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Schellhammer SK, Starnes JR, Mudhune S, Goore L, Marlar L, Oyugi S, Wamae J, Shumba CS, Rogers A, Mbeya J, Vill B, Otieno AS, Wamai RG, Were LPO. Interpersonal violence against women and maternity care in Migori County, Kenya: evidence from a cross-sectional survey. Front Glob Womens Health 2024; 5:1345153. [PMID: 38784942 PMCID: PMC11111867 DOI: 10.3389/fgwh.2024.1345153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 04/17/2024] [Indexed: 05/25/2024] Open
Abstract
Background Interpersonal violence (IPV) is an issue of major public health concern, with 24% of Kenyan women reporting physical violence perpetrated by a current husband or partner. IPV has profound impacts on physical and mental health outcomes, particularly for pregnant women; it has been found to increase the risk of perinatal mortality, low birth weight, and preterm birth. This study aims to identify variables associated with IPV and assess the effects of IPV experience on prenatal and peripartum maternal healthcare in Migori County, Kenya. Findings build on a previous study that investigated a smaller region of Migori County. Methods Responses to cross-sectional household surveys conducted in six wards of Migori County, Kenya in 2021 from female respondents aged 18 and older were analyzed. The survey contained validated screening tools for interpersonal violence. Group-wise comparisons, and bivariate and multivariate logistic regression analyses were performed to describe community prevalence, factors associated with IPV against women, and the effect of IPV exposure on prenatal and peripartum health care. Results This study finds that 2,306 (36.7%) of the 6,290 respondents had experienced lifetime IPV. IPV experience was associated with the age group 25-49 (adjusted odds ratio (aOR) 1.208; 95%CI: [1.045-1.397]; p = 0.011), monogamous marriage [aOR 2.152; 95%CI: (1.426-3.248); p < 0.001], polygamous marriage [aOR 2.924; 95%CI: (1.826-4.683); p < 0.001], being widowed/divorced/separated [aOR 1.745; 95%CI: (1.094-2.786); p < 0.001], feeling an attitude of "sometimes okay" toward wife beating [aOR 2.002 95%CI: (1.651, 2.428); p < 0.001], having been exposed to IPV in girlhood [aOR 2.525; 95%CI: (2.202-2.896); p < 0.001] and feeling safe in the current relationship [aOR 0.722; 95%CI: (0.609, 0.855); p < 0.001]. A depression score of mild [aOR 1.482; 95%CI: (1.269, 1.73); p < 0.001] and severe [aOR 2.403; 95%CI: (1.429, 4.039); p = 0.001] was also associated with IPV experience, and women who experienced emotional abuse were much more likely to have experienced IPV [aOR 10.462; 95% CI: (9.037, 12.112); p < 0.001]. Adjusted analyses showed that having experienced IPV was negatively associated with attending at least four antenatal care visits during the most recent pregnancy (OR 0.849, p = 0.044) and with having a skilled birth attendant (OR 0.638, p = 0.007). Conclusions IPV is prevalent in Migori County, Kenya, with increased prevalence among women aged 25-49, those residing in West Kanyamkago, those in a monogamous or polygamous marriage, those who have been widowed/divorced/separated, and those with severe depressive symptoms. Further, IPV exposure is associated with lower use of maternal care services and may lead to worse maternal health outcomes. There is need for enhanced effort in addressing social and gender norms that perpetuate IPV, and this study can contribute to guiding policy interventions and community responses towards IPV.
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Affiliation(s)
| | - Joseph R. Starnes
- Department of Pediatrics, Division of Pediatric Cardiology, Vanderbilt University School of Medicine, Nashville, TN, United States
- Lwala Community Alliance, Rongo, Kenya
| | | | - Lou Goore
- Lwala Community Alliance, Rongo, Kenya
| | | | | | | | - Constance S. Shumba
- Division of Epidemiology and Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, United States
| | | | | | - Beffy Vill
- Department of Health Services, Migori County, Kenya
| | | | - Richard G. Wamai
- Department of Cultures, Societies, and Global Studies, Northeastern University, Boston, MA, United States
| | - Lawrence P. O. Were
- Department of Health Sciences & Department of Global Health, Boston University, Boston, MA, United States
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Beck J, Koebach A, Abreu L, Regassa MD, Hoeffler A, Stojetz W, Brück T. COVID-19 Pandemic and Food Insecurity Fuel the Mental Health Crisis in Africa. Int J Public Health 2024; 68:1606369. [PMID: 38283859 PMCID: PMC10811217 DOI: 10.3389/ijph.2023.1606369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 12/18/2023] [Indexed: 01/30/2024] Open
Abstract
Objective: Providing country-level estimates for prevalence rates of Generalized Anxiety Disorder (GAD), COVID-19 exposure and food insecurity (FI) and assessing the role of persistent threats to survival-exemplified by exposure to COVID-19 and FI-for the mental health crisis in Africa. Methods: Original phone-based survey data from Mozambique, Sierra Leone, Tanzania and Uganda (12 consecutive cross-sections in 2021; n = 23,943) were analyzed to estimate prevalence rates of GAD. Logistic regression models and mediation analysis using structural equation models identify risk and protective factors. Results: The overall prevalence of GAD in 2021 was 23.3%; 40.2% in Mozambique, 17.0% in Sierra Leone, 18.0% in Tanzania, and 19.1% in Uganda. Both COVID-19 exposure (ORadj. 1.4; CI 1.3-1.6) and FI (ORadj 3.2; CI 2.7-3.8) are independent and significant predictors of GAD. Thus, the impact of FI on GAD was considerably stronger than that of COVID-19 exposure. Conclusion: Persistent threats to survival play a substantial role for mental health, specifically GAD. High anxiety prevalence in the population requires programs to reduce violence and enhance social support. Even during a pandemic, addressing FI as a key driver of GAD should be prioritized by policymakers.
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Affiliation(s)
- Jule Beck
- Development Research Group, Department of Politics and Public Administration, University of Konstanz, Konstanz, Germany
| | - Anke Koebach
- Development Research Group, Department of Politics and Public Administration, University of Konstanz, Konstanz, Germany
| | - Liliana Abreu
- Development Research Group, Department of Politics and Public Administration, University of Konstanz, Konstanz, Germany
| | | | - Anke Hoeffler
- Development Research Group, Department of Politics and Public Administration, University of Konstanz, Konstanz, Germany
| | - Wolfgang Stojetz
- ISDC—International Security and Development Center, Berlin, Germany
| | - Tilman Brück
- Leibniz Institute of Vegetable and Ornamental Crops, Großbeeren, Germany
- ISDC—International Security and Development Center, Berlin, Germany
- Albrecht Daniel Thaer Institute for Agricultural and Horticultural Sciences, Faculty of Life Sciences, Humboldt University of Berlin, Berlin, Germany
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Belete A, Abate MW, Nigat AB, Tigabu A, Bantie B, Yirga GK, Tiruneh CM, Emiru TD, Tibebu NS, Legas G, Asnakew S, Walle BG, Yitayew MY, Kibret S, Tesema KA. The magnitude of common mental illness and associated factors among adult holy water users in Amhara regional state Orthodox Tewahido churches, Ethiopia, 2021. BMC Psychiatry 2023; 23:53. [PMID: 36658515 PMCID: PMC9850569 DOI: 10.1186/s12888-023-04524-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 01/04/2023] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Because they are prevalent, persistent, and have substantial negative effects on physical health, psychological well-being, and economic implications, common mental illnesses like depression, anxiety, and somatic complaints are major public health problems. Patients with mental illness are devoted to religious therapy including holy water as a coping mechanism for their illnesses. The aim of this study was to investigate the magnitude and associated factors of common mental illness among adult holy water users. METHODS Facility-based cross-sectional study design was conducted in Amhara regional state orthodox Tewahido churches. A simple random sampling techinque was used to select participants. Data were collected by using the Brief Psychiatric Rating Scale for mental illnesses symptoms and a structured interviewer administered questionnaire was used. Data were entered into EpiData version 4.6 and exported to SPSS version 25 for analysis. Variables with a p-value of 0.25 in the bivariable logistic regression were entered into multivariable logistic regression. RESULT Three hundred eighty-two participants were involved in the study. The magnitude of Common mental illnesses among holy water users was 58.9%. Unemployed, using more than one substance, having Poor and moderate social support, current daily alcohol drinker and past history of mental illness were significantly associated with common mental illness. CONCLUSION The magnitude of common mental illness among adult holy water users was high. Giving special attention to decreasing unemployment, establishing social support services, and decreasing substance utilization are the keys to preventing common mental illnesses.
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Affiliation(s)
- Amsalu Belete
- grid.510430.3Department of Psychiatry, College of Health Sciences, Debre Tabor University, P.O.Box:272, Debre Tabor, Ethiopia
| | - Moges Wubneh Abate
- Department of Adult Health Nursing, Debre Tabor University, P.O.Box:272, Debre Tabor, Ethiopia.
| | - Adane Birhanu Nigat
- grid.510430.3Department of Adult Health Nursing, Debre Tabor University, P.O.Box:272, Debre Tabor, Ethiopia
| | - Agimasie Tigabu
- grid.510430.3Department of Adult Health Nursing, Debre Tabor University, P.O.Box:272, Debre Tabor, Ethiopia
| | - Berihun Bantie
- grid.510430.3Department of Adult Health Nursing, Debre Tabor University, P.O.Box:272, Debre Tabor, Ethiopia
| | - Gebrie Kassaw Yirga
- grid.510430.3Department of Adult Health Nursing, Debre Tabor University, P.O.Box:272, Debre Tabor, Ethiopia
| | - Chalie Marew Tiruneh
- grid.510430.3Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, P.O.Box:272, Debre Tabor, Ethiopia
| | - Tigabu Desie Emiru
- grid.510430.3Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, P.O.Box:272, Debre Tabor, Ethiopia
| | - Nigusie Selomon Tibebu
- grid.510430.3Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, P.O.Box:272, Debre Tabor, Ethiopia
| | - Getasew Legas
- grid.510430.3Department of Psychiatry, College of Health Sciences, Debre Tabor University, P.O.Box:272, Debre Tabor, Ethiopia
| | - Sintayehu Asnakew
- grid.510430.3Department of Psychiatry, College of Health Sciences, Debre Tabor University, P.O.Box:272, Debre Tabor, Ethiopia
| | - Belete Gelaw Walle
- Department of Pediatrics and Child Health Nursing, College of Health Sciences, Wolayta Sodo University, Wolayta, Ethiopia
| | | | - Simegnew Kibret
- grid.510430.3Department of Anesthesia, College of Health Sciences, Debre Tabor University, P.O.Box:272, Debre Tabor, Ethiopia
| | - Kassa Abebaw Tesema
- grid.449044.90000 0004 0480 6730Department of Human Physiology, School of Medicine, Debre Markos University, Debre Tabor, Ethiopia
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Psychometric evaluation of the PHQ-9 in university students: Factorial validity and measurement equivalence across three African countries. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-02997-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Muze M, Denur M, Hussein M, Muzemil M, Yesse M, Kedir S. Prevalence and Associated Factors of Common Mental Disorders Among Adult Residents in Silte Zone, Southern Ethiopia. Clin Pract Epidemiol Ment Health 2021; 17:128-135. [PMID: 34880924 PMCID: PMC8595979 DOI: 10.2174/1745017902117010128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 08/16/2021] [Accepted: 08/17/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Mental health problems appear to be increasing in importance in Africa. Mental and substance use disorders were the leading cause of yearly lived with disability in Sub-Saharan Africa. Evidence from previous studies shows considerable variation in the prevalence of these disorders. The most acceptable explanation for this wide variation is likely to be the fact that socio cultural factors are major determinants of mental disorders. Therefore a mental disorder has to be understood in a specific setting to develop effective and tailored interventions. OBJECTIVE The objective of this study was to determine the prevalence and associated factors of common mental disorders among adult residents in Silte Zone, southern Ethiopia. METHODS Community based cross-sectional study was conducted in the study area. A total of 1178 adults were selected by using a three-stage systematic sampling technique. The Self-Reporting Questionnaire (SRQ-20) was used to determine the prevalence of common mental disorders. Data were analyzed by using SPSS version 20. Both bivariate and multiple logistic regression analyses were employed to identify factors associated with common mental disorders. RESULTS The prevalence of common mental disorders among adults found to be 39.7%. Increased age (OR = 1.114; 95% CI = 1.095, 1.134), being female (OR = 9.421; 95% CI = 5.947, 14.926), poor social support (OR = 1.987; 95% CI = 1.358, 2.907) and having life threatening experience (OR = 2.162; 95% CI = 1.825, 2.562) were significantly associated with common mental disorders. CONCLUSION In the study, the magnitude of common mental disorders remains high in the study area. Increased age, being female, poor social support and having life-threatening experience were significantly associated with common mental disorders.
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Affiliation(s)
- Mohammed Muze
- Department of Nursing, College of Medicine and Health Sciences, Werabe University, Southern Ethiopia
| | - Mehbub Denur
- Department of psychiatry, Werabe Comprehensive Specialized Hospital, Southern Ethiopia
| | - Mubarek Hussein
- Department of Quality Assurance, Werabe Comprehensive Specialized Hospital, Southern Ethiopia
| | - Mufta Muzemil
- Department of Nursing, College of Medicine and Health Sciences, Werabe University, Southern Ethiopia
| | - Mubarek Yesse
- Department of Public Health, Collage of Medicine and Health Sciences, Werabe University, Southern Ethiopia
| | - Shemsu Kedir
- Department of Public Health, Collage of Medicine and Health Sciences, Werabe University, Southern Ethiopia
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Shah SSNH, Laving A, Okech-Helu VC, Kumar M. Depression and its associated factors: perceived stress, social support, substance use and related sociodemographic risk factors in medical school residents in Nairobi, Kenya. BMC Psychiatry 2021; 21:444. [PMID: 34496834 PMCID: PMC8425003 DOI: 10.1186/s12888-021-03439-0] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 08/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Little data exists regarding depression and its associated factors in medical residents and doctors in Sub-Saharan Africa. Residents are at high risk of developing depression owing to the stressful nature of their medical practice and academic training. Depression in medical residents leads to decreased clinical efficiency, and poor academic performance; it can also lead to substance abuse and suicide. Our primary aim was to measure depression prevalence among medical residents in Kenya's largest national teaching and referral hospital. Secondary aims were to describe how depression was associated with perceived stress, perceived social support, substance use, and educational environment. METHODS We sampled 338 residents belonging to 8 different specialties using self administered questionnaires in this cross-sectional survey between October 2019 and February 2020. Questionnaires included: sociodemographics, the Centres for Epidemiology Depression Scale - Revised, Perceived Stress Scale, Multidimensional Scale of Perceived Social Support, Alcohol, Smoking and Substance Involvement Screening Test, and Postgraduate Hospital Educational Environment Measure. Bivariate and multivariate linear regression were used to assess for risk factors for depression. RESULTS Mean participant age was 31.8 years and 53.4% were males. Most residents (70.4%) reported no to mild depressive symptoms, 12.7% had moderate, and 16.9% had severe depressive symptoms. Most residents had high social support (71.8%) and moderate stress (61.6%). The educational environment was rated as more positive than negative by 46.3% of residents. Bivariate analyses revealed significant correlations between depressive symptoms, perceived stress, substance use, perceived social support, and educational environment. Multivariate analysis showed that depression was strongly associated with: fewer hours of sleep (β = - 0.683, p = 0.002), high perceived stress (β = 0.709, p < 0.001) and low perceived social support (β = - 2.19, p < 0.001). CONCLUSIONS Only 30% of medical residents in our study had moderate and severe depressive symptoms. Most residents in our study reported high levels of social support, and moderate levels of stress. Though their overall appraisal of medical residency experience was positive, mental health support and self-care skills in the training of medical professionals needs prioritization.
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Affiliation(s)
| | - Ahmed Laving
- Department of Paediatrics and Child Health, Kenyatta National Hospital, University of Nairobi, Nairobi, Kenya
| | | | - Manasi Kumar
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya
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Bezerra HDS, Alves RM, Nunes ADD, Barbosa IR. Prevalence and Associated Factors of Common Mental Disorders in Women: A Systematic Review. Public Health Rev 2021; 42:1604234. [PMID: 34692182 PMCID: PMC8419231 DOI: 10.3389/phrs.2021.1604234] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 08/06/2021] [Indexed: 11/20/2022] Open
Abstract
Objectives: To identify the prevalence and factors associated with common mental disorders in adult women. Methods: Searches were carried out in the PubMed, Web of Science, Science Direct, Scopus, Cinahl, Google Scholar and Open Gray databases. The study protocol was registered with PROSPERO under number CRD42020168231. Cross-sectional studies showing the prevalence of common mental disorders in women over 18 years were included. Studies with men, children and pregnant women of another age group and with other mental disorders and other types of studies were excluded. The Joanna Briggs Institute checklist was used to assess the risk of bias. Results: Nineteen studies were included in this review. The prevalence of CMD ranged from 9.6% to 69.3%. The main associated factors were unemployment, indebtedness, low income, being a housewife, smoking, low education, poor self-rated health, being single, divorced or widowed. The risk of bias in the studies was classified as low and moderate. Conclusion: This review revealed a variable prevalence rate of CMD in adult women. Public policies are needed to create strategies to prevent the mental illness of these women.
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Greene MC, Yangchen T, Lehner T, Sullivan PF, Pato CN, McIntosh A, Walters J, Gouveia LC, Msefula CL, Fumo W, Sheikh TL, Stockton MA, Wainberg ML, Weissman MM. The epidemiology of psychiatric disorders in Africa: a scoping review. Lancet Psychiatry 2021; 8:717-731. [PMID: 34115983 PMCID: PMC9113063 DOI: 10.1016/s2215-0366(21)00009-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/07/2021] [Accepted: 01/08/2021] [Indexed: 01/12/2023]
Abstract
This scoping review of population-based epidemiological studies was done to provide background information on the prevalences and distribution of psychiatric disorders in Africa for calls to broaden diversity in psychiatric genetic studies. We searched PubMed, EMBASE, and Web of Science to retrieve relevant literature in English, French, and Portuguese from Jan 1, 1984, to Aug 18, 2020. In 36 studies from 12 African countries, the lifetime prevalence ranged from 3·3% to 9·8% for mood disorders, from 5·7% to 15·8% for anxiety disorders, from 3·7% to 13·3% for substance use disorders, and from 1·0% to 4·4% for psychotic disorders. Although the prevalence of mood and anxiety disorders appears to be lower than that observed in research outside the continent, we identified similar distributions by gender, although not by age or urbanicity. This review reveals gaps in epidemiological research on psychiatric disorders and opportunities to leverage existing epidemiological and genetic research within Africa to advance our understanding of psychiatric disorders. Studies that are methodologically comparable but diverse in geographical context are needed to advance psychiatric epidemiology and provide a foundation for understanding environmental risk in genetic studies of diverse populations globally.
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Affiliation(s)
- M Claire Greene
- Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Tenzin Yangchen
- Division of Translational Epidemiology, Department of Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - Thomas Lehner
- New York Genome Center, New York, NY, USA; Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA
| | - Patrick F Sullivan
- Center for Psychiatric Genomics, Department of Genetics, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Carlos N Pato
- Institute for Genomic Health, SUNY Downstate, Health Science University, Brooklyn, NY, USA
| | - Andrew McIntosh
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
| | - James Walters
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Lidia C Gouveia
- Department of Mental Health, Ministry of Health-Mozambique, Maputo, Mozambique
| | - Chisomo L Msefula
- Pathology Department, College of Medicine, University of Malawi, Chichiri, Blantyre, Malawi
| | - Wilza Fumo
- Department of Mental Health, Ministry of Health-Mozambique, Maputo, Mozambique
| | - Taiwo L Sheikh
- Department of Psychiatry, College of Medical Sciences, Ahmadu Bello University, Zaria, Nigeria
| | - Melissa A Stockton
- Division of Translational Epidemiology, Department of Psychiatry, New York State Psychiatric Institute, New York, NY, USA; Columbia University Vagelos College of Physicians and Surgeons; New York State Psychiatric Institute, New York, NY, USA
| | - Milton L Wainberg
- Division of Translational Epidemiology, Department of Psychiatry, New York State Psychiatric Institute, New York, NY, USA; Columbia University Vagelos College of Physicians and Surgeons; New York State Psychiatric Institute, New York, NY, USA
| | - Myrna M Weissman
- Division of Translational Epidemiology, Department of Psychiatry, New York State Psychiatric Institute, New York, NY, USA; Columbia University Vagelos College of Physicians and Surgeons; New York State Psychiatric Institute, New York, NY, USA.
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Laurenzi CA, Hunt X, Skeen S, Sundin P, Weiss RE, Kosi V, Rotheram-Borus MJ, Tomlinson M. Associations between caregiver mental health and young children's behaviour in a rural Kenyan sample. Glob Health Action 2021; 14:1861909. [PMID: 33397222 PMCID: PMC7801103 DOI: 10.1080/16549716.2020.1861909] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background: Research shows that caregiver mental health problems have direct, significant effects on child behaviour. While these risks are amplified in low-resource settings, limited evidence exists from these places, especially sub-Saharan Africa. Objective: We measured associations between caregiver mental health and child behaviour in a rural Kenyan sample, hypothesizing that higher rates of caregiver mental health would be associated with increased child behavioural problems. We also sought to provide an overview of caregiver mental health symptoms in our sample. Method: Cross-sectional data were collected from caregivers of children ages 4–5 years old enrolled in a community-based early child development programme in western Kenya. 465 caregivers were recruited and assessed at baseline, and answered questions about child behaviour, mental health symptoms (depression, anxiety, stress), and help-seeking. A multivariate linear regression model was used to assess significance of each mental health factor. Results: Caregiver anxiety (p = 0.01) and parenting stress (p < 0.001) were significantly associated with child behavioural problems. 245 caregivers (52.9%) had high levels of symptoms of depression, anxiety, or both; furthermore, 101 caregivers (21.7%) scored above the cut-off for both of these scales. A high proportion of our sample (60.6%) reported seeking some formal or informal psychosocial support services; however, less than one-third of these caregivers were symptomatic (30.9%). Conclusion: Anxiety and stress were associated with poorer child behavioural outcomes. Our sample reflected a higher prevalence of caregiving adults with mental health symptomology than previous estimates from Kenya, with few high-symptom caregivers seeking support. We discuss further implications for programming and health services delivery.
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Affiliation(s)
- Christina A Laurenzi
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University , Stellenbosch, South Africa
| | - Xanthe Hunt
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University , Stellenbosch, South Africa
| | - Sarah Skeen
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University , Stellenbosch, South Africa
| | - Phillip Sundin
- Department of Biostatistics, Fielding School of Public Health, University of California , Los Angeles, CA, USA
| | - Robert E Weiss
- Department of Biostatistics, Fielding School of Public Health, University of California , Los Angeles, CA, USA
| | | | - Mary Jane Rotheram-Borus
- Department of Biostatistics, Fielding School of Public Health, University of California , Los Angeles, CA, USA
| | - Mark Tomlinson
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University , Stellenbosch, South Africa.,School of Nursing and Midwifery, Queens University , Belfast, UK
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Reframing Non-Communicable Diseases and Injuries for Equity in the Era of Universal Health Coverage: Findings and Recommendations from the Kenya NCDI Poverty Commission. Ann Glob Health 2021; 87:3. [PMID: 33505862 PMCID: PMC7792462 DOI: 10.5334/aogh.3085] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background Kenya has implemented a robust response to non-communicable diseases and injuries (NCDIs); however, key gaps in health services for NCDIs still exist in the attainment of Universal Health Coverage (UHC). The Kenya Non-Communicable Diseases and Injury (NCDI) Poverty Commission was established to estimate the burden of NCDIs, determine the availability and coverage of health services, prioritize an expanded set of NCDI conditions, and propose cost-effective and equity-promoting interventions to avert the health and economic consequences of NCDIs in Kenya. Methods Burden of NCDIs in Kenya was determined using desk review of published literature, estimates from the Global Burden of Disease Study, and secondary analysis of local health surveillance data. Secondary analysis of nationally representative surveys was conducted to estimate current availability and coverage of services by socioeconomic status. The Commission then conducted a structured priority setting process to determine priority NCDI conditions and health sector interventions based on published evidence. Findings There is a large and diverse burden of NCDIs in Kenya, with the majority of disability-adjusted life-years occurring before age of 40. The poorest wealth quintiles experience a substantially higher deaths rate from NCDIs, lower coverage of diagnosis and treatment for NCDIs, and lower availability of NCDI-related health services. The Commission prioritized 14 NCDIs and selected 34 accompanying interventions for recommendation to achieve UHC. These interventions were estimated to cost $11.76 USD per capita annually, which represents 15% of current total health expenditure. This investment could potentially avert 9,322 premature deaths per year by 2030. Conclusions and Recommendations An expanded set of priority NCDI conditions and health sector interventions are required in Kenya to achieve UHC, particularly for disadvantaged socioeconomic groups. We provided recommendations for integration of services within existing health services platforms and financing mechanisms and coordination of whole-of-government approaches for the prevention and treatment of NCDIs.
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Smit M, Perez-Guzman PN, Mutai KK, Cassidy R, Kibachio J, Kilonzo N, Hallett TB. Mapping the Current and Future Noncommunicable Disease Burden in Kenya by Human Immunodeficiency Virus Status: A Modeling Study. Clin Infect Dis 2020; 71:1864-1873. [PMID: 31734688 PMCID: PMC8240998 DOI: 10.1093/cid/ciz1103] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 11/11/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The noncommunicable disease (NCD) burden in Kenya is not well characterized, despite estimates needed to identify future health priorities. We aimed to quantify current and future NCD burden in Kenya by human immunodeficiency virus (HIV) status. METHODS Original systematic reviews and meta-analyses of prevalence/incidence of cardiovascular disease (CVD), chronic kidney disease, depression, diabetes, high total cholesterol, hypertension, human papillomavirus infection, and related precancerous stages in Kenya were carried out. An individual-based model was developed, simulating births, deaths, HIV disease and treatment, aforementioned NCDs, and cancers. The model was parameterized using systematic reviews and epidemiological national and regional surveillance data. NCD burden was quantified for 2018-2035 by HIV status among adults. RESULTS Systematic reviews identified prevalence/incidence data for each NCD except ischemic heart disease. The model estimates that 51% of Kenyan adults currently suffer from ≥1 NCD, with a higher burden in people living with HIV (PLWH) compared to persons not living with HIV (62% vs 51%), driven by their higher age profile and partly by HIV-related risk for NCDs. Hypertension and high total cholesterol are the main NCD drivers (adult prevalence of 20.5% [5.3 million] and 9.0% [2.3 million]), with CVD and cancers the main causes of death. The burden is projected to increase by 2035 (56% in persons not living with HIV; 71% in PLWH), with population growth doubling the number of people needing services (15.4 million to 28.1 million) by 2035. CONCLUSIONS NCD services will need to be expanded in Kenya. Guidelines in Kenya already support provision of these among both the general and populations living with HIV; however, coverage remains low.
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Affiliation(s)
- Mikaela Smit
- Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Pablo N Perez-Guzman
- Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | | | - Rachel Cassidy
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Joseph Kibachio
- Division of Noncommunicable Diseases, Ministry of Health, Nairobi, Kenya
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | | | - Timothy B Hallett
- Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
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Sanhori Z, Hauff E, Eide AH, Mdala I, Abdelrahman A, Brunborg C, Lien L. Changes in prevalence of mental disorders among internally displaced persons in central Sudan: a 1-year follow-up study. Glob Ment Health (Camb) 2020; 7:e24. [PMID: 32963796 PMCID: PMC7490769 DOI: 10.1017/gmh.2020.16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 07/14/2020] [Accepted: 08/03/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Sudan has one of the largest numbers of internally displaced persons (IDPs) in the world, estimated at five million. The main cause of displacement was the civil war. Attention to the health and in particular the mental health of IDPs has been lacking. That includes limited population longitudinal data describing the "natural" fluctuations of mental morbidity among these groups. The aim of this study is to investigate the level and stability of mental disorders among IDPs over a 1-year period. METHOD In this 1-year follow-up of IDPs in two settlement areas in central Sudan, 1549 persons 18 years or older were interviewed twice using the MINI International Neuropsychiatric Interview. Trained psychologists collected the data in a random household survey in the selected IDP areas. RESULTS We found overall high stability among those having and those free of mental disorders in this 1-year follow-up study. There were, however, discernible and statistically significant increases in overall new cases of mental disorders from T1 to T2 as major depression increased by 1.4%, generalized anxiety by 2.8% and social phobia by 1.4%. CONCLUSION The study revealed continued high levels and increases of mental disorders over time, although with a pattern of substantial persistence among those initially ill and limited recovery. This might be due to a complex set of factors such as unavailability of mental health services, poverty, low educational level and social exclusion.
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Affiliation(s)
- Zienat Sanhori
- Federal Ministry of Health, Khartoum, Sudan, P.O. Box 303 Khartoum, Sudan
- Institute of Clinical Medicine, Division of Mental Health and Addiction, University of Oslo, Oslo, Norway
| | - Edvard Hauff
- Institute of Clinical Medicine, Division of Mental Health and Addiction, University of Oslo, Oslo, Norway
- Unit for Education and Professional Development, Oslo University Hospital, Norway
| | - Arne H. Eide
- SINTEF Digital, Health Research. P.O.Box 124, 0314 Blindern, Oslo, Norway
| | - Ibrahimu Mdala
- Department of General Practice, Institute of Health and Society, University of Oslo, Norway, P.O. Box 1130, 0318 Blindern, Norway
| | - Abdullah Abdelrahman
- Department of Psychiatry, University of Khartoum. P.O. Box 102, Elgasr Street, Khartoum11115, Sudan
| | - Cathrine Brunborg
- Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University, Oslo, Norway
| | - Lars Lien
- Department of Health and Social Sciences, Innlandet University College, P.O. Box 400, 2418 Elverum, Norway
- Innlandet Hospital Trust, PO Box 104, 2381 Brumunddal, Norway
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Coelho JMF, Miranda SS, Cruz SS, Santos DN, Trindade SC, Cerqueira EDMM, Passos‐Soares JDS, Costa MDCN, Figueiredo ACMG, Hintz AM, Almeida ARB, Pereira MN, Souza NM, Barreto ML, Gomes‐Filho IS. Common mental disorder is associated with periodontitis. J Periodontal Res 2020; 55:221-228. [DOI: 10.1111/jre.12705] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 08/13/2019] [Accepted: 09/18/2019] [Indexed: 01/06/2023]
Affiliation(s)
- Julita Maria F. Coelho
- Department of Biological Sciences Feira de Santana State University Bahia Brazil
- Department of Health Feira de Santana State University Bahia Brazil
| | | | - Simone S. Cruz
- Department of Health Feira de Santana State University Bahia Brazil
- Department of Epidemiology Federal University of Recôncavo of Bahia Bahia Brazil
| | - Darci N. Santos
- Department of Epidemiology Collective Health Institute Federal University of Bahia Salvador Brazil
| | | | | | - Johelle de S. Passos‐Soares
- Department of Health Feira de Santana State University Bahia Brazil
- Department of Preventive Dentistry Federal University of Bahia Salvador Brazil
| | | | | | | | - Alba R. B. Almeida
- Department of Education/Psychology State University of Bahia Bahia Brazil
| | | | - Nayra M. Souza
- Department of Health Feira de Santana State University Bahia Brazil
| | - Maurício L. Barreto
- Department of Epidemiology Collective Health Institute Federal University of Bahia Salvador Brazil
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Tuthill EL, Miller JD, Collins SM, Widen EM, Onono M, Young SL. HIV infection, hunger, breastfeeding self-efficacy, and depressive symptoms are associated with exclusive breastfeeding to six months among women in western Kenya: a longitudinal observational study. Int Breastfeed J 2020; 15:4. [PMID: 31948438 PMCID: PMC6966845 DOI: 10.1186/s13006-019-0251-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 12/20/2019] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Exclusive breastfeeding for the first six months of life is recommended for all infants. However, breastfeeding rates remain suboptimal; around 37% of infants are exclusively breastfed for the first six months globally. In Nyanza region, western Kenya, numerous challenges to breastfeeding have been identified, including food insecurity, hunger, depressive symptoms, and HIV infection. Yet, evidence to inform our understanding of how these problems influence women's breastfeeding behaviors across time is lacking. We therefore sought to examine these factors and how they interact to affect the initiation and duration of exclusive breastfeeding in this region. We hypothesized that women experiencing greater food insecurity, hunger, and/or depressive symptoms would be less likely to maintain exclusive breastfeeding for six months than women who were food secure or not depressed. We also hypothesized that women living with HIV would be more likely to maintain exclusive breastfeeding to six months compared to HIV-uninfected women. METHODS Women in Pith Moromo, a longitudinal cohort study in western Kenya, were surveyed at two antenatal and three postpartum timepoints (n = 275). Data were collected on breastfeeding behavior and self-efficacy, maternal food insecurity and hunger, maternal psychosocial health, and HIV status. Cox proportional hazards models were used to identify predictors of early exclusive breastfeeding cessation. RESULTS The majority of women (52.3%) exclusively breastfed for the first six months. In the final multivariable Cox proportional hazards model, living with HIV was associated with a 64% decrease in the rate of early exclusive breastfeeding cessation. Additionally, the rate of early exclusive breastfeeding cessation increased by 100 and 98% for those experiencing probable depression or hunger, respectively. Although there was no main effect of breastfeeding self-efficacy, the interaction between breastfeeding self-efficacy and hunger was significant, such that the rate of early exclusive breastfeeding cessation was predicted to decrease by 2% for every point increase in breastfeeding self-efficacy score (range: 0-56). CONCLUSIONS This study contributes to previous work demonstrating that women living with HIV more consistently exclusively breastfeed and suggests that rates of exclusive breastfeeding could be increased through targeted support that promotes maternal mental health and breastfeeding self-efficacy, while reducing maternal hunger. TRIAL REGISTRATION Study registration NCT02974972.
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Affiliation(s)
- Emily L Tuthill
- Department of Community Health Systems, School of Nursing, University of California, San Francisco, San Francisco, CA, USA
| | - Joshua D Miller
- Department of Anthropology, Northwestern University, Evanston, IL, USA
| | - Shalean M Collins
- Department of Anthropology, Northwestern University, Evanston, IL, USA
| | - Elizabeth M Widen
- Department of Nutritional Sciences, College of Natural Sciences, University of Texas at Austin, Austin, TX, USA
| | - Maricianah Onono
- Center for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Sera L Young
- Department of Anthropology, Northwestern University, Evanston, IL, USA.
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Prévalence des troubles mentaux en population générale au Burkina Faso. Encephale 2019; 45:367-370. [DOI: 10.1016/j.encep.2018.03.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 02/25/2018] [Accepted: 03/01/2018] [Indexed: 11/22/2022]
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Kajawu L, Chiweshe M, Mapara J. Community Perceptions of Indigenous Healers and Mental Disorders in Zimbabwe. ACTA ACUST UNITED AC 2019. [DOI: 10.4236/ojpsych.2019.93015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Malaria, mental disorders, immunity and their inter-relationships - A cross sectional study in a household population in a health and demographic surveillance site in Kenya. EBioMedicine 2018; 39:369-376. [PMID: 30552065 PMCID: PMC6355657 DOI: 10.1016/j.ebiom.2018.11.064] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 11/25/2018] [Accepted: 11/30/2018] [Indexed: 01/07/2023] Open
Abstract
Background Both malaria and mental disorders are associated with immune changes. We have previously reported the associations between malaria and mental disorders. We now report associations between malaria, mental disorders and immunity. Methods A household survey of malaria, mental disorders and immunity was conducted in a health and demographic surveillance system's site of 70,000 population in an area endemic for malaria in western Kenya. A random sample of 1190 adults was selected and approached for consent, blood samples and structured interview. Findings We found marginally raised CD4/CD3 ratios of participants with malaria parasites, but no difference in CD4/CD3 ratios for participants with common mental disorder (CMD) or psychotic symptoms. People with psychotic symptoms had increased levels of IL-6, IL-8, and IL-10, and lower levels of IL-1beta. People with CMD had higher levels of IL-8 and IL-10. People with malaria had higher levels of IL-10 and lower levels of TNF-alpha. At the bivariate level, CMD was associated with log TNF-α levels using unadjusted odds ratios, but not after adjusting for malaria. Psychotic symptoms were associated with log IL-10 and log TNF-α levels at the bivariate level while in the adjusted analysis, log TNF-α levels remained highly significant.. Interpretation This is the first population based study of immune markers in CMD and psychotic symptoms, and the first to examine the 3 way relationship with malaria. Our findings suggest that TNF-α may mediate the relationship between malaria and CMD. Fund The study was funded by UK Aid, Department for International Development, Kenya office.
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Kumar M, Kuria MW, Othieno CJ, Falkenström F. Improving psychotherapies offered in public hospitals in Nairobi, Kenya: extending practice-based research model for LMICs. Int J Ment Health Syst 2018; 12:76. [PMID: 30555529 PMCID: PMC6288907 DOI: 10.1186/s13033-018-0254-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 11/24/2018] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Psychotherapy and mental health services in Nairobi's public hospitals are increasing. Rather than prematurely imposing psychotherapy protocols developed in Western countries to Kenya, we argue that first studying psychological interventions as they are practiced may generate understanding of which psychological problems are common, what interventions therapists use, and what seems to be effective in reducing psychiatric problems in a lower and middle income country like Kenya. METHOD We present preliminary findings from a process-outcome study involving 345 patients from two public institutions, Kenyatta National and Mathare National Hospitals. We asked our patients to fill out a brief personal information questionnaire, Clinical Outcomes in Routine Evaluation-Outcome Measure (Evans et al. in Br J Psychiatry 180:51-60, 2002, and the Session Alliance Inventory (Falkenström et al. in Psychol Assess 27:169-183, 2015) after each session. We present descriptives for CORE-OM, patient-therapist concordance on the SAI, and using longitudinal mixed-effects model, test change in CORE-OM over time with various therapy and patient factors as predictors in regression analyses. RESULTS The majority of patients who attended the outpatient care clinics were young males. Our regression analysis suggested that patients with depression reported higher initial distress levels (2.75 CORE-OM scores, se = 1.11, z = 2.48, p = 0.013, 95% CI 0.57-4.93) than patients with addictions, anxiety, or psychosis. Older clients improved slower (0.08 CORE-OM scores slower improvement per session per year older age; se = 0.03, z = 3.02 p = 0.003, 95% CI 0.03, 0.14). Female patients reported higher initial distress than men (2.62 CORE-OM scores, se = 1.00, z = 2.61, p = 0.009, 95% CI 0.65, 4.58). However, interns had patients who reported significantly higher initial distress (3.24 CORE-OM points, se = 0.90, z = 3.60, p < 0.001, 95% CI 1.48, 5.00), and improved more over time (- 1.20 CORE-OM scores per session, se = 0.51, z = - 2.35, p = 0.019, 95% CI - 2.20, - 0.20) than patients seeing mental health practitioners. The results showed that at average alliance, CORE-OM decreased by 1.74 points per session (se = 0.21, p < 0.001). For each point higher on the SAI at session 2, the CORE-OM decreased by an additional 0.58 points per session (se = 0.25, p = 0.02). DISCUSSION Our objective was to study psychotherapies as they are practiced in naturalistic settings. The overall significant finding is that our participants report improvement in their functioning mental health condition and distress reduced as psychotherapy progressed. There were many more male than female participants in our sample; younger patients improved more than older ones; and while interns had patients with higher distress, their patients improved better than those patients attended by professionals. CONCLUSIONS These are preliminary observations to consider for a larger sample follow-up study. Before changing practices, evaluating the existing practices by mapping clinical outcomes is a helpful route.
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Affiliation(s)
- Manasi Kumar
- Department of Psychiatry, College of Health Sciences, University of Nairobi, P.O. Box 19676, Nairobi, 00202 Kenya
- Research Department of Clinical Health and Educational Psychology, University College London, Gower Street, London, WC1E 6BT UK
| | - Mary Wangari Kuria
- Department of Psychiatry, College of Health Sciences, University of Nairobi, P.O. Box 19676, Nairobi, 00202 Kenya
| | - Caleb Joseph Othieno
- Department of Psychiatry, College of Health Sciences, University of Nairobi, P.O. Box 19676, Nairobi, 00202 Kenya
| | - Fredrik Falkenström
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
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de Vries E, Rincon CJ, Tamayo Martínez N, Rodriguez N, Tiemeier H, Mackenbach JP, Gómez-Restrepo C, Guarnizo-Herreño CC. Housing index, urbanisation level and lifetime prevalence of depressive and anxiety disorders: a cross-sectional analysis of the Colombian national mental health survey. BMJ Open 2018; 8:e019065. [PMID: 29880561 PMCID: PMC6009503 DOI: 10.1136/bmjopen-2017-019065] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES To study socioeconomic inequalities in mental health in rural and urban Colombia, a country with a history of internal conflict and large socioeconomic inequalities. Recent survey data are available to study this understudied topic in a middle-income country. METHODS Using data from 9656 respondents from the 2015 Colombian Mental Health survey, we investigated the association between lifetime prevalence of depressive and anxiety disorders and quality of dwellings and access to public services housing score (HS). We calculated the relative index of inequality (RII) and slope index of inequality (SII) for HS in urban and rural areas, adjusting for potential confounders and mediating factors. OUTCOMES The lifetime prevalence of anxiety and depression (combined) was 9.6% in urban versus 6.9% in rural areas (p<0.001). HS was not associated with prevalence of anxiety and depression in urban settings, whereas a higher HS (poorer housing quality) was associated with fewer mental disorders in rural areas in both univariate and multivariate models (multivariate RIIurban0.96 (95% CI 0.51 to 1.81); RIIrural0.11 (95% CI 0.04 to 0.32)). In rural areas, the prevalence of mental health problems was 12% points lower in persons living in the poorest quality dwellings than in those living in high-quality dwellings (SII -0.12 (95% CI -0.18 to -0.06)). Interestingly, within rural areas, persons living in 'populated centres' (small towns, villages) had a higher lifetime prevalence of any mental health disorder (9.8% (95% CI 6.9 to 13.6)) compared with those living in more isolated, dispersed areas (6.0% (95% CI 4.6 to 7.7)). INTERPRETATION In rural Colombia, those living in the poorest houses and in dispersed areas had a lower prevalence of mental health problems. Further understanding of this phenomenon of a seemingly inverse association of prevalence of mental disorders with poverty and/or urbanisation in rural areas is needed. Particularly, considering the progressive urbanisation process in Colombia, it is important to monitor mental health in populations migrating to the cities.
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Affiliation(s)
- Esther de Vries
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogota, Colombia
| | - Carlos Javier Rincon
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogota, Colombia
| | - Nathalie Tamayo Martínez
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogota, Colombia
| | - Nelcy Rodriguez
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogota, Colombia
| | - Henning Tiemeier
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Johan P Mackenbach
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Carlos Gómez-Restrepo
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogota, Colombia
- Department of Psychiatry and Mental Health, Hospital Universitario San Ignacio, Bogota, Colombia
| | - Carol C Guarnizo-Herreño
- Departamento de Salud Colectiva, Facultad de Odontología, Universidad Nacional de Colombia, Bogota, Colombia
- Department of Epidemiology and Public Health, University College London, London, UK
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Jenkins R, Othieno C, Ongeri L, Ongecha M, Sifuna P, Omollo R, Ogutu B. Malaria and mental disorder: a population study in an area endemic for malaria in Kenya. World Psychiatry 2017; 16:324-325. [PMID: 28941104 PMCID: PMC5608856 DOI: 10.1002/wps.20473] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Affiliation(s)
- Rachel Jenkins
- Health Services and Population Research DepartmentInstitute of Psychiatry, King's College LondonLondonUK
| | - Caleb Othieno
- Department of PsychiatryUniversity of NairobiNairobiKenya
| | | | | | - Peter Sifuna
- Kombewa Health and Demographic Surveillance SiteKombewaKenya
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Kwobah E, Epstein S, Mwangi A, Litzelman D, Atwoli L. PREVALENCE of psychiatric morbidity in a community sample in Western Kenya. BMC Psychiatry 2017; 17:30. [PMID: 28100210 PMCID: PMC5242046 DOI: 10.1186/s12888-017-1202-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 01/10/2017] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND About 25% of the worldwide population suffers from mental, neurological and substance use disorders but unfortunately, up to 75% of affected persons do not have access to the treatment they need. Data on the magnitude of the mental health problem in Kenya is scarce. The objectives of this study were to establish the prevalence and the socio-demographic factors associated with mental and substance use disorders in Kosirai division, Nandi County, Western Kenya. METHODS This was a cross sectional descriptive study in which participants were selected by simple random sampling. The sampling frame was obtained from a data base of the population in the study area developed during door-to-door testing and counseling exercises for HIV/AIDS. Four hundred and twenty consenting adults were interviewed by psychologists using the Mini International Neuropsychiatric Interview Version 7 for Diagnostic and Statistical Manual 5th Edition and a researcher-designed social demographic questionnaire. RESULTS One hundred and ninety one (45%) of the participants had a lifetime diagnosis of at least one of the mental disorders. Of these, 66 (15.7%) had anxiety disorder, 53 (12.3%) had major depressive disorder; 49 (11.7%) had alcohol and substance use disorder. 32 (7.6%) had experienced a psychotic episode and 69 (16.4%) had a life-time suicidal attempt. Only 7 (1.7%) had ever been diagnosed with a mental illness. Having a mental condition was associated with age less than 60 years and having a medical condition. CONCLUSION A large proportion of the community has had a mental disorder in their lifetime and most of these conditions are undiagnosed and therefore not treated. These findings indicate a need for strategies that will promote diagnosis and treatment of community members with psychiatric disorders. In order to screen more people for mental illness, we recommend further research to evaluate a strategy similar to the home based counseling and testing for HIV and the use of simple screening tools.
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Affiliation(s)
- Edith Kwobah
- Department of Mental Health, Moi University School of Medicine and Moi Teaching and Referral Hospital, PO Box 3, 30100 Eldoret, Kenya
- Department of Psychiatry, Georgetown University, 3800 reservoir Rd NW, Washington, DC 20007 USA
| | - Steve Epstein
- Department of behavioral Sciences, Moi University School of Medicine, P.O Box 4606, Eldoret, Kenya
| | - Ann Mwangi
- Department of Psychiatry, Georgetown University, 3800 reservoir Rd NW, Washington, DC 20007 USA
| | - Debra Litzelman
- Department of Medicine, Indiana University School of medicine, 002 Wishard Blvd 4, Indianapolis, IN 46202 USA
| | - Lukoye Atwoli
- Department of Psychiatry, Georgetown University, 3800 reservoir Rd NW, Washington, DC 20007 USA
- Department of Mental Health, Moi University School of Medicine, P.O Box 4606, Eldoret, Kenya
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