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Maternal postpartum depression modifies the association between maternal HIV infection and infant diarrhea in Ghana's Eastern region
Author(s) -
Marquis Grace S,
Okronipa Harriet,
Lartey Anna,
Brakohiapa Lucy,
PerezEscamilla Rafael,
Mazur Robert E
Publication year - 2009
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.23.1_supplement.918.2
Subject(s) - medicine , diarrhea , incidence (geometry) , human immunodeficiency virus (hiv) , depression (economics) , obstetrics , pediatrics , immunology , physics , economics , optics , macroeconomics
Diarrhea remains a major public health concern in low‐income countries. We examined the incidence and determinants of diarrhea among infants of HIV positive (HIV‐P), HIV negative (HIV‐N), and unknown HIV status (HIV‐U) women. Pregnant women (n=492) were recruited from three antenatal clinics after voluntary counselling and testing and followed from 0 to 12 mo after delivery. The incidence of diarrhea in the first 12 mo of life was 0.6 episodes per 100 d of observation; there was no group difference by maternal HIV‐status. Infants of HIV‐U compared to HIV‐P and HIV‐N women tended to have more days ill with diarrhea between 0‐3 mo (P=0.08), 3‐6 mo (P=0.06), and 0‐12 mo (P=0.05). HIV‐P compared to HIV‐N and HIV‐U women tended to report symptoms of post‐partum depression (PPD) at 0 mo (P=0.10). Infants whose mothers showed symptoms of PPD at 0 mo had over twice as many days ill with diarrhea (P<0.001) and more diarrheal episodes (P=0.002) between 0‐3 mo. Multivariate analyses showed that between 0‐3 mo of age, there was a significant interaction (P=0.02) between maternal HIV status and PPD. Symptoms of PPD at 0 mo increased the risk of 0‐3 mo diarrhea for HIV‐P (OR=6.2; 95% CI: 2.7, 14.3) and HIV‐U (OR=3.5; 95% CI: 1.9, 6.7) women, but not for HIV‐N women. Support systems in health care facilities should include program components that address PPD, especially in HIV‐affected communities. Funded by NICHD HD43260