Sammendrag
Purpose: Postnatal depression (PND) rates in low-resource countries have reached levels
between 4.9% and 59%. Maternal mental health has not been researched in Sudan, and there
are no existing statistics on prevalence or significant risk factors for PND. Consequently, no
screening test has been validated to screen for PND at the primary health care level. This study
investigates the 3 months prevalence of PND and validates the Edinburgh Postnatal Depression
Scale (EPDS) against the Mini-International Neuropsychiatric Interview (MINI).
Methodology: Pregnant Sudanese women in the second and third trimesters were recruited
to the study during routine antenatal care visits in two major maternity hospitals in Khartoum
state. They were screened for PND at 3 months postpartum using the EPDS. Test positive
women were matched with test negative women according to nearest date of birth. A clinical
psychologist verified their depression status using the MINI.
Results: The follow-up rate was 79%. At a cutoff point of $12, the 3 months prevalence of
PND was 9.2%. The sensitivity and specificity of the EPDS were 89% and 82%, respectively.
The EPDS and MINI showed a strong positive relationship (odds ratio =36). The positive predictive
value and negative predictive value, using this study’s prevalence, were 33% and 98.7%,
respectively. The receiver operator characteristic analysis showed an area under the curve of
0.89. The cut-off point $12 was the most acceptable point as it had the lowest number needed
to diagnose (1.4) and a false-positive rate of 18%.
Conclusion: The EPDS is a valid tool for screening for PND on a Sudanese population.
It was accepted, easily administered, and understood by postnatal women. Health care personnel,
especially village midwives, should be trained on screening and referral of depressed women
for clinical evaluation and management. Due to limited resources available in Sudan, shorter
screening tests need to be validated in the future
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