Depressive symptoms in primary health care attendees in Sebeta Town, Ethiopia: Prevalence, associated factors, and detection by health workers

Abstract

Depression often goes unrecognized in the primary health care setting. When depression occurs in clinical settings, it increases the risk of mortality from co-morbid medical conditions. Besides, 70% of patients with depression have somatic complaints, resulting in unnecessary investigations and mismanagement. This study was intended to investigate the prevalence and associated factors of depressive symptoms in primary health care centers and the detection rate in Sebeta Town, Ethiopia. An institution-based cross-sectional study was conducted among 384 visitors of adult outpatient department of four primary health centers in Sebeta Town, Ethiopia from October 1 to November 3, 2020. Depressive symptoms were assessed using PHQ-9 at cut-off score of 5. Data were entered using EPI data version 3.1 and exported to SPSS version 20 for data analysis. Descriptive statistics and binary logistic regression analysis were conducted. The prevalence of depressive symptoms was 27.9% (95% CI: 23.4–32.6). Detection rate of depressive symptoms by PHC providers was 0.93% (95% CI: 0.0–5.1). The factors positively associated with depressive symptoms were being unmarried (adjusted odds ratio (AOR): 3.40, 95% CI: 1.56–7.40, p < 0.01), perceived worsening of illness (AOR: 3.67, 95% CI: 1.73–7.77, p < 0.01), having family history of depression (AOR: 3.78, 95% CI: 1.40–10.23, p < 0.01), current alcohol consumption (AOR: 2.73, 95% CI: 1.22–6.10, p < 0.05), and current khat consumption (AOR: 5.43, 95% CI: 2.55–11.56, p < 0.01). Moderate social support (AOR: 0.16, 95% CI: 0.06–0.41, p < 0.01) and strong social support (AOR: 0.23, 95% CI: 0.09–0.63, p < 0.01) compared to poor social support, and the age group 25–31 (AOR: 0.36, 95% CI: 0.14–0.92, p < 0.05), compared to the age group 18–24, were negatively associated. Prevalence of depressive symptoms was found to be high, while the detection rate was very low. Provision of depression care services integrated into routine health care at PHC level was recommended.