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Mugamba S, Ziegel L, Bulamba RM, Kyasanku E, Johansson Århem K, Sjöland CF, Miller AP, Nakigozi G, Nalwoga GK, Watya S, Kiwanuka N, Kagaayi J, Kiwanuka D, Ddaaki W, Wagman JA, Kigozi G, Ekström AM, Nalugoda F. Cohort Profile: The Africa Medical and Behavioral Sciences Organization (AMBSO) Population Health Surveillance (APHS) in rural, semi-urban and urban Uganda. Int J Epidemiol 2022; 52:e116-e124. [PMID: 35962975 PMCID: PMC10114126 DOI: 10.1093/ije/dyac164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 08/02/2022] [Indexed: 11/14/2022] Open
Affiliation(s)
- Stephen Mugamba
- Africa Medical and Behavioral Sciences Organization, Wakiso, Uganda.,Makerere University Walter Reed Project, Kampala, Uganda
| | - Leo Ziegel
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Robert M Bulamba
- Africa Medical and Behavioral Sciences Organization, Wakiso, Uganda
| | | | - Katarina Johansson Århem
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.,Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | | | - Amanda P Miller
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | | | | | - Stephen Watya
- Africa Medical and Behavioral Sciences Organization, Wakiso, Uganda
| | - Noah Kiwanuka
- Africa Medical and Behavioral Sciences Organization, Wakiso, Uganda.,School of Public Health, Makerere University, Kampala, Uganda
| | - Joseph Kagaayi
- Africa Medical and Behavioral Sciences Organization, Wakiso, Uganda.,School of Public Health, Makerere University, Kampala, Uganda
| | | | - William Ddaaki
- Africa Medical and Behavioral Sciences Organization, Wakiso, Uganda
| | - Jennifer A Wagman
- Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Godfrey Kigozi
- Africa Medical and Behavioral Sciences Organization, Wakiso, Uganda
| | - Anna Mia Ekström
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.,Department of Infectious Diseases, Södersjukhuset, Stockholm, Sweden
| | - Fred Nalugoda
- Africa Medical and Behavioral Sciences Organization, Wakiso, Uganda
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Miller AP, Espinosa da Silva C, Ziegel L, Mugamba S, Kyasanku E, Malyabe RB, Wagman JA, Mia Ekström A, Nalugoda F, Kigozi G, Nakigozi G, Kagaayi J, Watya S, Kigozi G. Construct validity and internal consistency of the Patient Health Questionnaire-9 (PHQ-9) depression screening measure translated into two Ugandan languages. Psychiatry Res Commun 2021; 1:100002. [PMID: 35187539 PMCID: PMC8855962 DOI: 10.1016/j.psycom.2021.100002] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
BACKGROUND In Uganda, depression is a major public health issue because of its direct disease burden and as a risk factor and co-morbidity for other pervasive health issues. Psychometric assessment of translated depression measures is critical to public health planning to ensure proper screening, surveillance, and treatment of depression and related outcomes. We examined aspects of the validity and reliability of the Patient Health Questionnaire-9 (PHQ-9) translated into Luganda and Runyoro in a large population-based cohort of Ugandan adolescents and adults. METHODS Data from the ongoing open cohort AMBSO Population Health Surveillance study were analyzed from the Wakiso and Hoima districts in Uganda. Descriptive statistics were calculated for the overall sample and stratified by translated language. Construct validity was assessed for each translated scale using confirmatory factor analysis for ordinal data. The internal consistency of each translated scale was assessed using Cronbach's alpha, McDonald's omega total and omega hierarchical. RESULTS Compared to the Runyoro-speaking subsample from Hoima (n=2297), participants in the Luganda-speaking subsample from Wakiso (n=672) were older (27 vs 21 years, p < 0.01) and a greater proportion were female (62% vs. 55%, p < 0.01). The Luganda-translated PHQ-9 had a sample mean of 3.46 (SD=3.26), supported a single-factor structure (RMSEA=0.05, CFI=0.96, TLI=0.94), and demonstrated satisfactory internal consistency (Cronbach's alpha=0.73, McDonald's omega total=0.76, McDonald's omega hierarchical=0.53). The Runyoro-translated PHQ-9 had a comparable sample mean of 3.58 (SD=3.00), also supported a one-factor structure (RMSEA=0.08, CFI=0.92, TLI=0.90), and demonstrated satisfactory internal consistency (Cronbach's alpha=0.72, McDonald's omega total=0.76, McDonald's omega hierarchical=0.57). CONCLUSIONS Our preliminary findings indicate that the Luganda and Runyoro translations of the PHQ-9 had satisfactory construct validity and internal consistency in our sample of Ugandan adolescents and adults. Future studies should expand on this promising work by assessing additional psychometric characteristics of these translated measures in other communities in Uganda.
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Affiliation(s)
- Amanda P. Miller
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
- Corresponding author: Amanda P Miler
| | - Cristina Espinosa da Silva
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
- San Diego State University, Department of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA, USA
| | - Leo Ziegel
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Stephen Mugamba
- Africa Medical and Behavioral Sciences Organization (AMBSO), Uro Care Limited, Wakiso District, Uganda
- Makerere University Walter Reed Project (MUWRP), Kampala, Uganda
| | - Emma Kyasanku
- Africa Medical and Behavioral Sciences Organization (AMBSO), Uro Care Limited, Wakiso District, Uganda
| | - Robert B. Malyabe
- Africa Medical and Behavioral Sciences Organization (AMBSO), Uro Care Limited, Wakiso District, Uganda
| | - Jennifer A. Wagman
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Anna Mia Ekström
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Fred Nalugoda
- Africa Medical and Behavioral Sciences Organization (AMBSO), Uro Care Limited, Wakiso District, Uganda
| | - Grace Kigozi
- Africa Medical and Behavioral Sciences Organization (AMBSO), Uro Care Limited, Wakiso District, Uganda
| | - Gertrude Nakigozi
- Africa Medical and Behavioral Sciences Organization (AMBSO), Uro Care Limited, Wakiso District, Uganda
| | - Josehp Kagaayi
- Africa Medical and Behavioral Sciences Organization (AMBSO), Uro Care Limited, Wakiso District, Uganda
| | - Stephen Watya
- Africa Medical and Behavioral Sciences Organization (AMBSO), Uro Care Limited, Wakiso District, Uganda
| | - Godfrey Kigozi
- Africa Medical and Behavioral Sciences Organization (AMBSO), Uro Care Limited, Wakiso District, Uganda
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Miller AP, Ziegel L, Mugamba S, Kyasanku E, Wagman JA, Nkwanzi-Lubega V, Nakigozi G, Kigozi G, Nalugoda F, Kigozi G, Nkale J, Watya S, Ddaaki W. Not Enough Money and Too Many Thoughts: Exploring Perceptions of Mental Health in Two Ugandan Districts Through the Mental Health Literacy Framework. Qual Health Res 2021; 31:967-982. [PMID: 33451275 PMCID: PMC8628861 DOI: 10.1177/1049732320986164] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Mental health disorders account for a heavy disease burden in Uganda. In order to provide culturally appropriate mental health prevention and treatment approaches, it is necessary to understand how mental health is conceptualized in the population. Three focus group discussions (FGDs) and 31 in-depth interviews (IDIs) were conducted with men and women aged 14 to 62 years residing in rural, urban, and semi-urban low-income communities in central and western Uganda to explore perceptions and knowledge of mental health. Interpretive thematic analysis was undertaken; results were organized through the lens of the mental health literacy framework. Environmental and societal stressors were identified as primary underlying causes of poor mental health. While participants recognized symptoms of poor mental health, gaps in mental health literacy also emerged. Mental health resources are needed in this setting and additional qualitative work assessing knowledge and attitudes toward mental health care seeking behavior can inform the development of acceptable integrated services.
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Affiliation(s)
| | - Leo Ziegel
- Karolinska Institutet, Stockholm, Sweden
- Stockholm Centre for Dependency Disorders, Stockholm, Sweden
| | - Stephen Mugamba
- Africa Medical and Behavioural Sciences Organization, Wakiso, Uganda
| | - Emmanuel Kyasanku
- Africa Medical and Behavioural Sciences Organization, Wakiso, Uganda
| | | | | | - Gertrude Nakigozi
- Africa Medical and Behavioural Sciences Organization, Wakiso, Uganda
| | - Godfrey Kigozi
- Africa Medical and Behavioural Sciences Organization, Wakiso, Uganda
| | - Fred Nalugoda
- Africa Medical and Behavioural Sciences Organization, Wakiso, Uganda
| | - Grace Kigozi
- Africa Medical and Behavioural Sciences Organization, Wakiso, Uganda
| | - James Nkale
- Africa Medical and Behavioural Sciences Organization, Wakiso, Uganda
| | - Stephen Watya
- Africa Medical and Behavioural Sciences Organization, Wakiso, Uganda
| | - William Ddaaki
- Africa Medical and Behavioural Sciences Organization, Wakiso, Uganda
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Awungafac G, Mugamba S, Nalugoda F, Sjöland CF, Kigozi G, Rautiainen S, Malyabe RB, Ziegel L, Nakigozi G, Nalwoga GK, Kyasanku E, Nkale J, Watya S, Ekström AM, Kågesten A. Household food insecurity and its association with self-reported male perpetration of intimate partner violence: a survey of two districts in central and western Uganda. BMJ Open 2021; 11:e045427. [PMID: 33789856 PMCID: PMC8016075 DOI: 10.1136/bmjopen-2020-045427] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 03/11/2021] [Accepted: 03/15/2021] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES This study aimed to determine the lifetime prevalence of male-perpetrated intimate partner violence (IPV), and to assess the association with food insecurity, sociodemographic factors and health risk behaviours in Uganda in the year preceding COVID-19-associated lockdowns. DESIGN Population-based, cross-sectional household survey. SETTING Urban, semiurban and rural communities of the Wakiso and Hoima districts in Uganda. PARTICIPANTS A total of N=2014 males aged 13-80 years participated in the survey. The current study included males who reported having ever been in a sexual union and responded to the IPV questions (N=1314). MEASURES Data were collected face-to-face from May 2018 to July 2019 using an interviewer-mediated questionnaire. Lifetime IPV perpetration was measured as 'no physical and/or sexual IPV', 'physical' versus 'sexual violence only', and 'physical and sexual violence'. Past-year food insecurity was measured through the Food Insecurity Experience Scale and categorised into 'none', 'low' and 'high'. Multinomial logistic regression was used to determine the crude and adjusted relative risk ratios (aRRRs) of IPV perpetration in relation to self-reported food insecurity, adjusting for sociodemographic and health risk behaviours. RESULTS The prevalence of self-reported lifetime IPV perpetration was 14.6% for physical and 6.5% for sexual violence, while 5.3% reported to have perpetrated both physical and sexual IPV. Most (75.7%) males reported no food insecurity, followed by low (20.7%) and high (3.6%) food insecurity. In adjusted models, food insecurity was associated with increased risk of having perpetrated both physical and sexual violence (aRRR=2.57, 95% CI 1.52 to 4.32). IPV perpetration was also independently associated with having had more than one lifetime sexual partner and drinking alcohol, but not with education level or religion. CONCLUSION This study suggests that food insecurity is associated with male IPV perpetration, and more efforts are needed to prevent and mitigate the expected worsening of this situation as a result of the COVID-19 pandemic.
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Affiliation(s)
- George Awungafac
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Stephen Mugamba
- Africa Medical and Behavioural Science Organization, Kampala, Uganda
| | - Fred Nalugoda
- Africa Medical and Behavioural Science Organization, Kampala, Uganda
| | | | - Godfrey Kigozi
- Africa Medical and Behavioural Science Organization, Kampala, Uganda
| | - Susanne Rautiainen
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | | | - Leo Ziegel
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Gertrude Nakigozi
- Africa Medical and Behavioural Science Organization, Kampala, Uganda
| | | | - Emmanuel Kyasanku
- Africa Medical and Behavioural Science Organization, Kampala, Uganda
| | - James Nkale
- Africa Medical and Behavioural Science Organization, Kampala, Uganda
| | - Stephen Watya
- Africa Medical and Behavioural Science Organization, Kampala, Uganda
| | - Anna Mia Ekström
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Anna Kågesten
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
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