Impacts of violence on the mental health of Afro-descendant survivors in Colombia

The Colombian armed conflict has disproportionately affected minorities, especially afro-Colombian communities. However, there is a lack of evidence about mental health of victims. This study aims to describe the prevalence of mental illness and its associated factors in Afro-descendant violence survivors in Buenaventura and Quibdó, Colombia. A cross-sectional study was carried out using data from a previous trial which aimed to reduce mental health symptoms (ClinicalTrials.gov: NCT01856673). Data of 710 adults identified through a snowball sampling technique was analysed. Diagnoses of depression, anxiety, post-traumatic stress disorder (PTSD), and dysfunction were established using adapted versions of the Hopkins Symptoms Checklist and the Harvard Trauma Questionnaire, plus variables identified in a qualitative study. Multivariate regressions were used to identify associated factors with these diagnoses. The prevalence of depression, anxiety and PTSD in both cities was 26.62% (95% confidence interval [95%CI]: 20.30;23.89), 36.53% (95%CI: 30.63;42.36), and 39.15% (95%CI: 33.36;44.83), respectively. Being married and having registered with the government as victim of the conflict were found to be protective factors for depression and PTSD, respectively. Psychological trauma, unemployment, and traumatic experiences, amongst others, were found as risk factors. The Colombian armed conflict, plus disparities and social exclusion, may be associated with mental health morbidity.

Homicide Epidemic in Cali, Colombia: A Surveillance System Data Analysis, 1993‒2018

Objectives. To examine homicide rates in Cali, Colombia, during the 1993-2018 period, using information derived from an interagency surveillance system. Methods. We used homicide data from Cali's Epidemiological Surveillance System to examine homicide trends by victim's age and sex, time, and type of method used. We estimated trend changes and the annual percentage changes using joinpoint regression analyses. Results. Homicide rates per 100 000 inhabitants dropped from 102 in 1993 to 47.8 in 2018. We observed reductions in homicide rates across age and sex groups. Most homicide victims were men aged 20 to 39 years from poor, marginalized areas. Firearms were used in 84.9% of all cases. The average annual percentage change for the entire period was -3.6 (95% confidence interval = -6.7, -0.4). Conclusions. Fluctuations in homicide rates in Cali show a clear epidemic pattern, occurring concurrently with the "crack epidemic" in different countries. Reliable and timely information provided by an Epidemiological Surveillance System allowed opportune formulation of public policies to reduce the impact of violence in Cali.