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

Keneilwe Motlhatlhedi,Vincent Setlhare,Adewale Ganiyu,Jacqueline Firth

doi:10.4102/phcfm.v9i1.1270

Abstract

BackgroundChildhood 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.AimThe 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.SettingThe study was conducted in the child welfare clinics of Xhosa and Airstrip clinics, two primary health care facilities in Mahalapye, Botswana.MethodsThis 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.ResultsFrom 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.ConclusionThis study found a significant association between PCG depression and child malnutrition.

Highlights

Childhood malnutrition is an important risk factor for child mortality and underlies close to 50% of child deaths worldwide.[1,2] Reducing the prevalence of malnutrition may contribute to the success of child survival strategies.[2]
In order to curb the high prevalence of malnutrition, it is important to identify and address all factors that contribute to poor child nutrition
The major finding of this study is that there is a statistically significant relationship between malnutrition in children aged between 6 months and 5 years and depression in their primary caregivers (PCGs) in Mahalapye

Summary

Introduction

Childhood malnutrition is an important risk factor for child mortality and underlies close to 50% of child deaths worldwide.[1,2] Reducing the prevalence of malnutrition may contribute to the success of child survival strategies.[2]. In order to curb the high prevalence of malnutrition, it is important to identify and address all factors that contribute to poor child nutrition. Depression, one of the most prevalent mental illnesses, is more common in women of child-bearing age,[3] and maternal depression has been linked to poor child growth outcomes in developing countries.[4,5]. A South African study estimated depression prevalence rates of 9.7%, while two studies in Botswana found depression prevalence of 25% and 31% Both studies in Botswana may be an overestimation of the population prevalence of depression in the country as they were done in high HIV prevalence settings and HIV is associated with higher depression levels.[6,7]. Inclusion of mental health screening of PCGs could help develop more efficacious child nutrition programmes and identify children at higher risk of poor outcomes. It is unclear whether the association between primary caregiver depression and child malnutrition remains when non-maternal PCGs are included

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