Two-third of inmates were depressed among HIV positive prisoners at central prison (Kaliti), Addis Ababa, Ethiopia

Abstract

ObjectiveDepression is the most frequently observed psychiatric disorder among HIV positives and it is becoming worse in prisoners. The aim this study was to assess prevalence and associated factors of depression among HIV positive prisoners at central prison (Kaliti) Addis Ababa.ResultThe prevalence of depression was found to be 66.5% (95% CI 62, 71). Primary education [AOR = 4.17, 95% CI (1.648–10.483)], perceived stigma [AOR = 3.88, 95% CI (2.08–7.25)], history of chronic illness [AOR = 2.88, 95% CI (1.34–6.17)] and WHO clinical stage II [AOR = 2.47, 95% CI (1.19–5.12)] and length of stay in prison 4–6 years[AOR = 2.27, 95% CI (1.22–4.23)] and ≥ 10 years [AOR = 3.53, 95% CI (1.15–10.85)] were factors associated with depression. This study indicated that prevalence of depression among HIV positive prisoners in Addis Ababa prison was high. Educational status, perceived stigma, history of chronic illness, WHO clinical stage and length of stay in prison were factors associated with depression. Establishing psychiatry care to screen and manage mental health disorders at the prison is needed. Special attention has to be given for those with primary in education, advanced disease, perceived stigma, and history of chronic illness and stayed many years in prison.

A meta-analysis of depressive symptoms among Ethiopian prisoners and a narrative description of its associated factors: a country based systematic review and meta-analysis study

“…A total of 9 studies that assessed depressive symptoms in 3201 Ethiopian prisoners were incorporated into this review and meta-analysis study [10,[20][21][22][23][24][25][26]28]. All included studies were institution based cross-sectional studies fulfilling the predefined inclusion criteria.…”

“…One of these studies utilized a qualitative method (in-depth interview) of data gathering for associated factors of prisoner's depressive symptoms in addition to the quantitative method [24]. Of these included studies, three were from Amhara region, Ethiopia [20,22,25], two other studies were from Oromia region, southwest Ethiopia [10,23], two studies were from Addis Ababa, central Ethiopia [26,28] and last two studies were also from the southern part of the country [21,24]. Four of the nine studies included in meta-analysis utilized BDI-II [10,23,24,28] for the assessment of depressive symptoms and the remaining five utilized PHQ-9 screening instruments [20-22, 25, 26].…”

“…Four of the nine studies included in meta-analysis utilized BDI-II [10,23,24,28] for the assessment of depressive symptoms and the remaining five utilized PHQ-9 screening instruments [20-22, 25, 26]. Regarding the size of the sample utilized by the individual study three [20,22,26] of the nine used a sample size of greater than 350 and the rest six [10,21,[23][24][25]28] have a sample size less than 350.…”

“…Other preceding studies publicized that depression in prisoners was 24% in France [5], 19.2% in Norway [15], 40.7% in Malaysia [16], 8.1% in Chile [17], 85% in Pakistan [18], and 35% of convicted inmates and 30.1% of prisoners awaiting trial in Nigeria [19]. Studies on prisoners of Ethiopia showed that the magnitude of depression in prisoner's population ranges between 41.9 and 89% [10,[20][21][22][23][24][25][26] higher than the pooled estimate of depression obtained by a meta-analysis study among the general population; 11% [27]. Regional distribution of depression in Ethiopian prisoners can be described as ranging from 43.8 to 45.5% in Amhara region [20,22,25], 56.4 to 89% in southern Ethiopia [21,24], 51.6 to 66.5% in Addis Ababa [26,28] and 41.9% in Oromia region [10,23].…”

“…Factors contributing to a variation of prevalence between studies in prisoners were gender, instruments used and offense categories (violent offenses) [14]. Identified determinants for depression in prisoners were female sex [8,[32][33][34][35][36], old age [37,38], multiple incarcerations and work burden inside the prison [8,39,40] and history of mental illness [40,41] from countries abroad whereas in the context of Ethiopia co-morbid medical illness [21,23,25,26], longer duration of a sentence [20,25,26], poor social support [22,23], family history of mental illness, previous incarceration and lifetime alcohol use [23], a suicidal attempt and ever-faced a stressful event [25] were mentioned so far as associated with depression in a correctional setting.…”