Prevalence, associated factors and perinatal outcomes of antepartum depression in Ibadan Nigeria.

BACKGROUND: Antepartum depression is the most common mental health disorder in pregnancy and it is also a risk factor for adverse perinatal outcomes. Low and middle income countries like Nigeria bear a higher burden of antepartum depression compared with high income countries. Prioritizing mental health issues among pregnant women is crucial to achieving the Sustainable Development Goals. We determined the prevalence, associated factors and perinatal outcomes of antepartum depression among pregnant women in Ibadan, Nigeria. METHODS: A prospective cohort study was conducted among 1745 pregnant women enrolled early in pregnancy (≤ 20 weeks) at four comprehensive obstetric facilities within Ibadan metropolis. Antepartum depression was ascertained during the third trimester using the Edinburg Postpartum Depression Scale ≥ 12. The primary exposure was antepartum depression and the outcome variables were the perinatal outcomes. The associated factors assessed included sociodemographic, obstetric, psychological, and lifestyle characteristics. Bi-variate logistic and Poisson regression analyses were used to assess the factors and relative risk for perinatal outcomes of antepartum depression. RESULTS: The prevalence of antepartum depression was 14.1%. The significant factors associated with APD after adjusting for confounders were: high income (≥ 20, 000) which was protective (AOR) = 0.59; 95% CI: (0.40 - 0.88); p-value: 0.010] and perceived stress increased the odds of APD in a monotonic fashion: moderate stress [AOR = 2.39; 95% CI: (1.01 - 5.7); p-value: 0.047], high stress [AOR = 6.43; 95% CI: (2.28 - 18.2); p-value: < 0.001]. Preterm delivery was the only significant perinatal outcome [Relative Risk (RR) = 1.66; 95% CI (1.14 - 2.39); p-value =  0.007]. Depression did not increase the risk of having low birth weight babies (p = 0.513), macrosomia (p = 0.894), birth asphyxia (p = 0.317), and caesarean section (p = 0.298). CONCLUSIONS: APD was prevalent among our study population. The significant factors identified in this study can be targeted to reduce the occurrence of APD among pregnant women in Nigeria through appropriate social and public health interventions which include APD screening, counselling, and the provision of emotional support for pregnant women during antenatal care.

COVID-19 knowledge and practices in Jigawa State, Nigeria: A cross-sectional survey conducted during the second wave.

Population knowledge of COVID-19 and adherence to prevention measures may not be equitably distributed, limiting the success of public health measures. We aimed to understand whether COVID-19 knowledge differed by socio-economic status in a rural low-income setting of Jigawa State, Nigeria. We conducted a secondary analysis of the baseline cross-sectional survey of the INSPIRING cluster randomised controlled trial in Kiyawa Local Government Area, Jigawa State, from January-June 2021. Compounds were selected using simple random sampling proportional to trial cluster size. Within each compound, a representative head of compound and all women aged 16-49 years were eligible to complete a survey, which asked about socioeconomics, knowledge of COVID-19 symptoms, prevention strategies and risks for poor outcomes. We converted these into binary outcomes of "good knowledge" for symptoms, prevention and risks. Associations between woman and head of compound characteristics and good knowledge were assessed using adjusted logistic regression. We surveyed 3800 compound heads and 9564 women. Overall, <1% of respondents had been tested for COVID-19, but access to facemasks (HoC 60.0%; women 86.3%) and willingness to be vaccinated (HoC 73.9%; women 73.4%) were high. COVID-19 knowledge was low, with 33.2% of heads of compounds and 26.0% of women having good symptom knowledge, 39.5% and 30.4% having good prevention knowledge, and 17.7% and 15.4% having good risk knowledge, respectively. Those with more education, from higher wealth quintiles and access to a radio had better knowledge. Access to a mobile phone was associated with good symptom knowledge, but worse prevention and risk knowledge. We found significant differences in COVID-19 knowledge associated with socio-economic factors in rural Jigawa state, and access to communication devices was not consistently associated with better knowledge. Public health messaging in Nigeria needs to be adapted and delivered in way that ensures accessibility to all.