Magnitude, clinical and sociodemographic correlate of depression in diabetic patients, Addis Ababa, Ethiopia.

BACKGROUND: Depression is a major factor in causing hospital admissions and deaths in persons with diabetes mellitus. So far there is no study available on depression among Ethiopian diabetic patients. OBJECTIVE: This study aimed to determine the magnitude of clinical depression in diabetic patients and its association with the various clinical and sociodemographic factors related to diabetes mellitus. METHODS: 313 diabetic patients were selected from diabetic clinics of Black Lion & St. Paul hospitals, using systematic randomized sampling technique and assessed for over a period of three months, October - December 2009. Presence and severity of depression was evaluated using clinical interviews and a structured questionnaire, the Hamilton Depression Rating Scale. RESULTS: Of the total 313 patients, females account for 58.8% (n = 184), patients having type I diabetes 37.2% (n = 116) and type 2 diabetes 62.8% (n = 197). The average duration of illness with diabetes among male patients is found to be 8.2 +/- 6 years and 10.3 +/- 8 years for female patients. The mean duration of diabetes is 9.4 +/- 7.2 years. The magnitude of depression was 61% (n = 188) with mild, moderate, severe depression occurring in 40.9%, 14.7% and 4.5% of patients respectively. In this study depression diagnosed in 52.6% (n = 61) of type 1 DM and 64.8% (n = 127) of type 2 DM, 63% (n = 116) of females and 55.8% (n = 72) males. Occurrence of depression was more in patients with diabetic complications 68.2% (n = 107) and among patients in 36-54 years age group 66.7% (n = 80) compared to the rest age groups. The diagnosis of depression was also more prevalent in those with educational status below secondary level 63.9% (n = 152), (X2 = 5.868, P = 0.0075), among those with duration of DM greater than 5 yrs, 64.2% (n = 140) (X2 = 58.52, p < 0.023). CONCLUSION: Depression is an important psychiatric co morbidity in diabetic patients. The magnitude of depression in our study is significantly higher than reports from other countries. Raising awareness about co morbid emotional disorders in such chronic illnesses and availing effective treatment for depression with the basic diabetic care at these clinics may improve glycemia and diabetic related complications.

Artemether-Lumefantrin (Coartem) and artesunate with sulfadoxine-pyrimethamine therapeutic efficacy in the treatment of uncomplicated malaria at Gilgel Gibe II (GGII) South-Western Ethiopia.

BACKGROUND: Artesunate derivative drugs are newly introduced antimalaria drugs developed in response to the increasing drug resistance malaria spread. OBJECTIVE: To determine the parasitological resistance and the clinical failure to Artemether-Lumefantrin (Coartem); and artesunate plus sulfadoxine pyrimethamine (SP) by the WHO 14 day in vivo test. METHODS: The WHO 14 day in vivo efficacy study for coartem and artesunate with sulfadoxine-pyrimethamine covered the period from Nov 28 to Dec. 26, 2006 with 141 patients of ages 2 - 35 years with uncomplicated malaria around the big hydroelectric power dam region of Gilgel Gibe II (GGII). There was close clinical follow up and included parasitic load and clearance. Packed red cell volume (Hematocrit) was measured at day 0 and 14. RESULTS: Parasitological resistance (RI, RII, RIII) to Coartem; and artesunate plus SP was not observed. There was no early as well as late clinical failure. All patients had adequate clinical response. The prevalence of malarial anemia (Hct < 33%) was 14.9% at day 0 and had decreased to 7.5% by day 14 in both groups. CONCLUSION: Coartem and artesunate with SP are highly efficacious in the treatment of uncomplicated malaria in the GGII hydroelectric dam area.