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Kirabira J, Kagoya EK, Mpagi J, Atala CE, Ndamanywa K, Okibure A, Kibuuka R, Katongole F, Wandabwa J. Burden of alcohol and other substance use and correlates among undergraduate students at Busitema University in rural Eastern Uganda after COVID-19 lockdown. Sci Rep 2024; 14:6194. [PMID: 38486017 PMCID: PMC10940298 DOI: 10.1038/s41598-024-56861-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 03/12/2024] [Indexed: 03/18/2024] Open
Abstract
Use of alcohol and other substances remains a major health concern among higher learning institutions. This study aimed at assessing the prevalence of alcohol and other substance use among students at Busitema University in Eastern Uganda. A cross sectional survey was conducted among 658 undergraduate students using a questionnaire consisting of Alcohol, Smoking and Substance Involvement Screening Tool and participant sociodemographic and clinical factors. Logistic regression was used to explore the associations. Two hundred sixty-five (40.3%) students reported ever using alcohol and 158 (24.0%) had used in last 3 months. Seventy-four (11.2%) students reported ever use of other substances including tobacco, cannabis, cocaine, stimulants sedatives and hallucinogens and 36 (5.5%) had used within the recent 3 months. After controlling for potential confounders, recent alcohol use was associated with engaging in romantic relationship (odd ratio (OR) = 1.9, P value (P) = 0.045) while having chronic medical conditions was protective (OR = 0.3, P = 0.031). On the other hand, recent use of other substances was 7 times higher among males (OR = 7.0, P = 0.008) compared to females while fourth year of study was protective (OR = 0.05, P = 0.011). Although alcohol use is a worsening challenge among university students, use of other substances is also highly prevalent after COVID-19 lockdown. There is need for universities to identify students with above factors and design interventions to address them in order to prevent the likely undesirable outcomes of alcohol and substance use.
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Affiliation(s)
- Joseph Kirabira
- Department of Psychiatry, Busitema University, Faculty of Health Sciences, P.O. Box 1460, Mbale, Uganda.
| | - Enid Kawala Kagoya
- Institute of Public Health, Department of Community Health, Busitema University, Faculty of Health Sciences, P.O. Box 1460, Mbale, Uganda
| | - Joseph Mpagi
- Deans Office, Department of Academics, Research and Innovation, Busitema University, Faculty of Health Sciences, P.O. Box 1460, Mbale, Uganda
| | - Christine Etoko Atala
- Department of Anaesthesia, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - Kalisiti Ndamanywa
- Directorate of Graduate Studies, Research and Innovations, Busitema University, P.O. Box 1460, Busia, Uganda
| | - Ambrose Okibure
- Institute of Public Health, Department of Community Health, Busitema University, Faculty of Health Sciences, P.O. Box 1460, Mbale, Uganda
| | - Ronald Kibuuka
- Department of Psychiatry, Busitema University, Faculty of Health Sciences, P.O. Box 1460, Mbale, Uganda
| | - Fauz Katongole
- Department of Pathology, Busitema University, Faculty of Health Sciences, P.O. Box 1460, Mbale, Uganda
| | - Julius Wandabwa
- Institute of Public Health, Department of Community Health, Busitema University, Faculty of Health Sciences, P.O. Box 1460, Mbale, Uganda
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Bintabara D, Singo JB, Mvula M, Jofrey S, Shayo FK. Mental health disorders among medical students during the COVID-19 pandemic in the area with no mandatory lockdown: a multicenter survey in Tanzania. Sci Rep 2024; 14:3451. [PMID: 38342933 PMCID: PMC10859363 DOI: 10.1038/s41598-024-53885-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 02/06/2024] [Indexed: 02/13/2024] Open
Abstract
The COVID-19 pandemic brought about a major public health concern worldwide. It forced many countries to enforce lockdowns, leading to the closure of higher learning institutions. The abrupt shift in the lifestyle of students had a profound impact on their mental health. This study aims to determine the prevalence and factors associated with mental health conditions among university students in Tanzania during the COVID-19 pandemic. A sample of 425 students from six medical universities and colleges in Tanzania completed an online survey and was included in the analysis. The questionnaire consisted of validated Depression, Anxiety and Stress Scale-21 Items (DASS-21) questions (Cronbach's alpha = 0.92) assessing the presence of mental health symptoms: depression, anxiety, and stress. Multivariable logistic regression models were fitted to explain the factors associated with mental health conditions. A P-value < 0.05 was considered statistically significant in all inferential analyses. The median age (interquartile range) of the participants was 24 (22-26). The prevalence of mental health conditions was 28.94%, 54.12%, and 15.06% for depression, anxiety, and stress, respectively, while the prevalence of having any mental health condition was 58.59%. In an adjusted regression model, being in the fourth and fifth years of study and living with a spouse were significantly associated with increased odds of depression: AOR = 5.99 (1.31-27.47), AOR = 5.52 (1.18-25.81), and AOR = 1.84 (1.08-3.15), respectively. Moreover, studying in private universities and living with a spouse were significantly associated with an increased likelihood of anxiety: AOR = 2.35 (1.72-2.76), and AOR = 2.32 (1.20-4.50), respectively. The likelihood of stress was only among participants studying in private universities; AOR = 2.90 (1.60-5.27). The study revealed alarmingly high rates of mental health conditions among medical students in Tanzania during the COVID-19 pandemic. The findings suggest the need for regular checkups for medical students regarding their mental health status. Additionally, it recommends that the government and other stakeholders establish mental health services within the universities for the effective prevention of the rising burden of mental health problems among universities in Tanzania and other countries with similar settings.
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Affiliation(s)
- Deogratius Bintabara
- Department of Community Medicine, School of Medicine and Dentistry, The University of Dodoma, Dodoma, Tanzania.
- Tanrep Research Consultancy Limited, Dar es Salaam, Tanzania.
| | - Joseph B Singo
- Department of Community Medicine, School of Medicine and Dentistry, The University of Dodoma, Dodoma, Tanzania
| | - Mathew Mvula
- Department of Community Medicine, School of Medicine and Dentistry, The University of Dodoma, Dodoma, Tanzania
| | - Sichone Jofrey
- Department of Community Medicine, School of Medicine and Dentistry, The University of Dodoma, Dodoma, Tanzania
| | - Festo K Shayo
- Tanrep Research Consultancy Limited, Dar es Salaam, Tanzania
- Department of Internal Medicine, Muhimbili National Hospital, Dar es Salaam, Tanzania
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Cheng X, Liu J, Li J, Hu Z. COVID-19 lockdown stress and problematic social networking sites use among quarantined college students in China: A chain mediation model based on the stressor-strain-outcome framework. Addict Behav 2023; 146:107785. [PMID: 37406403 PMCID: PMC10284454 DOI: 10.1016/j.addbeh.2023.107785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 06/16/2023] [Accepted: 06/19/2023] [Indexed: 07/07/2023]
Abstract
The COVID-19 pandemic has coincided with a global increase in problematic social networking sites use (PSNSU). By drawing on transactional stress theory and applying the stressor-strain-outcome (SSO) framework, we proposed and verified a chain mediation model to explore the mediating roles of fear of missing out (FoMO) and future anxiety (FA) in the relationship between COVID-19 lockdown stress (CL stress) and PSNSU. Our sample of 670 quarantined college students in China responded to a COVID-19 student stress questionnaire, a social network addiction scale, a fear of missing out scale, and a dark future scale. The results revealed that (1) CL stress significantly positively predicted PSNSU, (2) both FoMO and FA mediated the relationship between CL stress and PSNSU, (3) FoMO significantly positively predicted FA, and (4) a full chain mediation was observed between CL stress and PSNSU.
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Affiliation(s)
- Xiaoshuang Cheng
- School of Communication, Yunnan Normal University, 1 Yuhua Area, Chenggong District, Kunming 650500, Yunnan Province, PR China.
| | - Jingxuan Liu
- School of Communication, Yunnan Normal University, 1 Yuhua Area, Chenggong District, Kunming 650500, Yunnan Province, PR China.
| | - Jun Li
- School of Finance and Economics, Hainan Vocational University of Science and Technology, 18 Qiongshan Avenue, Meilan District, Haikou City 571126, Hainan Province, PR China.
| | - Ziao Hu
- School of Finance and Economics, Hainan Vocational University of Science and Technology, 18 Qiongshan Avenue, Meilan District, Haikou City 571126, Hainan Province, PR China.
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Kintu TM, Kaggwa MM, Namagembe R, Muganzi DJ, Kihumuro BR, Luyinda GS, Nabwana BW, Moses M, Nnyombi M, Kirega A, Kabakyenga JK, Maling S. Alcohol use disorder among healthcare professional students: a structural equation model describing its effect on depression, anxiety, and risky sexual behavior. BMC Psychiatry 2023; 23:505. [PMID: 37438721 DOI: 10.1186/s12888-023-04989-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 06/29/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND Mental health problems such as depression, anxiety and alcohol use disorders are among the leading causes of disability worldwide. Among university students, alcohol use and poor mental health are associated with risky sexual behavior. Given the syndemic occurrence of these disorders most especially in young adults, we describe the relationship between them so as to guide and intensify current interventions on reducing their burden in this population. METHODS This was a cross-sectional study based on an online survey among healthcare professional university students that captured sociodemographic characteristics, risky sexual behavior, alcohol use disorder, generalized anxiety disorder, and depression. Structural equation modelling was used to describe the relationship between these variables using RStudio. RESULTS We enrolled a total of 351 participants of which 11% (37/351) had Alcohol Use Disorder, 33% (117/351) had depressive symptoms and 32% (111/351) had symptoms of anxiety. A model describing the relationship between these variables was found to fit well both descriptively and statistically [χ2 = 44.437, df = 21, p-value = 0.01, CFI = 0.989, TFI = 0.980, RMSEA = 0.056]. All observed variables were found to fit significantly and positively onto their respective latent factors (AUD, anxiety, depression and risky sexual behavior). AUD was found to be significantly associated with risky sexual behavior (β = 0.381, P < 0.001), depression (β = 0.152, P = 0.004), and anxiety (β = 0.137, P = 0.001). CONCLUSION AUD, depression and anxiety are a significant burden in this health professional student population and there's need to consider screening for anxiety and depression in students reporting with AUD so as to ensure appropriate interventions. A lot of attention and efforts should be focused on the effect of AUD on risky sexual behavior and continued health education is still required even among health professional students.
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Affiliation(s)
- Timothy Mwanje Kintu
- Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda.
| | - Mark Mohan Kaggwa
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Robinah Namagembe
- College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
| | - David Jolly Muganzi
- Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - Bernard Raymond Kihumuro
- Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - Garvin Ssali Luyinda
- Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | | | - Muwanguzi Moses
- Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - Marvin Nnyombi
- Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - Alex Kirega
- Faculty of Medicine, Gulu University, P.O. Box 166, Gulu, Uganda
| | - Jerome Kahuma Kabakyenga
- Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - Samuel Maling
- Department of Psychiatry, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
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Sserunkuuma J, Kaggwa MM, Muwanguzi M, Najjuka SM, Murungi N, Kajjimu J, Mulungi J, Kihumuro RB, Mamun MA, Griffiths MD, Ashaba S. Problematic use of the internet, smartphones, and social media among medical students and relationship with depression: An exploratory study. PLoS One 2023; 18:e0286424. [PMID: 37235547 PMCID: PMC10218731 DOI: 10.1371/journal.pone.0286424] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Students in sub-Saharan African countries experienced online classes for the first time during the COVID-19 pandemic. For some individuals, greater online engagement can lead to online dependency, which can be associated with depression. The present study explored the association between problematic use of the internet, social media, and smartphones with depression symptoms among Ugandan medical students. METHODS A pilot study was conducted among 269 medical students at a Ugandan public university. Using a survey, data were collected regarding socio-demographic factors, lifestyle, online use behaviors, smartphone addiction, social media addiction, and internet addiction. Hierarchical linear regression models were performed to explore the associations of different forms of online addiction with depression symptom severity. RESULTS The findings indicated that 16.73% of the medical students had moderate to severe depression symptoms. The prevalence of being at risk of (i) smartphone addiction was 45.72%, (ii) social media addiction was 74.34%, and (iii) internet addiction use was 8.55%. Online use behaviors (e.g., average hours spent online, types of social media platforms used, the purpose for internet use) and online-related addictions (to smartphones, social media, and the internet) predicted approximately 8% and 10% of the severity of depression symptoms, respectively. However, over the past two weeks, life stressors had the highest predictability for depression (35.9%). The final model predicted a total of 51.9% variance for depression symptoms. In the final model, romantic relationship problems (ß = 2.30, S.E = 0.58; p<0.01) and academic performance problems (ß = 1.76, S.E = 0.60; p<0.01) over the past two weeks; and increased internet addiction severity (ß = 0.05, S.E = 0.02; p<0.01) was associated with significantly increased depression symptom severity, whereas Twitter use was associated with reduced depression symptom severity (ß = 1.88, S.E = 0.57; p<0.05). CONCLUSION Despite life stressors being the largest predictor of depression symptom score severity, problematic online use also contributed significantly. Therefore, it is recommended that medical students' mental health care services consider digital wellbeing and its relationship with problematic online use as part of a more holistic depression prevention and resilience program.
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Affiliation(s)
- Jonathan Sserunkuuma
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Mark Mohan Kaggwa
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
- Department of Psychiatry and Behavioural Neurosciences, McMaster University Hamilton, Hamilton, Ontario, Canada
| | - Moses Muwanguzi
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | | | - Nathan Murungi
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Jonathan Kajjimu
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Jonathan Mulungi
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, 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
| | - Scholastic Ashaba
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
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Zubayer AA, Rahman ME, Islam B, Zaman O, Jobe MC. COVID-19 anxiety and associated factors among university students in Bangladesh. DEATH STUDIES 2023; 48:27-32. [PMID: 36820609 DOI: 10.1080/07481187.2023.2180692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Cross-sectional data were collected from 787 Bangladeshi students ages 18 to 27 years, to assess dysfunctional COVID-19 anxiety using the Coronavirus anxiety Scale or CAS and to identify factors influencing their anxiety. Results indicated that 53% of the respondents attained CAS scores in the clinical range. Women reported a significantly higher anxiety than men. Additionally, not having a steady family income, having poor physical health, having relatives or acquaintances infected with COVID-19, and being highly worried about becoming infected were associated with COVID-19 anxiety. Psychosocial interventions should be adopted to mitigate the anxiety of these high-risk groups and to deter harmful behavior during this emergency.
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Affiliation(s)
| | - Md Estiar Rahman
- Department of Public Health & Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | - Bulbul Islam
- Centre for Entrepreneurship Development (CED), BRAC University (BRACU), Mohakhali, Dhaka, Bangladesh
| | - Ohidur Zaman
- Department of Sociology, University of Barishal, Barishal, Bangladesh
| | - Mary C Jobe
- Christopher Newport University, Newport News, VA, USA
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Muwanguzi M, Kaggwa MM, Najjuka SM, Mamun MA, Arinaitwe I, Kajjimu J, Nduhuura E, Ashaba S. Exploring adverse childhood experiences (ACEs) among Ugandan university students: its associations with academic performance, depression, and suicidal ideations. BMC Psychol 2023; 11:11. [PMID: 36639808 PMCID: PMC9838032 DOI: 10.1186/s40359-023-01044-2] [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: 03/26/2022] [Accepted: 01/09/2023] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Adverse childhood experiences (ACEs) among university students have been linked to a variety of factors and have been shown to have a dose-response relationship with adult health and behavior. OBJECTIVE To investigate the effect of exposure to ACEs on academic performance, depression, and suicidal ideations among university students. METHODS A cross-sectional survey among university students at a public university in southwestern Uganda was conducted in 2021, integrating the Adverse Childhood Experiences International Questionnaire for assessing ACEs, the Patient Health Questionnaire for assessing depression symptoms and suicidal ideations, and questions assessing the family structure and academic performance as adopted from similar studies. Regression analysis was performed, and 3 models were generated to answer the study hypotheses. RESULTS A total of 653 undergraduate university students with a mean age of 22.80 (± 3.16) years were recruited. Almost all students (99.8%) experienced one or more ACEs, with physical abuse being the common ACE reported. The average depression symptom severity was statistically higher among individuals who experienced any form of ACEs. No relationship was observed between the ACEs experienced and self-rated academic performance. Similarly, on regression analysis, the cumulative number of ACEs was not associated with self-rated academic performance (β = - 0.007; 95% CI - 0.031 to 0.016; p = 0.558). However, the cumulative number of ACEs was positively associated with depression symptom severity (β = 0.684; 95% CI 0.531-0.837; p < 0.001), as well as increased the likelihood of suicidal ideations (aOR = 1.264; 95% CI 01.090-1.465; p < 0.001). CONCLUSIONS The burden of ACEs is exceedingly high among Ugandan university students, highlighting the urgency in strengthening effective child protection strategies to protect Uganda's rapidly growing population from mental ill-health and avoid future psychological disability, a burden to the healthcare system. The study's findings will also be useful to practitioners/policymakers working to prevent/limit child maltreatment globally.
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Affiliation(s)
- Moses Muwanguzi
- grid.33440.300000 0001 0232 6272Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Mark Mohan Kaggwa
- grid.33440.300000 0001 0232 6272Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda ,grid.25073.330000 0004 1936 8227Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON Canada
| | - Sarah Maria Najjuka
- grid.11194.3c0000 0004 0620 0548Makerere University, College of Health Sciences, Kampala, Uganda
| | - Mohammed A. Mamun
- CHINTA Research Bangladesh, Savar, Dhaka Bangladesh ,grid.411808.40000 0001 0664 5967Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka Bangladesh
| | - Innocent Arinaitwe
- grid.33440.300000 0001 0232 6272Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Jonathan Kajjimu
- grid.33440.300000 0001 0232 6272Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Elicana Nduhuura
- grid.33440.300000 0001 0232 6272Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Scholastic Ashaba
- grid.33440.300000 0001 0232 6272Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda
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Wafula ST, Ninsiima LL, Mendoza H, Ssempebwa JC, Walter F, Musoke D. Association between recent COVID-19 diagnosis, depression and anxiety symptoms among slum residents in Kampala, Uganda. PLoS One 2023; 18:e0280338. [PMID: 37141298 PMCID: PMC10159354 DOI: 10.1371/journal.pone.0280338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 04/19/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Despite the known link between poor living conditions and mental health, there has been little research on the mental health of slum dwellers worldwide. Although the Coronavirus disease 2019 (COVID-19) pandemic has led to an increase in mental health issues, little focus has been given to the impact on slum dwellers. The study aimed to investigate the association between recent COVID-19 diagnosis and the risk of depression and anxiety symptoms among people living in an urban slum in Uganda. METHODS A cross-sectional study was conducted among 284 adults (at least 18 years of age) in a slum settlement in Kampala, Uganda between April and May 2022. We assessed depression symptoms and anxiety using validated Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder assessment tool (GAD-7) questionnaires respectively. We collected data on sociodemographic characteristics, and self-reported recent COVID-19 diagnosis (in the previous 30 days). Using a modified Poisson regression, adjusted for age, sex, gender and household income, we separately provided prevalence ratios and 95% confidence intervals for the associations between recent COVID-19 diagnosis and depressive and anxiety symptoms. RESULTS Overall, 33.8% and 13.4% of the participants met the depression and generalized anxiety screening criteria respectively and 11.3% were reportedly diagnosed with COVID-19 in the previous 30 days. People with recent COVID-19 diagnosis were more likely to be depressed (53.1%) than those with no recent diagnosis (31.4%) (p<0.001). Participants who were recently diagnosed with COVID-19 reported higher prevalence of anxiety (34.4%) compared to those with no recent diagnosis of COVID-19 (10.7%) (p = 0.014). After adjusting for confounding, recent diagnosis with COVID-19 was associated with depression (PR = 1.60, 95% CI 1.09-2.34) and anxiety (PR = 2.83, 95% CI 1.50-5.31). CONCLUSION This study suggests an increased risk of depressive symptoms and GAD in adults following a COVID-19 diagnosis. We recommend additional mental health support for recently diagnosed persons. The long-term of COVID-19 on mental health effects also need to be investigated.
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Affiliation(s)
- Solomon T Wafula
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Lesley L Ninsiima
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Hilbert Mendoza
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
- Social Epidemiology and Health Policy, Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium
| | - John C Ssempebwa
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Florian Walter
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - David Musoke
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
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Handouzi W, Maaoui C, Pruski A. Virtual reality exposure aided-diagnosis system for anxiety disorders: Long short-term memory architecture for three levels of anxiety recognition. Biomed Mater Eng 2023; 34:491-502. [PMID: 37248874 DOI: 10.3233/bme-222542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND The COVID-19 pandemic has resulted in increased psychological pressure on mental health since 2019. The resulting anxiety and stress have permeated every aspect of life during confinement. OBJECTIVE To provide psychologists with an unbiased measure that can aid in the preliminary diagnosis of anxiety disorders and be used as an initial treatment in cognitive-behavioral therapy, this article introduces automated recognition of three levels of anxiety. METHODS Anxiety was elicited by exposing participants to virtual environments inspired by social situations in reference to the Liebowitz social anxiety scale. Relevant parameters, such as heart rate variability and vasoconstriction were derived from the measurement of the blood volume pulse (BVP) signal. RESULTS A long short-term memory architecture achieved an accuracy of approximately 98% on the training and test set. CONCLUSION The generated model allowed for careful study of the state of seven phobic participants during virtual reality exposure (VRE).
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Affiliation(s)
- Wahida Handouzi
- Laboratoire d'Automatique de Tlemcen (LAT), Tlemcen University, Tlemcen, Algeria
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Alanazi M. Psychological Status of College Students During COVID-19 Pandemic: A Cross-Sectional Study in Saudi Arabia. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2022; 13:1443-1451. [PMID: 36483331 PMCID: PMC9724575 DOI: 10.2147/amep.s381916] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 11/23/2022] [Indexed: 06/02/2023]
Abstract
PURPOSE This study aimed to assess the prevalence and associated factors of depression, anxiety, and stress among college students in Saudi Arabia during the COVID-19 outbreak. METHODS This cross-sectional study was conducted between February 10th to April 10th, 2021. An online self-administered questionnaire was emailed to college students at a large institution in Saudi Arabia. The questionnaire consisted of sociodemographic, educational backgrounds, and the Depression Anxiety Stress Scale-21 (DASS-21). RESULTS The study included 311 university students (62.7% female and 39.3% male). The prevalence of higher than moderate level in each of the depression, anxiety, and stress were (n= 164, 52.7%), (n= 222, 71.4%), and (n= 112, 36%), respectively. Further analysis revealed that females, younger age, history of depression, history of being quarantined by a health authority, and having contact with a confirmed case of COVID-19 were associated with a greater level of depression, anxiety, and stress. CONCLUSION Depression, anxiety, and stress were highly prevalent among college students during the outbreak. There was a significant association between demographic characteristics and the DASS 21 score. Researchers are recommended to concentrate their future studies on establishing strategies to enhance students' flexibility and adaptability in the face of future catastrophes.
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Affiliation(s)
- Mona Alanazi
- College of Nursing, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Ministry of the National Guard – Health Affairs, Riyadh, Saudi Arabia
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Xu H, Wang Z, Peng L, Mi Y, Zeng P, Liu X. The study of psychological traits among Chinese college students during the COVID-19 campus lockdown. Front Psychol 2022; 13:1051770. [DOI: 10.3389/fpsyg.2022.1051770] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 11/03/2022] [Indexed: 11/21/2022] Open
Abstract
To investigate the prevalence of interpersonal sensitivity, anxiety, depression symptoms and associated risk factors among a large-scale sample of college students in China during the COVID-19 campus lockdown. The survey was conducted among undergraduate students at a university in eastern part of China in April 2022. The Chi-square test was used to compare the different variable groups and multivariable analysis was performed for the risk factors associated with interpersonal sensitivity, anxiety, and depression symptoms. A total of 12,922 college students were included, with an average age of (20.96 ± 1.66) years. The prevalence of interpersonal sensitivity, anxiety and depression symptoms in this study was 58.1, 22.7, and 46.8%, respectively. Male (OR = 1.16, p < 0.001), 22–23 years (OR = 1.40, p < 0.001), freshman (OR = 1.35, p = 0.002), and non-only child (OR = 1.15, p < 0.001) were positively associated with interpersonal sensitivity. Male (OR = 1.20, p < 0.001), sophomores (OR = 1.27, p = 0.020) and seniors (OR = 1.20, p = 0.027) were positively associated with anxiety symptoms. Compared with female students, male students (OR = 0.89, p < 0.001) were less likely to have depression symptoms. 22–23 years (OR = 1.37, p < 0.001), sophomores (OR = 1.26, p = 0.009) and non-only child (OR = 1.11, p = 0.009) were positively associated with depression symptoms. In addition, college students aged 18–21 years, learning status, skipping breakfast, roommate relationship and sleep quality were associated with interpersonal sensitivity, anxiety and depression symptoms (all p < 0.05). The findings of this study suggest a high prevalence of interpersonal sensitivity, anxiety and depression symptoms among Chinese college students during the COVID-19 campus lockdown. Younger ages, low grades, poor dormitory relationship, negative learning status, skipping breakfast and poor sleep quality were the risk factors for college students’ mental health, which should be concerned by the relevant departments of school during the campus lockdown.
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Risky sexual behaviours among Ugandan university students: A pilot study exploring the role of adverse childhood experiences, substance use history, and family environment. PLoS One 2022; 17:e0277129. [DOI: 10.1371/journal.pone.0277129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 10/21/2022] [Indexed: 11/17/2022] Open
Abstract
Background
University students are known to have risky sexual behaviours (RSBs). The severity of the RSB is influenced by many factors, including the family environment, exposure to adverse childhood events (ACEs), and the use of addictive substances. However, there is limited information about the influence of ACEs and the family environment of these students in low-and medium-income countries (LMICs). Therefore, a pilot study was conducted among university students from a LMIC, Uganda.
Methods
The present study comprised a cross-sectional online survey among Ugandan students at a public university (N = 316; 75% male; 52.2% aged between 18–22 years). The survey included questions relating to socio-demographic information, family environmental information, the Sexual Risk Survey (SRS), and the Adverse Childhood Experiences-International Questionnaire (ACE-IQ).
Results
Over half (53.8%) reported having had sexual intercourse. Males reported over two times higher mean total SRS score compared to females (χ2 = 4.06, p = 0.044). Approximately one-sixth of the sample had drunk alcohol or used illicit psychoactive substances in the past six months (16.1%). Among four regression analysis models, sociodemographic variables predicted the highest variance (13%), followed by family environment variables (10%), and both psychoactive substance use history (past six months) and ACEs individually explained approximately 5% variance in total SRS score, with the final model predicting 33% of the variance in RSB.
Conclusions
The present study demonstrated a gender disparity with males involved in more RSB than females, as has been reported in most previous RSB studies. Family environment, sociodemographic factors, substance use, and ACEs all appear to contribute to RSB among university students. These findings will benefit other researchers exploring factors associated with RSB among university students and will help develop interventions to reduce RSB to protect students from unwanted pregnancies, sexually transmitted diseases, and HIV/AIDS.
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Kihumuro RB, Kaggwa MM, Nakandi RM, Kintu TM, Muwanga DR, Muganzi DJ, Atwau P, Ayesiga I, Acai A, Najjuka SM, Najjuma JN, Frazier-Koussai S, Ashaba S, Harms S. Perspectives on mental health services for medical students at a Ugandan medical school. BMC MEDICAL EDUCATION 2022; 22:734. [PMID: 36284284 PMCID: PMC9592876 DOI: 10.1186/s12909-022-03815-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 10/19/2022] [Indexed: 06/01/2023]
Abstract
BACKGROUND University-based mental health services for medical students remain a challenge, particularly in low-income countries, due to poor service availability. Prior studies have explored the availability of mental health services in high-income countries but little is known about mental health services in countries in sub-Saharan Africa, such as Uganda. Medical students are at a higher risk of developing mental health challenges during their course of study as compared with other students. Thus, there is a need for well-structured mental health services for this group of students. The aim of this study was to explore perspectives on mental health services for medical students at a public University in Uganda. METHODS This was a qualitative study where key informant interviews were conducted among purposively selected university administrators (n = 4), student leaders (n = 4), and mental health employees of the university (n = 3), three groups responsible for the mental well-being of medical students at a public university in Uganda. Interviews were audio-recorded, transcribed, and thematically analyzed to identify relevant themes. RESULTS The working experience of university administrators and mental health providers was between eight months to 20 years, while student leaders had studied at the university for over four years. We identified five broad themes: (1) Burden of medical school: A curriculum of trauma, (2) Negative coping mechanisms and the problem of blame, (3) The promise of services: Mixed Messages, (4) A broken mental health system for students, and (5) Barriers to mental health services. CONCLUSION Distinguishing between psychological distress that is anticipated because of the subject matter in learning medicine and identifying those students that are suffering from untreated psychiatric disorders is an important conceptual task for universities. This can be done through offering education about mental health and well-being for administrators, giving arm's length support for students, and a proactive, not reactive, approach to mental health. There is also a need to redesign the medical curriculum to change the medical education culture through pedagogical considerations of how trauma informs the learning and the mental health of students.
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Affiliation(s)
| | - Mark Mohan Kaggwa
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
- African Centre for Suicide Prevention and Research, Mbarara, Uganda.
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada.
| | | | - Timothy Mwanje Kintu
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | | | - David Jolly Muganzi
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Pius Atwau
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Innocent Ayesiga
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Anita Acai
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | | | | | - Susan Frazier-Koussai
- Texas Juvenile Crime Prevention Center at Prairie View, A and M University (PVAMU), Texas, USA
| | - Scholastic Ashaba
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Sheila Harms
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
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Kihumuro RB, Kaggwa MM, Kintu TM, Nakandi RM, Muwanga DR, Muganzi DJ, Atwau P, Ayesiga I, Najjuma JN, Ashaba S. Knowledge, attitude and perceptions of medical students towards mental health in a university in Uganda. BMC MEDICAL EDUCATION 2022; 22:730. [PMID: 36266646 PMCID: PMC9584261 DOI: 10.1186/s12909-022-03774-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 09/12/2022] [Accepted: 09/26/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The prevalence of mental illness among medical students is high. A gap remains on what knowledge should be given to improve the attitudes and perceptions towards mental health. Despite the vast body of literature globally, no study has been conducted in Uganda to assess the levels of knowledge, attitude, and perception among medical students in Uganda. OBJECTIVE To determine the level of knowledge, attitude, and perception and their associated factors among medical students in Uganda. METHODS A cross-sectional study was done among 259 undergraduate medical students in a public university capturing information on knowledge, attitude, and perception towards mental health. Linear regression analysis was used to determine the factors associated with knowledge, attitude, and perception. RESULTS About 77.72% had high knowledge, 49.29% had positive attitudes, and 46.92% had good perceptions of mental health. There was a significant positive relationship between attitude and perceptions towards mental illness. At multilevel analysis, being in year 4 increased the level of knowledge (β = 1.50 [95% confidence interval (CI) = 0.46-2.54], p = 0.005) while a positive history of mental illness worsened perceptions towards mental illness (β = -4.23 [95% CI = -7.44-1.03], p = 0.010). CONCLUSION Medical students have a high level of knowledge about mental illness but the majority had poor attitudes and perceptions of mental illness. Exposure to psychiatry knowledge about mental illness in year four increased students' knowledge while prior experience with mental illness conditions was associated with poorer perceptions. The information present in this study can be used by policymakers and future researchers to design future studies and interventions to improve knowledge, perceptions, and attitudes especially among students who have a history of mental illness. Improvements in knowledge, attitude, and perception may improve the mental health services for the future patients of these medical students.
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Affiliation(s)
| | - Mark Mohan Kaggwa
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
- African Centre for Suicide Prevention and Research, Mbarara, Uganda
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Ontario, Canada
| | - Timothy Mwanje Kintu
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | | | | | - David Jolly Muganzi
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Pius Atwau
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Innocent Ayesiga
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | | | - Scholastic Ashaba
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
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15
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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).
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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
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Niba Rawlings N, Akwah EA, Musisi J, Awanchiri K, Babirye R, Emalieu D, Nduhukyire L, Kakeeto R, Ngongalah L. Perceived risks of COVID-19, attitudes towards preventive guidelines and impact of the lockdown on students in Uganda: A cross-sectional study. PLoS One 2022; 17:e0266249. [PMID: 35377918 PMCID: PMC8979440 DOI: 10.1371/journal.pone.0266249] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 03/17/2022] [Indexed: 11/21/2022] Open
Abstract
Background This study explored students’ perceptions of COVID-19 risks and preventive measures and assessed the impacts of the national lockdown on students in Uganda. Methods A web-based survey was conducted to explore students’ perceived risks of COVID-19 and preventive measures; sources of COVID-19 information and impacts of the lockdown. Both undergraduate and post-graduate students (n = 398) participated in the study. Data were analysed using IBM-SPSS-26. Results Students acknowledged COVID-19 as a health risk, and their preventive behaviours were influenced by age, gender, marital status and living situation. Most students followed face mask guidelines but did not comply with lockdown restrictions. Social distancing was not always possible due to overcrowding. Students’ main sources of COVID-19 information were local media (e.g., TV, radio) and social media. Most students (especially females) were unable to access online learning platforms due to poor internet connectivity, high costs and no access to computers. Meanwhile, a majority of those who studied online did not enjoy the experience. Students experienced depression, frustration, stress and anxiety during the lockdown; became less physically active and spent most of their time on social media, sleeping, eating or watching movies. Some students indulged in smoking, drinking alcohol, taking drugs and gambling for their first time, while others did them more often than before. Conclusion The increase in sedentary activity, poor mental health and substance use over the lockdown period puts students at risk of health complications and poses a potential threat to the healthcare system. These risks may also negatively impact their future learning and academic potential. Further research is needed to understand the transitional experiences of students between physical and virtual learning, and how they can be supported. There is also a need to ascertain the feasibility of guidelines such as social distancing in developing countries, to increase compliance.
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Affiliation(s)
- Ngwa Niba Rawlings
- Department of Research and Development, The Collaboration for Research Excellence in Africa (CORE Africa), Douala, Cameroon
- * E-mail:
| | - Emmanuela Ambe Akwah
- Department of Research and Development, The Collaboration for Research Excellence in Africa (CORE Africa), Douala, Cameroon
| | - James Musisi
- Department of Research and Development, The Collaboration for Research Excellence in Africa (CORE Africa), Douala, Cameroon
| | - Kimonia Awanchiri
- Department of Research and Development, The Collaboration for Research Excellence in Africa (CORE Africa), Douala, Cameroon
| | - Rachel Babirye
- Department of Health Policy & Management, School of Public Health, Makerere University, Kampala, Uganda
| | - Diana Emalieu
- Faculty of Health Sciences, Islamic University, Mbale, Uganda
| | - Lawrence Nduhukyire
- Department of Epidemiology and Biostatistics, School of Public Health, Makerere University, Kampala, Uganda
| | - Ronald Kakeeto
- Department of Health Policy & Management, School of Public Health, Makerere University, Kampala, Uganda
| | - Lem Ngongalah
- Department of Research and Development, The Collaboration for Research Excellence in Africa (CORE Africa), Douala, Cameroon
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Kaggwa MM, Rukundo GZ, Wakida EK, Maling S, Sserumaga BM, Atim LM, Obua C. Suicide and Suicide Attempts Among Patients Attending Primary Health Care Facilities in Uganda: A Medical Records Review. Healthc Policy 2022; 15:703-711. [PMID: 35469181 PMCID: PMC9034861 DOI: 10.2147/rmhp.s358187] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 04/07/2022] [Indexed: 11/30/2022] Open
Abstract
Background Suicide is one of the leading causes of death globally, accounting for about 800,000 deaths annually. The suicide burden drastically increased since the beginning of the COVID-19 pandemic. In Uganda, no known study has determined the suicide rate since the beginning of the COVID-19 pandemic. Objective To determine the suicide mortality rate and describe the characteristics of victims of suicide attempts from January to December 2020 in south western Uganda. Methods This study was based on the health management information systems (HMIS) of patients’ registered data for the year 2020 at 15 selected primary health care facilities in four districts in south-western Uganda. We used a data extraction tool to capture demographic and clinical characteristics of the individuals who had attempted or completed suicide. We estimated yearly incidence rates of fatal and non-fatal suicide attempts, and used chi-square and t-test to determine the statistical difference between suicide attempt outcomes. Results A total of 130 non-fatal suicide attempts and 26 suicides were identified. Majority were male 69.87% (n = 109/156) and the mean age was 27.16 (SD = 14.71) years. The overall incidence of suicide attempts was about 60 attempts per 100,000 people, while that of completed suicide was about three deaths per 100,000 people. The suicide attempts increased following the first month of COVID-19 lockdown in the country (March 2020) and most individuals attempted suicide by poisoning (n = 144). Conclusion Suicide is a common occurrence in primary health care settings of Uganda and there has been a rapid increase in suicide attempts since the onset of the COVID-19 pandemic. With suicide by poisoning being common, there is need for proactive interventions, such as the control of pesticides and herbicides, to prevent suicide among members of this community, especially during pandemic conditions.
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Affiliation(s)
- Mark Mohan Kaggwa
- Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda
- African Centre for Suicide Prevention and Research, Mbarara, Uganda
- Correspondence: Mark Mohan Kaggwa, Email
| | - Godfrey Zari Rukundo
- Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda
- African Centre for Suicide Prevention and Research, Mbarara, Uganda
| | - Edith K Wakida
- African Centre for Suicide Prevention and Research, Mbarara, Uganda
- Office of Research Administration, Mbarara University of Science and Technology, Mbarara, Uganda
- Department of Medical Education, California University of Science and Medicine, San Barnardino, CA, United States of America
| | - Samuel Maling
- Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Baker Makaya Sserumaga
- Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda
- African Centre for Suicide Prevention and Research, Mbarara, Uganda
| | - Letizia Maria Atim
- Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda
- African Centre for Suicide Prevention and Research, Mbarara, Uganda
| | - Celestino Obua
- Department of Pharmacology and Therapeutics, Mbarara University of Science and Technology, Mbarara, Uganda
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18
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Kaggwa MM, Arinaitwe I, Muwanguzi M, Nduhuura E, Kajjimu J, Kule M, Najjuka SM, Nkola R, Ajuna N, Wamala NK, Machacha I, Mamun MA, Ho CSH, Griffiths MD, Rukundo GZ. Suicidal behaviours among Ugandan university students: a cross-sectional study. BMC Psychiatry 2022; 22:234. [PMID: 35365105 PMCID: PMC8972906 DOI: 10.1186/s12888-022-03858-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 03/15/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Suicide remains the leading cause of death among university students often resulting from multiple physical and psychological challenges. Moreover, suicidal behaviours among students appear to have increased due to the COVID-19 pandemic according to some studies. OBJECTIVE To explore the prevalence and associated factors for suicidal ideation, suicide plans, and suicide attempts among university students in Uganda. METHODS Cross-sectional study data were collected from May to September 2021 from 540 undergraduate university students in south-western Uganda (363 males, mean age 23.3 years). Questions from the General Health Questionnaire (GHQ-28) were used to assess suicidal ideation, while other bespoke questions were used to assess suicide plans and attempts. The survey also investigated the suicide attempt/plan method, location of the suicidal activity, and reason for not enacting the suicide plan. Three independent regression analyses were used to determine the factors associated with different forms of suicidal behaviours. RESULTS The prevalence of past-year suicidal behaviours was 31.85% for suicidal ideation, 8.15% for suicide plans, and 6.11% for suicide attempts. Having a chronic physical medical condition increased the likelihood of having all forms of suicidal behaviours. Suicidal ideation was associated with having difficulty paying university tuition fees. However, being in the fifth year of university education, and feeling satisfied with current academic grades reduced the likelihood of suicidal ideation. Individuals feeling satisfied with academic performance appeared to be a protective factor against having suicide plans. Suicide attempts were associated with having a history of sexual abuse and having difficulty paying university tuition fees. The most common method used for attempted suicide was a drug overdose, and the most common location for attempted suicide was their homes. CONCLUSION University students have prevalent suicide behaviours especially among students with a chronic physical medical condition, a history of sexual abuse, and problems paying university tuition fees. Based on the present study, for students at risk, universities should provide appropriate interventions such as life skills education and suicide prevention techniques.
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Affiliation(s)
- Mark Mohan Kaggwa
- grid.33440.300000 0001 0232 6272Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, 1410, Uganda ,African Centre for Suicide Prevention and Research, Mbarara, 379, Uganda
| | - Innocent Arinaitwe
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, 1410, Uganda.
| | - Moses Muwanguzi
- grid.33440.300000 0001 0232 6272Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, 1410, Uganda
| | - Elicana Nduhuura
- grid.33440.300000 0001 0232 6272Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, 1410, Uganda
| | - Jonathan Kajjimu
- grid.33440.300000 0001 0232 6272Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, 1410, Uganda
| | - Moses Kule
- grid.459749.20000 0000 9352 6415Department of Psychiatry, Mbarara Regional Referral Hospital, Mbarara, 40, Uganda
| | - Sarah Maria Najjuka
- grid.11194.3c0000 0004 0620 0548College of Health Sciences, Makerere University, Kampala, 7072, Uganda
| | - Rahel Nkola
- grid.33440.300000 0001 0232 6272Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, 1410, Uganda ,African Centre for Suicide Prevention and Research, Mbarara, 379, Uganda
| | - Noble Ajuna
- grid.448548.10000 0004 0466 5982Department of Nursing, Bishop Stuart University, Mbarara, Uganda
| | - Nicholas Kisaakye Wamala
- grid.440478.b0000 0004 0648 1247Faculty of Clinical Medicine and Dentistry, Kampala International University – western Campus, Kampala, 20000, Uganda
| | - Ivan Machacha
- grid.449527.90000 0004 0534 1218School of Medicine, Kabale University, Kabale, 364, Uganda
| | - Mohammed A. Mamun
- CHINTA Research Bangladesh, Savar, Dhaka 1342 Bangladesh ,grid.411808.40000 0001 0664 5967Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka 1342 Bangladesh ,grid.442989.a0000 0001 2226 6721Department of Public Health, Daffodil International University, Dhaka, Bangladesh
| | - Cyrus Su-Hui Ho
- grid.4280.e0000 0001 2180 6431Department of Psychological Medicine, National University of Singapore, Singapore, 119007 Singapore
| | - Mark D. Griffiths
- grid.12361.370000 0001 0727 0669Psychology Department, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ UK
| | - Godfrey Zari Rukundo
- grid.33440.300000 0001 0232 6272Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, 1410, Uganda ,African Centre for Suicide Prevention and Research, Mbarara, 379, Uganda
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19
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Nantaayi B, Ndawula RK, Musoke P, Ssewante N, Nakyagaba L, Wamala JN, Makai EA, Wannyana B, Wamala NK, Kanyike AM, Akech GM, Ojilong D, Agira D, Nakimuli AB, Asiimwe A, Bongomin F. Psychological Distress and Access to Mental Health Services Among Undergraduate Students During the COVID-19 Lockdown in Uganda. Front Psychiatry 2022; 13:792217. [PMID: 35722591 PMCID: PMC9201074 DOI: 10.3389/fpsyt.2022.792217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 05/11/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Lockdown is an important public health approach aimed at curbing the raging effect of the coronavirus disease-2019 (COVID-19). This study aimed at determining the impact of prolonged lockdown on mental health and access to mental health services among undergraduate students in Uganda. METHODS An online cross-sectional study was conducted anonymously among undergraduates across 10 universities in Uganda. The Distress Questionnaire-5 (DQ-5) and the Patient Health Questionnaire-2 (PHQ-2) were used. Logistic regression analysis was conducted to determine factors associated with psychological distress. RESULTS We enrolled 366 participants with a mean age of 24.5 ± 4.6 years. The prevalence of psychological distress was 40.2% (n = 147) (cut off 14/25 based on DQ-5) while depression stood at 25.7% (n = 94; cut off 3/6 based on PHQ-2) with mean scores of 12.1 ± 4.6 and 1.7 ± 1.6 respectively. Female gender (aOR: 1.6, 95%CI: 1.0-2.6, p = 0.032), pursuing a non-medical program (aOR: 2.2, 95%CI: 1.3-3.7, p = 0.005) were factors associated with psychological distress while non-medical program (aOR: 2.2, 95%CI: 1.3-3.7, p = 0.005) was associated with increased depression. Access to mental health services was associated with both reduced distress (aOR: 0.5, 95%CI: 0.3-0.8, p = 0.005) and depression (aOR: 0.6, 95%CI: 0.3-0.9, p = 0.034). A majority (65.3%) of the participants reported knowing how to access mental health care and 188 (51.4%) reported having needed emotional support but, only 67 (18.3%) ever sought care from a mental health professional. Of those who had access, only 10 (7%), and 13 (9%) accessed a counselor or a mental health unit, respectively. The barriers to accessibility of mental health care included financial limitations (49.5%), lack of awareness (32.5%), lack of mental health professionals (28.4%), and stigma (13.9%). CONCLUSION Among university students in Uganda during the COVID- 19 lockdown, the burden of psychological distress and depression was substantial. However, access to mental health services was limited by several factors.
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Affiliation(s)
- Brandy Nantaayi
- School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Rodney Kato Ndawula
- School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Phillip Musoke
- School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Nelson Ssewante
- School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Lourita Nakyagaba
- School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | | | - Emmanuel Arthur Makai
- School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Babrah Wannyana
- School of Clinical Medicine and Dentistry, Kampala International University Western, Bushenyi, Uganda
| | - Nicholas Kisaakye Wamala
- School of Clinical Medicine and Dentistry, Kampala International University Western, Bushenyi, Uganda
| | | | | | - Daniel Ojilong
- Faculty of Health Sciences, Busitema University, Mbale, Uganda
| | - Drake Agira
- Faculty of Medicine, Gulu University, Gulu, Uganda
| | | | - Asaph Asiimwe
- School of Medicine, Soroti University, Soroti, Uganda
| | - Felix Bongomin
- School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.,Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda
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20
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Kaggwa MM, Arinaitwe I, Nduhuura E, Muwanguzi M, Kajjimu J, Kule M, Ajuna N, Machacha I, Nkola R, Najjuka SM, Wamala NK, Bongomin F, Griffiths MD, Rukundo GZ, Mamun MA. Prevalence and Factors Associated With Depression and Suicidal Ideation During the COVID-19 Pandemic Among University Students in Uganda: A Cross-Sectional Study. Front Psychiatry 2022; 13:842466. [PMID: 35492697 PMCID: PMC9046690 DOI: 10.3389/fpsyt.2022.842466] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 03/08/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has negatively impacted psychosocial well-being and mental health of students across the world. Although students are vulnerable to depression and suicidal ideation, few studies have been conducted in Uganda. This study aimed to determine the prevalence of depression and suicidal ideation, and associated factors among undergraduate university students in Uganda. METHODS A cross-sectional study was conducted among undergraduates [N = 540; 363 males; mean age = 23.3 (± 2.64) years] recruited from four universities using an online questionnaire that explored sociodemographic factors, depression, and other associated factors. The Patient Health Questionnaire (PHQ-9) was used to assess depression, and Item 9 was used to assess suicidal ideation in the past 2 weeks. Multivariable logistic regression analyses were performed to determine the factors associated with depression and suicidal ideation. RESULTS The prevalence of moderate to severe depression was 20% (n = 108) (cut-off: 10/27 based on the PHQ-9), and the prevalence of past-2-week suicidal ideation was 13.89% (n = 75) (cut-off: 1/3 based on the PHQ-9 Item 9). About half of the individuals who screened positive for depression had suicidal ideation. Factors associated with depression were: having relationship issues [adjusted odds ratio (aOR) = 1.79, 95% confidence interval (CI) = 1.13-2.81, p = 0.012], and having a history of sexual abuse (aOR = 2.06, 95% CI = 1.10-3.84, p = 0.023). Factors associated with reducing the risk of depression were: satisfaction with current academic performance (aOR = 0.50, 95% CI = 0.32-0.79, p = 0.003), and being in the fifth year of academic study (aOR = 0.16, 95% CI = 0.03-0.73, p = 0.018). Factors associated with suicidal ideation were: smoking cigarettes and/or marijuana (aOR = 4.83, 95% CI = 1.10-21.12, p = 0.037), and having financial tuition constraints (aOR = 1.85, 95% CI = 1.08-3.16, p = 0.024), However, satisfaction with current academic performance reduced the likelihood of suicidal ideation (aOR = 0.40, 95% CI = 0.23-0.70, p = 0.001). CONCLUSION Approximately one-fifth of undergraduate university students were moderately to severely depressed, especially those who had relationship issues and those with a history of sexual abuse. Suicidal ideation was common among smokers and those having financial tuition constraints. Therefore, it is recommended that the university authorities implement measures to provide psychological support for the students with problems concerning financial tuition constraints, relationships, and sexual abuse. Also, all students with depression should be screened for suicidality.
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Affiliation(s)
- Mark Mohan Kaggwa
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.,African Centre for Suicide Prevention and Research, Mbarara, Uganda
| | - Innocent Arinaitwe
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Elicana Nduhuura
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Moses Muwanguzi
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Jonathan Kajjimu
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Moses Kule
- Department of Psychiatry, Mbarara Regional Referral Hospital, Mbarara, Uganda
| | - Noble Ajuna
- Department of Nursing, Bishop Stuart University, Mbarara, Uganda
| | - Ivan Machacha
- School of Medicine, Kabale University, Kabale, Uganda
| | - Rahel Nkola
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.,African Centre for Suicide Prevention and Research, Mbarara, Uganda
| | | | | | - Felix Bongomin
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda
| | - Mark D Griffiths
- Department of Psychology, Nottingham Trent University, Nottingham, United Kingdom
| | - Godfrey Zari Rukundo
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.,African Centre for Suicide Prevention and Research, Mbarara, Uganda
| | - Mohammed A Mamun
- CHINTA Research Bangladesh, Savar, Bangladesh.,Department of Public Health and Informatics, Jahangirnagar University, Savar, Bangladesh.,Department of Public Health, Daffodil International University, Dhaka, Bangladesh
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