1
|
Tadesse G, Gashaw F, Amare Zeleke T, Fentahun S, Yitayih S. Prevalence and factors associated with suicidal ideation and attempts among war-affected internally displaced people in northwest Ethiopia, 2022. BJPsych Open 2024; 10:e132. [PMID: 39086297 DOI: 10.1192/bjo.2024.71] [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] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND People who are forced to leave home often experience emotional suffering and may be disproportionately subjected to risk factors for suicide. Although it is a grave concern for the global public health community, it has not been understood in Ethiopia. AIMS This study aims to assess the prevalence and factors associated with suicidal ideation and attempts among war-affected internally displaced people in northwest Ethiopia, 2022. METHOD From 23 May to 22 June 2022, a cross-sectional study design was conducted, and a sample of 765 participants was selected through simple random sampling. A structured interview was employed to collect data. Suicidal ideation and attempts were assessed using the Composite International Diagnostic Interview. RESULTS Out of 751 interviewed participants with a response rate of 98.2%, the magnitude of suicidal ideation and attempt was 22.4% (95% CI: 19.5%, 25.4%) and 6.7% (95% CI: 5.1%, 8.7%), respectively. People of female gender, having depression, family with a history of mental illness, and poor social support were significantly associated with both suicidal ideation and attempts. Furthermore, post-traumatic stress symptoms and the death of a family member were significantly associated with suicide ideation and attempt, respectively. CONCLUSION At least one in five of the displaced people in this population had experienced suicide ideation, and one in fifteen had attempted suicide. Therefore, strengthening early detection and intervention for individuals is recommended, especially for females with depression, post-traumatic stress symptoms, family with a history of mental illness, poor social support and the death of family members.
Collapse
Affiliation(s)
- Gebresilassie Tadesse
- Department of Psychiatry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Ethiopia
| | - Fanuel Gashaw
- Department of Psychiatry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Ethiopia
| | - Tadele Amare Zeleke
- Department of Psychiatry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Ethiopia
| | - Setegn Fentahun
- Department of Psychiatry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Ethiopia
| | - Sewbesew Yitayih
- Department of Psychiatry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Ethiopia
| |
Collapse
|
2
|
Kalungi A, Kinyanda E, Akena DH, Gelaye B, Ssembajjwe W, Mpango RS, Ongaria T, Mugisha J, Makanga R, Kakande A, Kimono B, Amanyire P, Kirumira F, Lewis CM, McIntosh AM, Kuchenbaecker K, Nyirenda M, Kaleebu P, Fatumo S. Prevalence and correlates of common mental disorders among participants of the Uganda Genome Resource: Opportunities for psychiatric genetics research. Mol Psychiatry 2024:10.1038/s41380-024-02665-8. [PMID: 39003415 DOI: 10.1038/s41380-024-02665-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 06/27/2024] [Accepted: 07/04/2024] [Indexed: 07/15/2024]
Abstract
Genetics research has potential to alleviate the burden of mental disorders in low- and middle-income-countries through identification of new mechanistic pathways which can lead to efficacious drugs or new drug targets. However, there is currently limited genetics data from Africa. The Uganda Genome Resource provides opportunity for psychiatric genetics research among underrepresented people from Africa. We aimed at determining the prevalence and correlates of major depressive disorder (MDD), suicidality, post-traumatic stress disorder (PTSD), alcohol abuse, generalised anxiety disorder (GAD) and probable attention-deficit hyperactivity disorder (ADHD) among participants of the Uganda Genome Resource. Standardised tools assessed for each mental disorder. Prevalence of each disorder was calculated with 95% confidence intervals. Multivariate logistic regression models evaluated the association between each mental disorder and associated demographic and clinical factors. Among 985 participants, prevalence of the disorders were: current MDD 19.3%, life-time MDD 23.3%, suicidality 10.6%, PTSD 3.1%, alcohol abuse 5.7%, GAD 12.9% and probable ADHD 9.2%. This is the first study to determine the prevalence of probable ADHD among adult Ugandans from a general population. We found significant association between sex and alcohol abuse (adjusted odds ratio [AOR] = 0.26 [0.14,0.45], p < 0.001) and GAD (AOR = 1.78 [1.09,2.49], p = 0.019) respectively. We also found significant association between body mass index and suicidality (AOR = 0.85 [0.73,0.99], p = 0.041), alcohol abuse (AOR = 0.86 [0.78,0.94], p = 0.003) and GAD (AOR = 0.93 [0.87,0.98], p = 0.008) respectively. We also found a significant association between high blood pressure and life-time MDD (AOR = 2.87 [1.08,7.66], p = 0.035) and probable ADHD (AOR = 1.99 [1.00,3.97], p = 0.050) respectively. We also found a statistically significant association between tobacco smoking and alcohol abuse (AOR = 3.2 [1.56,6.67], p = 0.002). We also found ever been married to be a risk factor for probable ADHD (AOR = 2.12 [0.88,5.14], p = 0.049). The Uganda Genome Resource presents opportunity for psychiatric genetics research among underrepresented people from Africa.
Collapse
Affiliation(s)
- Allan Kalungi
- The African Computational Genomics (TACG) Research Group, Medical Research Council/ Uganda Virus Research Institute & London School of Hygiene and Tropical Medicine (MRC/UVRI & LSHTM) Uganda Research Unit, Entebbe, Uganda.
- Department of Medical Biochemistry, College of Health Sciences, Makerere University, Kampala, Uganda.
- The Department of Non-communicable Diseases Epidemiology, London School of Hygiene and Tropical Medicine London, London, UK.
| | - Eugene Kinyanda
- Mental Health Section, Medical Research Council/ Uganda Virus Research Institute & London School of Hygiene and Tropical Medicine (MRC/UVRI & LSHTM) Uganda Research Unit, Entebbe, Uganda
- Department of Psychiatry, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Dickens Howard Akena
- Department of Psychiatry, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Bizu Gelaye
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave Room 505F, Boston, MA, 02115, USA
- The Chester M. Pierce, MD Division of Global Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Wilber Ssembajjwe
- Mental Health Section, Medical Research Council/ Uganda Virus Research Institute & London School of Hygiene and Tropical Medicine (MRC/UVRI & LSHTM) Uganda Research Unit, Entebbe, Uganda
| | - Richard Steven Mpango
- The African Computational Genomics (TACG) Research Group, Medical Research Council/ Uganda Virus Research Institute & London School of Hygiene and Tropical Medicine (MRC/UVRI & LSHTM) Uganda Research Unit, Entebbe, Uganda
- Mental Health Section, Medical Research Council/ Uganda Virus Research Institute & London School of Hygiene and Tropical Medicine (MRC/UVRI & LSHTM) Uganda Research Unit, Entebbe, Uganda
| | - Terry Ongaria
- Medical Research Council/ Uganda Virus Research Institute & London School of Hygiene and Tropical Medicine (MRC/UVRI & LSHTM) Uganda Research Unit, Entebbe, Uganda
| | - Joseph Mugisha
- Medical Research Council/ Uganda Virus Research Institute & London School of Hygiene and Tropical Medicine (MRC/UVRI & LSHTM) Uganda Research Unit, Entebbe, Uganda
| | - Ronald Makanga
- Medical Research Council/ Uganda Virus Research Institute & London School of Hygiene and Tropical Medicine (MRC/UVRI & LSHTM) Uganda Research Unit, Entebbe, Uganda
| | - Ayoub Kakande
- Medical Research Council/ Uganda Virus Research Institute & London School of Hygiene and Tropical Medicine (MRC/UVRI & LSHTM) Uganda Research Unit, Entebbe, Uganda
| | - Beatrice Kimono
- Medical Research Council/ Uganda Virus Research Institute & London School of Hygiene and Tropical Medicine (MRC/UVRI & LSHTM) Uganda Research Unit, Entebbe, Uganda
| | - Philip Amanyire
- Mental Health Section, Medical Research Council/ Uganda Virus Research Institute & London School of Hygiene and Tropical Medicine (MRC/UVRI & LSHTM) Uganda Research Unit, Entebbe, Uganda
| | - Fred Kirumira
- Medical Research Council/ Uganda Virus Research Institute & London School of Hygiene and Tropical Medicine (MRC/UVRI & LSHTM) Uganda Research Unit, Entebbe, Uganda
| | - Cathryn M Lewis
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, de Crespigny Park, London, SE5 8AF, UK
| | - Andrew M McIntosh
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
| | | | - Moffat Nyirenda
- The Department of Non-communicable Diseases Epidemiology, London School of Hygiene and Tropical Medicine London, London, UK
- Medical Research Council/ Uganda Virus Research Institute & London School of Hygiene and Tropical Medicine (MRC/UVRI & LSHTM) Uganda Research Unit, Entebbe, Uganda
| | - Pontiano Kaleebu
- Medical Research Council/ Uganda Virus Research Institute & London School of Hygiene and Tropical Medicine (MRC/UVRI & LSHTM) Uganda Research Unit, Entebbe, Uganda
| | - Segun Fatumo
- The African Computational Genomics (TACG) Research Group, Medical Research Council/ Uganda Virus Research Institute & London School of Hygiene and Tropical Medicine (MRC/UVRI & LSHTM) Uganda Research Unit, Entebbe, Uganda.
- Precision Healthcare University Research Institute, Queen Mary University of London, London, UK.
| |
Collapse
|
3
|
Bandara P, Page A, Rajapakse T, Knipe D. Intimate partner violence, suicide and self-harm in Sri Lanka: Analysis of national data. PLoS One 2024; 19:e0298413. [PMID: 38512911 PMCID: PMC10956877 DOI: 10.1371/journal.pone.0298413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 01/25/2024] [Indexed: 03/23/2024] Open
Abstract
There is increasing evidence from South Asia and internationally that intimate partner violence (IPV) is strongly associated with self-harm, however its association with suicide and self-harm has not been extensively examined, nor has this relationship been explored at a national level. Using national datasets, area-level variation in IPV, suicide and self-harm in Sri Lanka were examined. In addition, the association between individual level exposure to past-year IPV and non-fatal self-harm by any household member were explored in a series of multi-level logistic regression models, adjusting for age. Similar patterns in the distribution of suicide and IPV were found, with higher rates evident in post-conflict districts, specifically Batticaloa, Kilinochchi, and Mullaitivu. Experience of past year IPV and its various forms were strongly associated with household-level self-harm in the past year (adjusted odds ratio [AOR] = 3.83 95% CI 2.27-6.46). A similar magnitude was found for physical/sexual abuse (AOR 5.17 95% CI 2.95-9.05) and psychological abuse (AOR 4.64 95% CI 2.50-7.00). A dose-response association was also evident for frequency of abuse, with an increasing risk of household-level self-harm for women reporting abuse 'less often' (AOR 2.95 95% CI 1.46-5.92), and abuse experienced 'daily, weekly, or monthly' (AOR 4.83 95% CI 2.59-9.00), compared to no abuse. This study contributes to a growing body of evidence on the relationship between IPV and suicidal behaviour in South Asia. Addressing IPV and its various forms should be a priority for suicide prevention in Sri Lanka, alongside trauma-informed approaches in post-conflict settings.
Collapse
Affiliation(s)
- Piumee Bandara
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
- Translational Health Research Institute, Western Sydney University, New South Wales, Australia
| | - Andrew Page
- Translational Health Research Institute, Western Sydney University, New South Wales, Australia
| | - Thilini Rajapakse
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
- Department of Psychiatry, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Duleeka Knipe
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| |
Collapse
|
4
|
Kizilhan JI, Berger T, Sennhauser L, Wenzel T. The psychological impact of genocide on the Yazidis. Front Psychol 2023; 14:1074283. [PMID: 37063562 PMCID: PMC10090394 DOI: 10.3389/fpsyg.2023.1074283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 02/28/2023] [Indexed: 03/31/2023] Open
Abstract
BackgroundThe genocide against the Yazidis by the Islamic State of Iraq and Al-Sham (ISIS) in the Sinjar area of Northern Iraq has costed many lives and has also caused a psychological long-term impact in this minority. This impact can be seen among individual survivors. Additionally, there is a large number of direct and indirect victims and for this reason, the impact can also be observed on the level of the group and society in this region at large.MethodologyThe research examines three different population groups (Yazidis members who had been exposed to violence by terrorist group actions, those not exposed to this experience as they were living in an area not directly exposed to ISIS violence, and a control group of non – Yazidi general population members). In total, 425 participants (age range 15–78) took part in the study and participated in interviews using standard scales to measure general physical and mental health.ResultsThe results demonstrate that psychological stress and suicidality are higher among the Yazidis survivors of violence than in the other Yazidi participants.ConclusionPsychological disorders after a genocide and war in post-conflict populations should receive more attention in the planning of mental health care and prevention and should be seen as a major problem, especially in camp settings and displaced persons besides the usual increased prevalence of posttraumatic stress and other disorders covered by research so far in this context.
Collapse
Affiliation(s)
- Jan Ilhan Kizilhan
- University of Duhok, Duhok, Iraq
- Institut for Transcultural Health Science, Cooperative State University Villingen-Schwenningen, Stuttgart, Germany
- *Correspondence: Jan Ilhan Kizilhan,
| | - Thomas Berger
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
| | - Laura Sennhauser
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
| | - Thomas Wenzel
- World Psychiatric Association, Scientific Section on Psychological Aspects of Persecution and Torture, Geneva, Switzerland
| |
Collapse
|
5
|
Tsai YT, K. M. SP, Ku HC, Wu YL, Ko NY. Global overview of suicidal behavior and associated risk factors among people living with human immunodeficiency virus: A scoping review. PLoS One 2023; 18:e0269489. [PMID: 36940193 PMCID: PMC10029973 DOI: 10.1371/journal.pone.0269489] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 05/22/2022] [Indexed: 03/21/2023] Open
Abstract
Death by suicide is a major public health problem. People living with human immunodeficiency virus (PLHIV) have higher risk of suicidal behavior than the general population. The aim of this review is to summarize suicidal behavior, associated risk factors, and risk populations among PLHIV. Research studies in six databases from January 1, 1988, to July 8, 2021, were searched using keywords that included "HIV," "suicide," and "risk factors." The study design, suicide measurement techniques, risk factors, and study findings were extracted. A total of 193 studies were included. We found that the Americas, Europe, and Asia have the highest rates of suicidal behavior. Suicide risk factors include demographic factors, mental illness, and physiological, psychological, and social support. Depression is the most common risk factor for PLHIV, with suicidal ideation and attempt risk. Drug overdosage is the main cause of suicide death. In conclusion, the current study found that PLHIV had experienced a high level of suicidal status. This review provides an overview of suicidal behavior and its risk factors in PLHIV with the goal of better managing these factors and thus preventing death due to suicide.
Collapse
Affiliation(s)
- Yi-Tseng Tsai
- Department of Nursing, An Nan Hospital, China Medical University, Tainan,
Taiwan
- Department of Nursing, College of Medicine, National Cheng Kung
University, Tainan, Taiwan
| | - Sriyani Padmalatha K. M.
- Department of Nursing, College of Medicine, National Cheng Kung
University, Tainan, Taiwan
- Operating Room Department, National Hospital of Sri Lanka, Colombo, Sri
Lanka
| | - Han-Chang Ku
- Department of Nursing, An Nan Hospital, China Medical University, Tainan,
Taiwan
- Department of Nursing, College of Medicine, National Cheng Kung
University, Tainan, Taiwan
| | - Yi-Lin Wu
- Department of Nursing, College of Medicine, National Cheng Kung
University, Tainan, Taiwan
| | - Nai-Ying Ko
- Department of Nursing, College of Medicine, National Cheng Kung
University, Tainan, Taiwan
- Department of Public Health, College of Medicine, National Cheng Kung
University, Tainan, Taiwan
| |
Collapse
|
6
|
Rukundo GZ, Wakida EK, Karungi CK, Asasira J, Kumakech E, Obua C. Depression, suicidality, substance-use and associated factors among people living with HIV the COVID-19 pandemic in Uganda. PLoS One 2023; 18:e0285310. [PMID: 37146057 PMCID: PMC10162553 DOI: 10.1371/journal.pone.0285310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 04/19/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND Mental disorders are common in people living with HIV (PLHIV) but they are often unrecognized and untreated. Furthermore, the COVID-19 pandemic has disrupted the already limited mental health services in low resource countries such as Uganda, and yet the extent to which the COVID-19 mitigation measures have affected the mental health of PLHIV is not fully known. We aimed to determine the burden of depression, suicidality, substance use and associated factors among adult PLHIV who were seeking care at two HIV clinics in northern and southwestern Uganda. METHODS We conducted a phenomenological qualitative and quantitative cross-sectional study among 431 PLHIV to determine the burden of depression, suicidality and substance-use disorders at two HIV clinics, at Lira Regional Referral Hospital and Mbarara Regional Referral Hospital in northern and southwestern Uganda respectively, during the COVID-19 lockdown. We used the Patient Health Questionnaire (PHQ-9) to assess for depression and suicidality, and the Michigan Assessment-Screening Test for Alcohol and drugs (MAST-AD) to assess for substance use disorder. We conducted descriptive statistics analysis to determine the burden of the disorders, and logistic regression to determine the associated factors. For the qualitative method we conducted in-depth interviews with 30 PLHIV and did thematic analysis. RESULTS Of the 431 PLHIV surveyed, mean age was 40.31 ± 12.20 years; 53.1% (n = 229) had depression; 22.0% (n = 95) had suicidality; and 15.1% (n = 65) had substance-use disorder. Female gender (PR = 1.073, 95%CI 1.004-1.148, P = 0.038), lack of formal education (PR = 1.197, 95% CI 1.057-1.357, P = 0.005), substance-use disorder (PR = 0.924, 95%CI 0.859-0.994, P = 0.034) and suicidality (PR = 0.757, 95%CI 0.722-0.794, p = 0.000) were associated with depression after adjusting for confounders. Further analysis showed that being female (PR = 0.843, 95% CI 0.787-0.903, P = 0.000*) and having depression (PR = 0.927, 95% CI 0.876-0.981, P = 0.009) and owning a large business (PR = 0.886, 95% CI 0.834-0.941, p = 0.000*) were significantly associated with having a substance-use disorder. Only depression was independently associated with suicidality after adjusting for confounding factors (PR 0.108, 95%CI 0.054-0.218, p = 0.000*). For the qualitative results, there were three apriori themes: a) Burden of depression, b) substance-use, and c) suicidality among the PLHIV during the COVID-19 containment measures. CONCLUSION There was high prevalence of depression, suicidality and substance-use disorder in adult PLHIV in Uganda during the COVID-19 pandemic and the associated lockdown measures. The three mental health problems seem to have bidirectional relationships and gender has a lot of contribution to the relationships. Interventions aimed at any of the disorders should consider these bidirectional relationships.
Collapse
Affiliation(s)
- Godfrey Zari Rukundo
- Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Edith K Wakida
- Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda
- Department of Medical Education, California University of Science and Technology, Milpitas, CA, United States of America
| | - Christine K Karungi
- Office of Research Administration, Mbarara University of Science and Technology Mbarara, Mbarara, Uganda
| | - Jenipher Asasira
- Office of Research Administration, Mbarara University of Science and Technology Mbarara, Mbarara, Uganda
| | - Edward Kumakech
- Department of Nursing and Midwifery, Faculty of Health Sciences, Lira University, Lira, Uganda
| | - Celestino Obua
- Department of Pharmacology and Therapeutics, Mbarara University of Science and Technology, Mbarara, Mbarara, Uganda
| |
Collapse
|
7
|
Kaggwa MM, Najjuka SM, Bongomin F, Mamun MA, Griffiths MD. Prevalence of depression in Uganda: A systematic review and meta-analysis. PLoS One 2022; 17:e0276552. [PMID: 36264962 PMCID: PMC9584512 DOI: 10.1371/journal.pone.0276552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 10/09/2022] [Indexed: 11/07/2022] Open
Abstract
Background Depression is one of the most studied mental health disorders, with varying prevalence rates reported across study populations in Uganda. A systematic review and meta-analysis was carried out to determine the pooled prevalence of depression and the prevalence of depression across different study populations in the country. Methods Papers for the review were retrieved from PubMed, Scopus, PsycINFO, African Journal OnLine, and Google Scholar databases. All included papers were observational studies regarding depression prevalence in Uganda, published before September 2021. The Joanna Briggs Institute Checklist for Prevalence Studies was used to evaluate the risk of bias and quality of the included papers, and depression pooled prevalence was determined using a random-effects meta-analysis. Results A total of 127 studies comprising 123,859 individuals were identified. Most studies were conducted among individuals living with HIV (n = 43; 33.9%), and the most frequently used instrument for assessing depression was the Depression sub-section of the Hopkins Symptom Checklist (n = 34). The pooled prevalence of depression was 30.2% (95% confidence interval [CI]: 26.7–34.1, I2 = 99.80, p<0.001). The prevalence of depression was higher during the COVID-19 pandemic than during the pre-pandemic period (48.1% vs. 29.3%, p = 0.021). Refugees had the highest prevalence of depression (67.6%; eight studies), followed by war victims (36.0%; 12 studies), individuals living with HIV (28.2%; 43 studies), postpartum or pregnant mothers (26.9%; seven studies), university students (26.9%; four studies), children and adolescents (23.6%; 10 studies), and caregivers of patients (18.5%; six studies). Limitation Significantly high levels of heterogeneity among the studies included. Conclusion Almost one in three individuals in Uganda has depression, with the refugee population being disproportionately affected. Targeted models for depression screening and management across various populations across the country are recommended. Trial registration Protocol registered with PROSPERO (CRD42022310122).
Collapse
Affiliation(s)
- Mark Mohan Kaggwa
- Department of Psychiatry, Mbarara University of Science & Technology, Mbarara, Uganda
- African Centre for Suicide Prevention and Research, Mbarara, Uganda
- Department of Psychiatry and Behavioural Neurosciences, Forensic Psychiatry Program, McMaster University, Hamilton, Ontario, Canada
- * E-mail:
| | - Sarah Maria Najjuka
- School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Felix Bongomin
- Department of Medical Microbiology & Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda
| | - Mohammed A. Mamun
- CHINTA Research Bangladesh, Savar, Dhaka, Bangladesh
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | - Mark D. Griffiths
- Psychology Department, Nottingham Trent University, Nottingham, United Kingdom
| |
Collapse
|
8
|
Rukundo GZ, Wakida EK, Maling S, Kaggwa MM, Sserumaga BM, Atim LM, Atuhaire CD, Obua C. Knowledge, attitudes, and experiences in suicide assessment and management: a qualitative study among primary health care workers in southwestern Uganda. BMC Psychiatry 2022; 22:605. [PMID: 36096787 PMCID: PMC9465925 DOI: 10.1186/s12888-022-04244-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 08/31/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Suicide is one of the leading causes of death globally, with over 75% of all suicides occurring in low-and middle-income Countries. Although 25% of people have contact with their health care workers before suicide attempts, most never receive proper suicide assessment and management. We explored primary care health workers' knowledge, attitudes, and experiences in evaluating and managing suicidality in structured primary healthcare services in Uganda. METHODS This was a cross-sectional qualitative study among health workers in southwestern Uganda from purposively selected health facilities. A semi-structured interview guide was used, and data were analyzed using thematic analysis. RESULTS The in-depth interviews were conducted with 18 individuals (i.e., five medical doctors, two clinical officers, two midwives, and nine nurses) from 12 health facilities in the five selected districts. Four themes emerged from the discussions: a) Knowledge and attitudes of primary healthcare workers in the assessment and management of suicidality, b) Experiences in the assessment and management of suicidality, c) challenges faced by primary healthcare workers while assessing and managing suicidality, and d) Recommendations for improving assessment and management of suicidality in PHC. Most participants were knowledgeable about suicide and the associated risk factors but reported challenges in assessing and managing individuals with suicide risk. The participants freely shared individual experiences and attitudes in the assessment and management of suicide. They also proposed possible ways to improve the evaluation and management of suicidality in PHC, such as setting up a system of managing suicidality, regularizing community sensitization, and training health workers. CONCLUSION Suicidality is commonly encountered by primary health care workers in Uganda who struggle with its assessment and management. Improving the knowledge and attitudes of primary health care workers would be a big step towards ensuring equitable services.
Collapse
Affiliation(s)
- Godfrey Z. Rukundo
- grid.33440.300000 0001 0232 6272Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda ,African Center for Suicide Prevention and Research, Mbarara, Uganda
| | - Edith K. Wakida
- African Center for Suicide Prevention and Research, Mbarara, Uganda ,grid.33440.300000 0001 0232 6272Office of Research Administration, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Samuel Maling
- grid.33440.300000 0001 0232 6272Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Mark M. Kaggwa
- grid.33440.300000 0001 0232 6272Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda ,African Center for Suicide Prevention and Research, Mbarara, Uganda ,grid.25073.330000 0004 1936 8227Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Canada
| | - Baker M. Sserumaga
- grid.33440.300000 0001 0232 6272Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Letizia M. Atim
- grid.33440.300000 0001 0232 6272Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Clara D. Atuhaire
- grid.33440.300000 0001 0232 6272Office of Research Administration, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Celestino Obua
- grid.33440.300000 0001 0232 6272Department of Pharmacology and Therapeutics, Mbarara University of Science and Technology, Mbarara, Uganda
| |
Collapse
|
9
|
Daw MA, El-Bouzedi AH, Ahmed MO. The Impact of Armed Conflict on the Prevalence and Transmission Dynamics of HIV Infection in Libya. Front Public Health 2022; 10:779778. [PMID: 35433583 PMCID: PMC9009867 DOI: 10.3389/fpubh.2022.779778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 02/18/2022] [Indexed: 11/13/2022] Open
Abstract
The interrelationships between HIV/AIDS and armed conflict are a complex phenomenon, and studies are rarely devoted to this area of research. Libya is the second-largest country in Africa that has been evoked with war since the NATO intervention in 2011. The country has also experienced one of the largest HIV outbreaks associated with the Bulgarian nurse's saga. The effect of the armed conflict on the dynamic spread of HIV is not yet well-known. The objectives of this study were to determine the impact of armed conflict on the epidemiological situation of HIV infection in Libya and to analyze the transmission dynamics of HIV strains during the conflict. We investigated the movement of people with HIV during the Libyan armed conflict, analyzed the HIV subtypes reported from 2011 to 2020, and followed up the infected cases all over the country. The patterns of HIV spread within the Libyan regions were traced, and the risk factors were determined during the conflict period. A total of 4,539 patients with HIV/AIDS were studied from the four regions during the Libyan conflict. Our data analysis indicated that Benghazi, the biggest city in the Eastern region, was the significant exporter of the virus to the rest of the country. The viral dissemination changes were observed within the country, particularly after 2015. A major virus flows from the Eastern region during the armed conflict associated with internally displaced people. This resulted in the dissemination of new HIV strains and accumulations of HIV cases in western and middle regions. Although, there were no significant changes in the national prevalence of HIV/AIDS. Our data highlight the factors that complicated the spread and dissemination of HIV during the armed conflict, which provide a better understanding of the interaction between them. This could be used to plan for effective preventive measures in tackling the spread of HIV in conflict and post-conflict settings.
Collapse
Affiliation(s)
- Mohamed Ali Daw
- Department of Medical Microbiology and Immunology, Faculty of Medicine, University of Tripoli, Tripoli, Libya
- *Correspondence: Mohamed Ali Daw
| | | | - Mohamed Omar Ahmed
- Department of Microbiology and Parasitology, Faculty of Veterinary Medicine, University of Tripoli, Tripoli, Libya
| |
Collapse
|
10
|
Bukuluki P, Kisaakye P, Wandiembe SP, Besigwa S. Suicide ideation and psychosocial distress among refugee adolescents in Bidibidi settlement in West Nile, Uganda. DISCOVER PSYCHOLOGY 2021. [PMCID: PMC8488914 DOI: 10.1007/s44202-021-00003-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
This study investigated the factors associated with suicidal ideation and psychological distress among Sudanese refugees (aged 10–19 years) in Bidibidi refugee settlement, Yumbe district, Uganda. The analysis is based on cross-sectional data collected as part of the implementation of a project on sexual and reproductive health in Bidibidi refugee settlement. Data were collected from 284 South Sudanese adolescents in July 2020. We estimated the prevalence of psychological distress and suicidal ideation, and their associated profiles. Odds ratios and their 95% Confidence Intervals based on a logistic regression model were used to assess the effect of different potential factors on the risk profiles for suicidal ideation and psychological distress. The prevalence of psychological distress (on KS-6 scale) was estimated to be 12.3% (95%CI: 8.7, 16.7%). The risk for psychological distress is low among male adolescents (AOR = 0.51; 95%CI: 0.23, 1.02), older adolescents, (AOR = 0.12; 95%CI: 0.04, 0.40), and adolescents with a friend or family members they can confide in (AOR = 0.33; 95%CI: 0.11, 0.96). Both suicidal ideation and psychological distress are very high among the female adolescents. Familial and individual interventions can be potentially useful for female adolescents who have a high risk of suicide and psychological distress.
Collapse
Affiliation(s)
- Paul Bukuluki
- Department of Social Work and Social Administration, School of Social Sciences, Makerere University, Kampala, Uganda
| | - Peter Kisaakye
- Department of Population Studies, School of Statistics and Planning, Mathematics Building, Makerere University Main Campus, P O Box 7062, Kampala, Uganda
| | - Symon Peter Wandiembe
- Department of Statistical Methods, 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
| |
Collapse
|
11
|
Wesonga S, Osingada C, Nabisere A, Nkemijika S, Olwit C. Suicidal tendencies and its association with psychoactive use predictors among university students in Uganda: a cross-sectional study. Afr Health Sci 2021; 21:1418-1427. [PMID: 35222607 PMCID: PMC8843277 DOI: 10.4314/ahs.v21i3.53] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background Globally, suicide is one of the leading causes of death, and approximately 80% of all suicides occur in lowand middle-income countries. Younger people in Africa are at a higher risk of suicide than others. Objective To describe the prevalence and factors associated with suicidal tendencies among undergraduate university students using alcohol and other psychoactive substances. Methods Convenient sampling was used to identify 400 students who participated in the study. Socio-demographic and Mini-International Neuropsychiatric Interview tools were used to obtain information. Data were analyzed using SAS 9.4 and presented in descriptive and inferential statistics. Results Among the respondents, 80% were male, and 85% were using marijuana. 6.3% had suicidal tendencies. Respondents from the northern region had more suicidal tendencies than other regions, and unemployed students had more suicidal tendencies than those employed. After multivariate analysis, being abusive and dependent on other psychoactive substances was associated with suicidality. And having dependence on both alcohol and other psychoactive substances was associated with suicidality. Conclusion Suicidality screening and psychosocial support should be provided to this vulnerable population. Efforts There is a need to strengthen, implement more effective preventive strategies to reduce the use of alcohol and other psychoactive substances.
Collapse
|
12
|
Bantjes J, Kagee A. Suicide Prevention in HIV Treatment Centres: Population Attributable Risk Analysis of Treating Common Mental Disorders. AIDS Behav 2021; 25:1864-1872. [PMID: 33387136 DOI: 10.1007/s10461-020-03116-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2020] [Indexed: 11/24/2022]
Abstract
The aim was to establish the potential reduction in non-fatal suicidal behaviour (NFSB) that could be achieved by treating common mental disorders (CMDs) among persons receiving HIV treatment. Data were collected from antiretroviral therapy (ART) patients in South Africa (n = 688). Structured Clinical Interviews assessed CMDs and the Mini International Neuropsychiatric Interview assessed 1-month prevalence of NFSB and suicide risk. Population Attributable Risk (PAR) analysis established the potential reduction in prevalence of NFSB and suicide risk that could be achieved by treating CMDs, with the simplifying assumption of a causal relationship between psychopathology and suicidality. Treating CMDs could result in as much as a 63.9% proportional reduction in the prevalence of suicide ideation, 84.2% proportional reduction in the prevalence of suicide plan, and 63.4% proportional decrease in prevalence of suicide risk. There is potential to significantly reduce NFSB among ART patients. Pragmatic trials are needed to evaluate the effects of treating CMDs in HIV treatment centres.
Collapse
Affiliation(s)
- Jason Bantjes
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Private Bag X1, Matieland, 7602, South Africa.
| | - Ashraf Kagee
- Department of Psychology, Stellenbosch University, Private Bag X1, Matieland, 7602, South Africa
| |
Collapse
|
13
|
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.
Collapse
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
| |
Collapse
|
14
|
Gebreegziabhier Kindaya G, Kassaw Demoze C. Lifetime Prevalence and Determinants of Suicidal Ideation and Attempt Among All Patients Living with HIV/AIDS in Hiwot Fana Specialized Hospital, Harar, Ethiopia, 2020. HIV AIDS-RESEARCH AND PALLIATIVE CARE 2020; 12:331-339. [PMID: 32821172 PMCID: PMC7418163 DOI: 10.2147/hiv.s257502] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 07/31/2020] [Indexed: 11/23/2022]
Abstract
Background Suicide is a psychiatric emergency and the second leading cause of death among youths. Suicide risk is 7 to 36 times greater among PLWHA as compared to the general population. This study was aimed at determining the prevalence of suicide and its associated factors among PLWHA and attendings at Hiwot Fana Specialized University Hospital, Ethiopia, 2020. Patients and Methods We conducted a cross-sectional study on 412 randomly selected respondent PLWHA and attendingz at Hiwot Fana Specialized University Hospital from February 1–March 1, 2020. The interviewers administered a structured questionnaire consisting of the World Health Organization Composite International Diagnostic Interview (CIDI) tool to measure suicidality. We used the clinical records to collect clinical variables of the respondents. We used simple logistic regression ≤ 0.25 at p-value ≤ 0.25 and multiple logistic regression at p-value ≤ 0.05 to identify the predictor variables of the outcome. Results A total of 412 participants have completed the questionnaire, with a response rate of 97.4%. The majority, 252 (61.2) of the participants were female, while 112 (27.2%) of the respondents were in the age group of 28–37. The prevalence of suicidal ideation and attempt among PLWHA was 24.3% (CI; 20.4, 28.4) and 12.6% (9.5–15.8), respectively. Predictors for suicidal ideation were being in extreme poverty, living alone, widowed, CD4 level less than 250, and current alcohol use, and for suicidal attempt were an urban residence, stage IV HIV, family history of suicide, and depression. Conclusion Nearly one-fourth of the respondents reported suicidal ideation. So, early screening and working on those identified predictors of suicidality is vital to prevent the mortality of it in PLWHA.
Collapse
Affiliation(s)
| | - Chalachew Kassaw Demoze
- Department of Psychiatry, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia
| |
Collapse
|
15
|
Ng LC, Stevenson A, Kalapurakkel SS, Hanlon C, Seedat S, Harerimana B, Chiliza B, Koenen KC. National and regional prevalence of posttraumatic stress disorder in sub-Saharan Africa: A systematic review and meta-analysis. PLoS Med 2020; 17:e1003090. [PMID: 32413027 PMCID: PMC7228043 DOI: 10.1371/journal.pmed.1003090] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 04/13/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND People living in sub-Saharan Africa (SSA) are disproportionately exposed to trauma and may be at increased risk for posttraumatic stress disorder (PTSD). However, a dearth of population-level representative data from SSA is a barrier to assessing PTSD. This manuscript sought to calculate pooled PTSD prevalence estimates from nationally and regionally representative surveys in SSA. METHODS AND FINDINGS The search was conducted in PubMed, Embase, PsycINFO, and PTSDpubs and was last run between October 18, 2019, and November 11, 2019. We included studies that were published in peer-reviewed journals; used probabilistic sampling methods and systematic PTSD assessments; and included ≥ 450 participants who were current residents of an SSA country, at least 50% of whom were aged between 15 and 65 years. The primary outcomes were point prevalence estimates of PTSD across all studies, and then within subgroups. The protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) (registration number CRD42016029441). Out of 2,825 unique articles reviewed, 25 studies including a total of 58,887 eligible participants (54% female) in 10 out of the 48 countries in SSA were identified. Most studies enrolled any adult aged 18 years or older. However, some studies only enrolled specific age brackets or persons as young as 15 years old. Six studies were national surveys, and 19 were regional. There were 4 key findings in the meta-analysis: (1) the overall pooled prevalence of probable PTSD was 22% (95% CI 13%-32%), while the current prevalence-defined as 1 week to 1 month-was 25% (95% CI 16%-36%); (2) prevalence estimates were highly variable, ranging from 0% (95% CI 0%-0%) to 74% (95% CI 72%-76%); (3) conflict-unexposed regions had a pooled prevalence of probable PTSD of 8% (95% CI 3%-15%), while conflict-exposed regions had a pooled prevalence of probable PTSD of 30% (95% CI 21%-40%; p < 0.001); and (4) there was no significant difference in the pooled prevalence of PTSD for men and women. The primary limitations of our methodology are our exclusion of the following study types: those published in languages other than English, French, and Portuguese; smaller studies; those that focused on key populations; those that reported only on continuous measures of PTSD symptoms; and unpublished or non-peer-reviewed studies. CONCLUSIONS In this study, PTSD symptoms consistent with a probable diagnosis were found to be common in SSA, especially in regions exposed to armed conflict. However, these studies only represent data from 10 of the 48 SSA countries, and only 6 studies provided national-level data. Given the enormous heterogeneity expected across the continent, and also within countries and regions, this review cannot speak to rates of PTSD in any regions not included in this review. Thus, substantial gaps in our knowledge of PTSD prevalence in SSA remain. More research on population-level prevalence is needed to determine the burden of trauma symptoms and PTSD in SSA and to identify acceptable and feasible approaches to address this burden given limited mental healthcare resources.
Collapse
Affiliation(s)
- Lauren C. Ng
- Department of Psychology, University of California Los Angeles, Los Angeles, California, United States of America
- * E-mail:
| | - Anne Stevenson
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Sreeja S. Kalapurakkel
- Duke University Global Health Institute, Durham, North Carolina, United States of America
- Centre for Global Mental Health, Health Service and Population Research, Department Institute of Psychiatry, Psychology and Neuroscience King’s College, London, United Kingdom
| | - Charlotte Hanlon
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Soraya Seedat
- Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Boniface Harerimana
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Bonginkosi Chiliza
- Department of Psychiatry, Nelson R. Mandela School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Karestan C. Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| |
Collapse
|
16
|
Seb-Akahomen OJ, Lawani AO, James BO. Stigma and suicidality among people living with HIV attending a secondary healthcare facility in Nigeria. Perspect Psychiatr Care 2019; 55:538-545. [PMID: 30171699 DOI: 10.1111/ppc.12321] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 06/26/2018] [Accepted: 07/22/2018] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To ascertain the relationship between HIV-related stigma and suicidality among people living with HIV receiving care at a hospital in Nigeria. DESIGN AND METHODS Four hundred and ten participants were administered a socio-demographic and clinical history questionnaire, the 40-item Berger's HIV-stigma scale, and the Mini International Neuropsychiatric Interview (MINI) to diagnose suicidality and depression in a cross-sectional study. FINDINGS Fifty-four (13.2%) reported suicidality; suicidal ideation was commonest and suicide plans least, in the month preceding the study. Higher suicidality risk was significantly associated with stigma (P < 0.001) and major depressive disorder ( P < 0.001). PRACTICE IMPLICATIONS Suicidality is common and is associated with HIV-related stigma.
Collapse
Affiliation(s)
| | - Ambrose Onivefu Lawani
- Department of Clinical Services, Federal Neuro-Psychiatric Hospital, Benin City, Nigeria
| | - Bawo Onesirosan James
- Department of Clinical Services, Federal Neuro-Psychiatric Hospital, Benin City, Nigeria
| |
Collapse
|
17
|
Mugisha J, Muyinda H, Hjelmeland H, Kinyanda E, Vancampfort D, Knizek BL. Cultural responses towards the aftermath of suicide among the Acholi in Northern Uganda. Int J Soc Psychiatry 2018; 64:545-553. [PMID: 29963938 DOI: 10.1177/0020764018784625] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Suicide is a public health problem in Uganda among indigenous societies, and different societies manage its aftermath differently. AIM To explore how the Acholi in Northern Uganda manage the aftermath of suicide. METHODS We conducted a qualitative study in Gulu district, a post-conflict area in Northern Uganda. We conducted a total of four focus group discussions (FGDs) and 12 key informant (KI) interviews. KI interviews were conducted with community leaders, while the FGDs were conducted with members of the general population. We analysed the data by means of Grounded Theory. RESULTS Our findings indicate that rituals form a large part in managing suicide among the Acholi. Study communities practised distancing (symbolically and physically) as a way of dealing with the threat of suicide. CONCLUSION Distancing was organized into two broad themes: affect regulation and securing future generations. It is recommended that public health interventions should utilize cultural institutions in the prevention of suicide.
Collapse
Affiliation(s)
- James Mugisha
- 1 Department of Sociology and Social Administration, Faculty of Arts and Social Sciences, Kyambogo University, Kampala, Uganda.,2 Child Health and Development Centre, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Herbert Muyinda
- 2 Child Health and Development Centre, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Heidi Hjelmeland
- 3 Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Eugene Kinyanda
- 4 Medical Research Council (MRC)/Uganda Virus Research Institute, Entebbe, Uganda
| | - Davy Vancampfort
- 5 Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Catholic University Leuven, Leuven, Belgium
| | - Birthe Loa Knizek
- 3 Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| |
Collapse
|
18
|
Tumwine JK. Child, reproductive, mental health; infections and NCDs in the African environment. Afr Health Sci 2016; 16:i-iii. [PMID: 28479915 DOI: 10.4314/ahs.v16i4.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
|