Association between depression in carers and malnutrition in children aged 6 months to 5 years.

BACKGROUND:  Childhood malnutrition is an important risk factor for child mortality and underlies close to 50% of child deaths worldwide. Previous studies have found an association between maternal depression and child malnutrition, but it is not known whether this association exists in Botswana. In addition, previous studies excluded non-maternal primary caregivers (PCGs). It is unclear whether the association between primary caregiver depression and child malnutrition remains when non-maternal PCGs are included. AIM: The aim of this study was to determine if there is an association between PCG depression and malnutrition in children aged between 6 months and 5 years in Mahalapye, Botswana. SETTING: The study was conducted in the child welfare clinics of Xhosa and Airstrip clinics, two primary health care facilities in Mahalapye, Botswana. METHODS: This was a case control study. Cases were malnourished children aged between 6 months and 5 years, and controls were non-malnourished children matched for age and gender. The outcome of interest was depression in the PCGs of the cases and controls, which was assessed using the Patient Health Questionnaire 9 (PHQ 9), a depression screening tool. RESULTS: From a sample of 171 children, 84 of whom were malnourished, we found that the malnourished children were significantly more likely to have depressed PCGs (odds ratio = 4.33; 95% CI: 1.89, 9.89) than non-malnourished children in the 6-month to 5-year age group; the PCGs of malnourished children also had lower educational status. CONCLUSION: This study found a significant association between PCG depression and child malnutrition.

Prevention of mother-to-child transmission in HIV audit in Xhosa clinic, Mahalapye, Botswana.

BACKGROUND: The Mahalapye district health management team (DHMT) conducts regular audits to evaluate the standard of services delivered to patients, one of which is the prevention of mother-to-child-transmission (PMTCT) programme. Xhosa clinic is one of the facilities in Mahalapye which provides a PMTCT programme. AIM: This audit aimed to identify gaps between the current PMTCT clinical practice in Xhosa clinic and the Botswana PMTCT national guidelines. SETTING: This audit took place in Xhosa clinic in the urban village of Mahalapye, in the Central District of Botswana. METHODS: This was a retrospective audit using PMTCT Xhosa clinic records of pregnant mothers and HIV-exposed babies seen from January 2013 to June 2013. RESULTS: One hundred and thirty-three pregnant women registered for antenatal care. Twenty-five (19%) knew their HIV-positive status as they had been tested before their pregnancy or had tested HIV positive at their first antenatal clinic visit. More than two-thirds of the 115 pregnant women (69%) were seen at a gestational age of between 14 and 28 weeks. About two-thirds of the pregnant women (67%) took antiretroviral drugs. Of the 44 HIV-exposed infants, 39 (89%) were HIV DNA PCR negative at 6 weeks. Thirty-two (73%) children were given cotrimoxazole prophylaxis between 6 and 8 weeks. CONCLUSION: The PMTCT programme service delivery was still suboptimal and could potentially increase the mother-to-child transmission of HIV. Daily monitoring mechanism to track those eligible could help to close the gap.

The diabetic foot risks profile in Selebi Phikwe Government Hospital, Botswana.

AIM: The present study aimed: (1) to evaluate the proportion of each diabetic foot (DF) risk category, according to the International Working Group on the Diabetic Foot (IWGDF) consensus, in patients attending the diabetic clinic in Selebi Phikwe Government Hospital (SPGH) and (2) to examine some of the factors that may be associated with the progression to higher risk categories such as anthropometric measurements, blood pressure, glycosylated haemoglobin (HbA1c) and lipid profile. METHODS: A retrospective, cross sectional chart review of patients who had attended the diabetic clinic in SPGH from January 2013 to December 2013 was performed. Patients were included if they had undergone a foot examination. Patients with amputation due to accident were excluded. The DF risk category was assessed by determining the proportion of patients in each of four risk categories, as described by the IWGDF consensus. RESULTS: The study encompassed 144 records from patients reviewed for foot examination from January to December 2013. Patients' ages were between 16 and 85 years, 46 (40%) were male and 98 (60%) were female. The majority (122, [85%]) of patients were in DF risk category 0, whilst a limited number of patients were classified in risk category 1 (10, [6.9%]), risk category 2 (7, [4.9%]) and risk category 3 (5, [3.5%]). Most of the patients had the type 2 diabetes mellitus (139, [97%; 95% CI 92% - 99%]). Patients' ages were associated with the progressively higher DF risk categories. The adjusted odd ratio was 1.1 (95% CI 1.03-1.14; p = 0.004). CONCLUSION: The present study revealed that about 15% of patients attending the SPGH diabetic clinic were categorised in higher risk groups for diabetic foot; patients' ages were linked to the higher DF risk categories.

Association between depression in carers and malnutrition in children aged 6 months to 5 years

Background: Childhood malnutrition is an important risk factor for child mortality and underlies close to 50% of child deaths worldwide. Previous studies have found an association between maternal depression and child malnutrition, but it is not known whether this association exists in Botswana. In addition, previous studies excluded non-maternal primary caregivers (PCGs). It is unclear whether the association between primary caregiver depression and child malnutrition remains when non-maternal PCGs are included. Aim: The aim of this study was to determine if there is an association between PCG depression and malnutrition in children aged between 6 months and 5 years in Mahalapye, Botswana. Setting: The study was conducted in the child welfare clinics of Xhosa and Airstrip clinics, two primary health care facilities in Mahalapye, Botswana. Methods: This was a case control study. Cases were malnourished children aged between 6 months and 5 years, and controls were non-malnourished children matched for age and gender. The outcome of interest was depression in the PCGs of the cases and controls, which was assessed using the Patient Health Questionnaire 9 (PHQ 9), a depression screening tool.Results: From a sample of 171 children, 84 of whom were malnourished, we found that the malnourished children were significantly more likely to have depressed PCGs (odds ratio = 4.33; 95% CI: 1.89, 9.89) than non-malnourished children in the 6-month to 5-year age group; the PCGs of malnourished children also had lower educational status. Conclusion: This study found a significant association between PCG depression and child malnutrition