title: Screening for Antepartum Depression Through Community Health Outreach in Swaziland.
abstract: Maternal depression, including antepartum and postpartum depression, is a neglected public health issue with potentially far-reaching effects on maternal and child health. We aimed to measure the burden of antepartum depression and identify risk factors among women in a peri-urban community in Swaziland. We conducted a cross-sectional study within the context of a community outreach peer support project involving "Mentor Mothers". We used of the Edinburgh Postnatal Depression Scale (EPDS) to screen women for depression during the third trimester of pregnancy, using a cut-off score of ≥13 to indicate depression. We also collected demographic and socioeconomic factors, and assessed the association of these factors with EPDS score using logistic regression models. A total of 1038 pregnant women were screened over a period of 9 months. Almost a quarter (22.7 %) had EPDS scores ≥13 and 41.2 % were HIV positive. A fifth, 17.5 % were teenagers and 73.7 % were unemployed. Depression was not associated with HIV status, age or employment status. However, women with multiple socioeconomic stressors were found to be more likely to score highly on the EPDS. Depression was common among pregnant women in the peri-urban areas of Swaziland. Screening for depression using the EPDS is feasible and can be included in the community health worker standard tool box as a way to improve early detection of depression and to highlight the importance of maternal mental health as a core public health concern.
authors.affiliation: International Maternal and Child Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden. mats.malqvist@kbh.uu.se.|Siphilile Maternal and Child Health (NGO), Matsapha, Swaziland. mats.malqvist@kbh.uu.se.|Church of Sweden, Uppsala, Sweden. mats.malqvist@kbh.uu.se.
authors.forename: Mats
authors.identifier: 0000-0002-8184-3530
authors.initials: M
authors.lastname: Målqvist
authors.affiliation: University College London, London, UK.
authors.forename: Kelly
authors.initials: K
authors.lastname: Clarke
authors.affiliation: Siphilile Maternal and Child Health (NGO), Matsapha, Swaziland.
authors.forename: Themba
authors.initials: T
authors.lastname: Matsebula
authors.affiliation: International Maternal and Child Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
authors.forename: Mattias
authors.initials: M
authors.lastname: Bergman
authors.affiliation: Stellenbosch University, Stellenbosch, South Africa.
authors.forename: Mark
authors.initials: M
authors.lastname: Tomlinson
mesh_terms: D000293:Adolescent; D003159:Community-Institutional Relations; D003863:Depression / Q000175:diagnosis*; D013541:Eswatini; D005260:Female; D006801:Humans; D008403:Mass Screening; D009035:Mothers / Q000523:psychology*; D011247:Pregnancy / Q000523:psychology*; D055815:Young Adult
keywords: Antepartum depression; Community health; EPDS; Swaziland