High Prevalence of Depressive Symptoms Among Ugandan Patients with Rheumatoid Arthritis

• Main Authors: Bongomin F, Natukunda B, Sekimpi M, Olum R, Baluku JB, Makhoba A, Kaddumukasa M
• Format: Article
• Language: English
• Published: Dove Medical Press 2021-05-01
• Series: Open Access Rheumatology : Research and Reviews
• Subjects: rheumatoid arthritis; depression; ed-5d-5l; uganda
• Online Access: https://www.dovepress.com/high-prevalence-of-depressive-symptoms-among-ugandan-patients-with-rhe-peer-reviewed-fulltext-article-OARRR

Felix Bongomin,1,2 Barbra Natukunda,1 Maria Sekimpi,1 Ronald Olum,1 Joseph Baruch Baluku,3,4 Anthony Makhoba,5,6 Mark Kaddumukasa1 1Department of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda; 2Department of Immunology and Medical Microbiology, Gulu University Medical School, Gulu, Uganda; 3Division of Pulmonology, Mulago National Referral Hospital, Kampala, Uganda; 4Directorate of Programs, Mildmay Uganda, Wakiso, Uganda; 5Department of Medicine, St. Francis’s Hospital- Nsambya, Kampala, Uganda; 6Department of Medicine, Mother Kevin Postgraduate Medical School, Uganda Martyrs University, Kampala, UgandaCorrespondence: Felix BongominDepartment of Medicine, College of Health Sciences, Makerere University, Kampala, UgandaTel [phone]Email [e-mail]: There is a scarcity of data on the burden of depression among Ugandans with rheumatoid arthritis (RA) patients. We aimed to screen for symptoms of depression, their severity and associated factors among patients with RA in Uganda.Patients and Methods: A descriptive, cross-sectional study was conducted between September and December 2020 at Mulago National Referral Hospital (MNRH) and Nsambya Hospital. Patients with RA were enrolled consecutively. Data on demographics, disease course and comorbidities and depression symptomatology were collected through an interviewer administered questionnaire. Symptoms of depression were screened for using the depression/anxiety dimension of the EuroQoL questionnaire.Results: Forty-eight patients with a median age of 52 (IQR: 43.5– 60.5) years were recruited in the study. The majority of the patients were female (91.7%, n=44). Twenty-nine patients (60.4%) had comorbidities with a median Charlson comorbidity score of 3 (IQR: 2– 4). Overall, 70.8% (n=34) had depressive symptoms. Patients attending MNRH were more likely to have depressive symptoms (p=0.025). Significantly, patients with depressive symptoms were younger (p=0.027), had lower health index value (p< 0.001), and lower overall self-reported health status (p=0.013). At binary logistic regression, patients at MNRH (crude odds ratio (COR): 4.32, 95% confidence interval (CI): 1.16– 16.15, P=0.030), patients aged < 52 years (COR: 5.24, 95% CI: 1.23– 22.28, P=0.025) and those with mild RA (COR: 5.71, 95% CI: 1.15– 28.35, P=0.033) were significantly more likely to have depressive symptoms. Increase in age (COR: 0.94, 95% CI: 0.89– 0.99, P=0.025), and high visual analogue score (COR: 0.94, 95% CI: 0.89– 0.99, P=0.013) were protective.Conclusion: Depressive symptoms were common among RA patients in Uganda. Routine screening, diagnosis and management of depression is recommended among young patients to improve quality of life and patient outcomes.Keywords: rheumatoid arthritis, depression, ED-5D-5L, Uganda