Depression Prevalence and Associated Factors Among Adolescents with Sickle Cell Anemia in Dar es Salaam, Tanzania: A Cross-Sectional Study

Abstract

Background: Depression commonly arises among adolescents who have experienced long-standing psychosocial difficulties especially those facing chronic illnesses like Sickle Cell Anemia (SCA). SCA is a global health concern, and Tanzania is one of the countries with a high incidence, estimated at 8,000 to 11,000 births per year. This study aims to assess the magnitude and factors associated with depression among adolescents with SCA. Methodology: A cross-sectional analytical study conducted on adolescents aged 11-19 years attending sickle cell clinics in referral hospitals in Dar-es-salaam Tanzania, from October 2023-March 2024. A validated Patient Health Questionnaire (PHQ-9) tool was used to screen for depression. Univarite and multivariate regression model was used to determine factors associated with clinical depression.A P value of less than 0.05 was considered statistically significant. Results: Among 326 adolescents enrolled, the majority (64.7%) were 10-14 years of age. A total of 216 (54 %) had depression; when categorized into severity, 167 (38.7 %) had mild, 48 (14.7 %) had moderate and 1 (0.3%) had severe depression. Clinical depression, encompassing moderate to severe depression, was prevalent in 49 (15%) adolescents. Painful episodes were significantly associated with depression (aOR = 2.49) (95% CI: 1.17 - 5.29, p = 0.01). Conclusion: Depression is common among adolescents with SCA in our setting. Painful episodes experienced by these adolescents were significantly associated with depression. This study highlights the need for screening adolescents with SCA for depression and integration of mental health services in sickle cell clinics.