4%) were the top four common malignancies in the study. At least 55% of the study participants had depressive symptoms. The prevalence of probable major depressive disorders was 11.5 %; most (52%) of whom had moderate depressive symptoms on PHQ-9 scale. Patients supported by palliative care were associated with reduced odds of major depressive disorders 0.36 (95% CI: 0.14-0.94).
Conclusion: A high proportion of patients living with cancer had probable major depressive disorder. Patients supported by palliative care had reduced odds of probable major depressive disorder. There was need to integrate screening and management of depressive disorder as well as palliative care services among patients during routine cancer care in Malawi.
Keywords: cancer; prevalence; depression; Patient Health Questionnaire
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