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Goldstein L, Smith AM, Romagnoli D, Katergi E. The effect of Transcendental Meditation on self-esteem, self-efficacy, and gratitude, for increasing empowerment of female youth in Uganda. Health Care Women Int 2024:1-34. [PMID: 38980139 DOI: 10.1080/07399332.2024.2358789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 05/20/2024] [Indexed: 07/10/2024]
Abstract
This longitudinal study with female youth in the slums of Kampala, Uganda (n = 130), explored the impact of the Transcendental Meditation® (TM®) technique on self-esteem, the primary outcome measure, and self-efficacy, gratitude, hope, tiredness, and resilience as secondary outcomes. Quality-of-life behaviors were also assessed, including excessive alcohol use. After baseline testing participants learned TM over five consecutive days. Participants practiced TM at home for 20 min twice a day and attended two follow-up sessions. Post-testing occurred at five months. Significant improvements in self-esteem (p < .001), self-efficacy (p < .001), gratitude (p < .001), and tiredness (p = .05) were found. A decrease in excessive alcohol use was also observed (p = .02). At eight months a short answer questionnaire showed improved physical health, decreased stress and anxiety levels, and improved relationships in the family and community. Our findings have important implications for enhancing the well-being and empowerment of these vulnerable female youth.
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Affiliation(s)
- Leslee Goldstein
- Center for Social Emotional Health and Consciousness, Maharishi International University, Fairfield, Iowa, USA
| | | | - Daniela Romagnoli
- University Workforce Education and Development, College of Education, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Elissa Katergi
- School of Psychology, University of Ottawa, Ottawa, Canada
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Culbreth RE, Nielsen KE, Mobley K, Palmier J, Bukuluki P, Swahn MH. Life Satisfaction Factors, Stress, and Depressive Symptoms among Young Women Living in Urban Kampala: Findings from the TOPOWA Project Pilot Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:184. [PMID: 38397675 PMCID: PMC10887819 DOI: 10.3390/ijerph21020184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/19/2024] [Accepted: 01/31/2024] [Indexed: 02/25/2024]
Abstract
Young women living in Kampala, Uganda, often face adversities related to Social Determinants of Mental Health (SDoMH) including poverty, food scarcity, environmental stressors such as high levels of community violence, and lack of adequate healthcare access. Two consecutive pilot studies were conducted to assess the feasibility and acceptability of survey questions, wearable fitness trackers, and daily diaries before launching a larger prospective cohort study. Preliminary associations between SDoMH factors with depressive symptoms, stress levels, and life satisfaction were examined among the total sample of 60 women across two pilot studies. A total of 32.2% of respondents (out of n = 59) reported being depressed most or all of the time in the past 30 days. Frequent depressive symptoms correlated with food insecurity (χ2 = 5.38, df = 1, p = 0.02). Higher stress levels were significantly associated with lower overall life satisfaction scores (t = 2.74, df = 6.20, p = 0.03). Additionally, frequent depressive symptoms were associated with lower satisfaction scores in the living conditions and lifestyle domain (t = 2.22, df = 36.18, p = 0.03). However, overall life satisfaction scores and other domains (social relationships and personal independence) were not statistically associated with frequent depressive symptoms. Identifying the most impactful SDoMH factors among young women in Kampala can inform targeted approaches to improve mental health outcomes.
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Affiliation(s)
- Rachel E. Culbreth
- American College of Medical Toxicology, 10645 N. Tatum Blvd, Phoenix, AZ 85028, USA;
| | - Karen E. Nielsen
- School of Public Health, Georgia State University, 140 Decatur Street, Atlanta, GA 30303, USA;
| | - Kate Mobley
- School of Data Science and Analytics, College of Computing and Software Engineering, Kennesaw State University, Kennesaw, GA 30144, USA;
| | - Jane Palmier
- Wellstar College of Health and Human Services, Kennesaw State University, Kennesaw, GA 30144, USA;
| | - Paul Bukuluki
- School of Social Sciences, Makerere University, Kampala P.O. Box 7062, Uganda;
| | - Monica H. Swahn
- Wellstar College of Health and Human Services, Kennesaw State University, Kennesaw, GA 30144, USA;
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Edwards KM, Kumar M, Waterman EA, Mullet N, Madeghe B, Musindo O. Programs to Prevent Violence Against Children in Sub-Saharan Africa: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2024; 25:593-612. [PMID: 36964686 DOI: 10.1177/15248380231160742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Violence against children-which includes maltreatment (including physical, sexual, psychological and emotional violence, and neglect), bullying (including cyberbullying), youth violence (including physical assault with or without weapons), intimate partner violence (including exposure to domestic violence and direct involvement in teen dating violence), and sexual violence-continues to present itself as a significant public health crisis in Sub-Saharan Africa (SSA) leading to numerous short- and long-term deleterious outcomes. As such, the prevention of violence against children in SSA is a critical public health priority. In this systematic literature review, we identified 45 articles that reported on results from 22 programs that seek to reduce violence against children in SSA. Results suggested that programs that focus on (1) economic strengthening, (2) teachers schools, (3) entire families, (4) caregivers only, and (5) children only are generally effective in reducing violence against children by promoting focused action on the mechanisms of change (e.g., parenting skills, enhanced parent-child relationships, resistance skills for children). To date, no research in SSA has examined the impact of policy interventions on childhood victimization or community-level interventions to change norms and values that support violence against children. Future research is needed to examine the impacts of comprehensive efforts to prevent violence against children in SSA as well as factors that predict uptake and sustainability of such prevention efforts in SSA.
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Abaatyo J, Favina A, Bulega SE, Kaggwa MM. Suicidal behavior among inpatients with severe mental conditions in a public mental health hospital in Uganda. BMC Psychiatry 2023; 23:346. [PMID: 37208631 DOI: 10.1186/s12888-023-04858-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 05/10/2023] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND Suicidal behaviors are prevalent among inpatients with severe mental conditions and may result in many dying by suicide. Few studies have focused on the burden of suicidal behaviors among these inpatients in low-income settings, despite suicide being consistently higher in lower-income countries such as Uganda. This study, therefore, provides the prevalence and associated factors of suicidal behaviors and suicide attempts among inpatients with severe mental conditions in Uganda. METHOD This was a retrospective chart review of all individuals admitted with severe mental conditions to a large psychiatry inpatient unit in Uganda for four years (2018-2021). Two separate logistic regressions were conducted to determine the factors associated with suicidal behaviors or suicidal attempts among the admitted individuals. RESULTS The prevalence of suicidal behavior and suicidal attempts among 3104 (mean age = 33, Standard deviation [SD] = 14.0; 56% were males) were 6.12% and 3.45%, respectively. Having a diagnosis of depression increased the likelihood of both suicidal behaviors (adjusted odds ratio [aOR]: 5.36; 95% confidence interval [CI]: 2.14-13.37; p =0.001) and attempts (aOR: 10.73; 95% CI: 3.44-33.50; p < 0.001). However, a diagnosis of substance-related disorder increased the likelihood of having attempted suicide (aOR: 4.14; 95% CI: 1.21-14.15; p = 0.023). The likelihood of having suicidal behavior decreased as one increased in age (aOR: 0.97; 95% CI: 0.94-0.99; p = 0.006) and increased among individuals reporting stress from financial constraints (aOR: 2.26; 95% CI: 1.05-4.86; p = 0.036). CONCLUSION Suicidal behaviors are common among inpatients managed for severe mental health conditions in Uganda, especially those with substance use and depressive disorders. In addition, financial stressors are a main predictor in this low-income country. Therefore, regular screening for suicide behaviors is warranted, especially among individuals with depression, and substance use, among those who are young, and among those reporting financial constraints/stress.
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Affiliation(s)
- Joan Abaatyo
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Alain Favina
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Steven Elijah Bulega
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Mark Mohan Kaggwa
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, McMaster, Canada.
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Swahn MH, Nassaka J, Nabulya A, Palmier J, Vaught S. A Qualitative Assessment of Place and Mental Health: Perspectives of Young Women Ages 18-24 Living in the Urban Slums of Kampala, Uganda. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12935. [PMID: 36232235 PMCID: PMC9566181 DOI: 10.3390/ijerph191912935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/04/2022] [Accepted: 10/04/2022] [Indexed: 06/16/2023]
Abstract
This paper examines the link between place and mental health using a qualitative assessment and focus group discussion with young women, ages 18 to 24 years of age, residing in three slums in Kampala, Uganda. The assessment, conducted in August of 2022, engaged 15 women who participated in Uganda Youth Development Drop-in center activities. The objective was to assess mental health and the link between place and mental health. Facilitated group discussions and photograph review yielded the following results. In terms of understanding their views of mental health and wellbeing, participants clearly focused on feelings. However, they also assessed resilience, the environment and a person's choice as relating to their mental health. Participants also found the physical spaces related to sports, education, worship, workplaces and green space to be linked to happiness. In terms of the attributes that were linked to sadness, participants listed the physical locations where drugs are sold, clubs for dancing and partying and also sanitation issues in the community. Participants frequently reported on the social environment and reflected on harassment, discrimination, alcohol use and criminal behavior that did not reflect a specific physical space, but rather the embedded social interactions they may face or observe by living in close proximity to hotspots for criminal activity. Given the dire shortages of mental health services and care that are available in this setting, a better understanding of young women's perceptions of place and mental health will be key for low-cost interventions and strategies to mitigate the contextual factors that may exacerbate mental illness.
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Affiliation(s)
- Monica H. Swahn
- Health Promotion and Physical Education, Wellstar College of Health and Human Services, Kennesaw State University, Kennesaw, GA 30144, USA
| | | | - Anna Nabulya
- Uganda Youth Development Link, Kampala P.O. Box 12659, Uganda
| | - Jane Palmier
- Wellstar College of Health and Human Services, Kennesaw State University, Kennesaw, GA 30144, USA
| | - Seneca Vaught
- Interdisciplinary Studies, Radow College of Humanities and Social Sciences, Kennesaw State University, Kennesaw, GA 30144, USA
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Swahn MH, Culbreth R, Fodeman A, Cottrell-Daniels C, Tumwesigye NM, Jernigan DH, Kasirye R, Obot I. Heavy drinking and problem drinking among youth in Uganda: A structural equation model of alcohol marketing, advertisement perceptions and social norms. Drug Alcohol Rev 2022; 41:1444-1456. [PMID: 35761763 PMCID: PMC9546093 DOI: 10.1111/dar.13497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 05/05/2022] [Accepted: 05/08/2022] [Indexed: 11/30/2022]
Abstract
Introduction To determine the role of alcohol marketing, perceptions of marketing and social norms on heavy alcohol use and problem drinking among vulnerable youth in Uganda. Methods The Kampala Youth Survey is a cross‐sectional study conducted in 2014 with service‐seeking youth (ages 12–18 years) living in the slums of Kampala (n = 1134) who were participating in Uganda Youth Development Link drop‐in centres. Survey measures assessed perceptions of alcohol advertisements, social norms regarding alcohol use, heavy alcohol use and problem drinking. Factor analyses and structural equation models were computed to determine the predictors (e.g. social norms and alcohol marketing exposure) for drinking amounts, heavy drinking and problem drinking. Results Alcohol marketing allure, perceptions of adults' alcohol attitudes and respondent's male gender were significantly predictive of heavy drinking. Similarly, in addition to drinking amount and heaviness, only alcohol marketing exposure and friends' alcohol attitudes, as well as respondent's own attitudes about alcohol, significantly predicted variation in problem drinking. Discussion and Conclusions Alcohol marketing exposure and allure are significant predictors of heavy drinking and problem drinking among youth in Uganda. Prevention programs that reduce exposure to and allure of alcohol marketing may prove promising for reducing alcohol use and related problems among these vulnerable youth in a low‐resource setting.
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Affiliation(s)
- Monica H Swahn
- Wellstar College of Health and Human Services, Kennesaw State University, Kennesaw, USA.,School of Public Health, Georgia State University, Atlanta, USA
| | - Rachel Culbreth
- Byrdine F. Lewis School of Nursing and Health Professions, Georgia State University, Atlanta, USA
| | - Ari Fodeman
- College of Arts and Sciences, Georgia State University, Atlanta, USA
| | | | | | | | | | - Isidore Obot
- Centre for Research and Information on Substance Abuse, Uyo, Nigeria
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Perry EW, Culbreth R, Self-Brown S, Gilmore AK, Kasirye R, Musuya T, Ndetei D, Swahn MH. Violence Exposure, Self-Reported Mental Health Concerns and Use of Alcohol and Drugs for Coping among Youth in the Slums of Kampala, Uganda. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2022; 53:83-110. [PMID: 38577222 PMCID: PMC10989775 DOI: 10.1080/00207411.2022.2073755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study aimed to a) compute the prevalence of violence exposure types, polyvictimization, and self-reported depression, anxiety, and using substances to cope among youth ages 12 to 18 years living on the streets or in the slums of Kampala, Uganda, (b) examine the independent associations among orphan status, violence exposure types, and self-reported mental health concerns, and c) explore the association between polyvictimization and mental health concerns. Data are from a 2014 cross-sectional survey of service-seeking youth ages 12 to 18 years (N = 1134) in Kampala, Uganda. Violence exposure types explored in this study were: witnessing family physical violence, direct physical abuse by a parent, any rape history, and physical dating violence. We used descriptive statistics and multivariable logistic regression to test study objectives. Over half of the sample (60.5%) reported experiencing at least one type of violence exposure; many youth endorsed self-reported depression (57.8%), anxiety (76.8%), and substance use to cope (37.0%). Exposure to violence was associated with higher odds for self-reported depression, anxiety, and using substances to cope. These findings underscore the urgent need to implement evidence-based interventions among this young, underserved population and their families to prevent violence, improve mental health outcomes, and promote resilience.
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Affiliation(s)
| | - Rachel Culbreth
- Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, GA USA
| | | | - Amanda K Gilmore
- School of Public Health, National Center for Sexual Violence Prevention, Georgia State University, Atlanta, GA USA
| | | | - Tina Musuya
- Center for Domestic Violence Prevention, Kampala, Uganda
| | - David Ndetei
- Department of Psychiatry, University of Nairobi, Africa Mental Health Foundation, Nairobi, Kenya
| | - Monica H Swahn
- Wellstar College of Health and Human Services, Kennesaw State University, Kennesaw, GA USA, School of Public Health, Georgia State University, Atlanta, GA USA
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Swahn MH, Palmier JB, May A, Dai D, Braunstein S, Kasirye R. Features of alcohol advertisements across five urban slums in Kampala, Uganda: pilot testing a container-based approach. BMC Public Health 2022; 22:915. [PMID: 35534847 PMCID: PMC9082884 DOI: 10.1186/s12889-022-13350-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 04/27/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite the high prevalence of alcohol use and marketing in many settings across sub-Saharan Africa, few studies have systematically sought to assess alcohol marketing exposure, particularly in vulnerable areas such as urban slums where alcohol is often highly prevalent but where educational programs and alcohol prevention messages are scarce. OBJECTIVE To pilot test the development and implementation of environmental scans of alcohol advertisements in five urban slums across different areas of Kampala, Uganda: Bwaise, Kamwokya, Makindye, Nakulabye, and Nateete. METHODS Each of the five scans was conducted in geographical circles, within a 500-m radius of a Uganda Youth Development Link (UYDEL) drop-in Center using a container-based approach. Using a Garmin GPS with photo capabilities and a tablet for data entry, teams of at least two trained researchers walked the main roads within the target area and gathered information about each alcohol advertisement including its location, type, size, and placement and other characteristics. Data with the GPS coordinates, photos and descriptive details of the adverts were merged for analyses. RESULTS A total of 235 alcohol adverts were found across all five data collection sites reflecting 32 different brands. The majority of the adverts (85.8%) were smaller and medium sizes placed by restaurants and bars, stores and kiosks, and liquor stores. The most frequently noted types of alcohol in the adverts were spirits (50.6%) and beer (30.6%). RECOMMENDATIONS The pilot test of the methodology we developed indicated that implementation was feasible, although challenges were noted. Since monitoring alcohol marketing is key for addressing underage alcohol use and harm, the advantages and disadvantages of the approach we developed are discussed. Future research needs to strengthen and simplify strategies for monitoring alcohol marketing in low-resource settings such as urban slums which have unique features that need to be considered. Meanwhile, the findings may yield valuable information for stakeholders and to guide intervention developments and alcohol marketing policy to protect youth.
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Affiliation(s)
- Monica H Swahn
- Department of Epidemiology and Biostatistics, School of Public Health, Georgia State University, P.O. Box 3995, Atlanta, GA, 30302-3995, USA. .,Department of Health Promotion and Physical Education, Wellstar College of Health and Human Services, Kennesaw State University, Kennesaw, GA, 30144, USA.
| | - Jane B Palmier
- Department of Health Promotion and Physical Education, Wellstar College of Health and Human Services, Kennesaw State University, Kennesaw, GA, 30144, USA
| | - Alicia May
- School of Public Health, University of Georgia, Athens, GA, USA
| | - Dajun Dai
- Department of Geosciences, Georgia State University, P.O. Box 4105, Atlanta, GA, 30302, USA
| | - Sarah Braunstein
- Department of Epidemiology and Biostatistics, School of Public Health, Georgia State University, P.O. Box 3995, Atlanta, GA, 30302-3995, USA
| | - Rogers Kasirye
- Uganda Youth Developmental Link, P.O. Box 12659, Kampala, Uganda
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Swahn MH, Culbreth R, Masyn KE, Salazar LF, Wagman J, Kasirye R. The Intersection of Alcohol Use, Gender Based Violence and HIV: Empirical Findings among Disadvantaged Service-Seeking Youth in Kampala, Uganda. AIDS Behav 2021; 25:3106-3114. [PMID: 33988783 PMCID: PMC8120497 DOI: 10.1007/s10461-021-03301-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2021] [Indexed: 11/30/2022]
Abstract
The SAVA syndemic is frequently used to describe the co-occurrence of HIV, gender-based violence (GBV), and substance use. In this study we determine the extent to which the typologies of the SAVA syndemic can be described and utilized for intervention strategies among youth living in the slums of Kampala, Uganda. We analyzed the “Kampala Youth Survey 2014,” a cross-sectional survey conducted in the spring of 2014, consisting of a convenience sample (N = 1134) of urban youth (12–18 years of age). Descriptive statistics were computed for hypothesized risk factors and demographic variables among the 8 typologies of GBV, HIV, and alcohol use. Multinomial logistic regression was conducted to determine statistically significant correlates with each typology. The overall prevalence of GBV was 31.7%, whereas the overall prevalence of alcohol use in the past 12 months was 31.2%. HIV-Positive youth comprised 10.5% of the total sample. Females comprised the majority of the typology with no SAVA components compared to males (55% vs. 45%, respectively), as well as the SAVA syndemic typology (GBV + HIV + ALC +) (58% vs. 42%, respectively). Engaging in commercial sex work (36%), witnessing parental abuse (61%), and depression/suicidality (81%) were all highly prevalent among youth in the SAVA syndemic typology (GBV, HIV, and alcohol use). Sex work and observing parental abuse were associated with the SAVA syndemic typology in the multivariable model. In our study, alcohol rarely coexisted without GBV among the typologies. Therefore, prevention efforts including structural interventions may be particularly warranted in vulnerable populations to address alcohol use, which may directly or indirectly impact GBV and HIV.
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Affiliation(s)
- Monica H. Swahn
- Wellstar College of Health and Human Services, Kennesaw State University, 520 Parliament Garden Way, Kennesaw, GA 30144 USA
| | - Rachel Culbreth
- Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, P.O. Box 4019, Atlanta, GA 30302-4019 USA
| | - Katherine E. Masyn
- School of Public Health, Georgia State University, P.O. Box 3995, Atlanta, GA 30302-3995 USA
| | - Laura F. Salazar
- School of Public Health, Georgia State University, P.O. Box 3995, Atlanta, GA 30302-3995 USA
| | - Jennifer Wagman
- Fielding School of Public Health, University of California, P.O. Box 951772, Los Angeles, CA 90095-1772 USA
| | - Rogers Kasirye
- Uganda Youth Developmental Link, P.O. Box 12659, Kampala, Uganda, USA
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Bukuluki P, Wandiembe S, Kisaakye P, Besigwa S, Kasirye R. Suicidal Ideations and Attempts Among Adolescents in Kampala Urban Settlements in Uganda: A Case Study of Adolescents Receiving Care From the Uganda Youth Development Link. FRONTIERS IN SOCIOLOGY 2021; 6:646854. [PMID: 34368292 PMCID: PMC8334726 DOI: 10.3389/fsoc.2021.646854] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 02/26/2021] [Indexed: 05/21/2023]
Abstract
There is an increasing recognition that suicidal ideation is a major public health concern in sub-Saharan Africa. We employed a case study design, taking a case study of adolescents currently under the care of Uganda Youth Development Link (UYDEL). The data analyzed were collected from 219 female and male adolescents (13-19 years) recruited through UYDEL in Kampala, Uganda. A Poisson regression model with robust variance was used to assess the risk factors associated with suicidality. The prevalence of suicidal ideation in the past 4 weeks and attempt within the past 6 months among adolescents was 30.6% (95% CI: 24.8, 38.0%) and 24.2% (95% CI: 18.7, 30.4%), respectively. The most stressful precursors of suicidal ideation or attempt included financial difficulties (59.5%), family breakdown or conflicts (37.4%), and trauma (23.1%). Suicidal ideation in the past 1 week preceding the survey was as high as 13.3% (95% CI: 9.0, 18.6%), of which 75.0% (95% CI: 55.1%, 89.3%) had a suicide plan. Prevalence of suicidal ideation in the past 4 weeks was significantly higher among respondents with moderate psychological distress [Prevalence Ratio (PRR) = 2.74; 95% CI: 0.96, 7.84] and severe psychological distress (PRR = 4.75; 95% CI: 1.72, 13.08) but lower among adolescents who knew where to obtain professional psychological care (PRR = 0.51; 95% CI: 0.30, 0.87). Similarly, suicidal attempt was significantly higher among respondents with moderate psychological distress (PRR = 4.72; 95% CI: 1.01, 12.03) and severe psychological distress (PRR = 11.8; 95% CI: 4.66, 32.37), and who abuse drugs or substances (PRR = 2.13; 95% CI: 1.13, 4.01). Therefore, suicidal ideation is a major public health issue among adolescents living in poor urban settlements in Kampala, Uganda. Psychological distress due to financial difficulties, unemployment, and family breakdown are major facilitators of suicidality among adolescents in urban poor settlements in Kampala. Interventions aimed at preventing suicide among vulnerable adolescents in urban settlements in Kampala, Uganda should incorporate this unique risk factor profile.
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Affiliation(s)
- Paul Bukuluki
- Department of Social Work and Social Administration, School of Social Sciences, Makerere University, Kampala, Uganda
- *Correspondence: Paul Bukuluki
| | - Symon Wandiembe
- Department of Statistical Methods, School of Statistics and Planning, Makerere University, Kampala, Uganda
| | - Peter Kisaakye
- Department of Population Studies, School of Statistics and Planning, Makerere University, Kampala, Uganda
| | - Samuel Besigwa
- Department of Social Work and Social Administration, School of Social Sciences, Makerere University, Kampala, Uganda
| | - Rogers Kasirye
- Department of Social Work and Social Administration, School of Social Sciences, Makerere University, Kampala, Uganda
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