A post-traumatic stress disorder among internally displaced people in sub-Saharan Africa: a systematic review

IntroductionDespite the prevalence of post-traumatic disorder in internally displaced persons, which is well established, and the fact that respective international organizations are working on the issues, little attention is given in the context of sub-Saharan Africa, This study aims to review the available data about the prevalence and determinants of post-traumatic stress disorders among internally displaced people in sub-Saharan Africa.MethodsStudies published in the English language that have a clear outcome of interest and are available in full text were included. Six electronic databases were searched to identify published studies on the prevalence and determinants of posttraumatic stress disorder among IDPs in sub-Saharan Africa. This includes PubMed/MEDLINE, Scopus, EMBASE, PsychInfo, and the Web of Science. All relevant studies till June, 2023 were assessed. The review was done as per the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA-2009) and registered on PROSPERO (CRD420222997111).ResultsOriginally, 33,138 articles were found in six databases, and finally, eleven studies were reviewed. The prevalence of post-traumatic stress disorder in sub-Saharan African countries was disproportionately presented in this review, ranging from 12.3% in Central Sudan to 85.5% in Nigeria. From a total of 11 studies, eight of them reported more than 50% of the magnitude of post-traumatic stress disorder, pointing to a higher magnitude of the prevalence of post-traumatic stress disorders in the region. The study identified numerous factors that contributed to post-traumatic stress disorder among the internally displaced population. Female gender, depression, anxiety, stress, being single, low level of educational status, experiencing or witnessing traumatic events, and psychological trauma were evidenced for their association with post-traumatic stress disorder.ConclusionThese results demonstrate a higher prevalence of post-traumatic stress disorder compared to other regions of the world. The participants’ socio-demographic characteristics, including age, being single, being female, and a low level of education, were identified as factors contributing to PTSD. Moreover, the review identified that depression, anxiety, and experiencing or witnessing traumatic events were also influencing factors for PTSD among IDPs. The concerned bodies need to reinforce the monitoring and evaluation of the mental health programs of IDPs in the region.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=299711, CRD42022299711

Strategies to promote mental health among students in higher education institutions in Ethiopia

Pieces of evidence show that due to various factors mental health problems are on the rise among students in higher education institutions globally and particularly in Ethiopia. The level of positive mental health and associated factors among students in higher education are not widely known. There are limited evidences on mental health programs or strategies that help to promote the mental well-being of learners in higher institutions in Ethiopia. The purpose of this study was to develop and describe strategies for the promotion of students’ mental health in higher education in Ethiopia. A sequential exploratory mixed-method design was used in three phases. In phase I: the qualitative phase, in-depth interviews were conducted among 28 purposefully selected students and key informants from different categories and genders. Translation to English, verbatim transcription of recorded audio files, coding, and finally thematic analysis was employed for qualitative data management and analysis. In phase II: the quantitative phase, a cross-sectional study was conducted among systematically selected 805 students who filled out a self-administered questionnaire. Data were cleaned and entered into EPI-data version 3.1.1 and analysed using SPSS version 26. Univariate analysis and bivariate logistic regression were employed for quantitative data management. Statistically, a significant association was determined by OR and CI of 95% with a p-value <0.05. In phase III of this study, the mental health promotion strategy for students in higher institutions was developed and described. The findings of the qualitative phase of the study indicated five interrelated and connected themes which were generated from the coding of all transcripts and thematic analysis. These themes include mental health problem experiences and potential causes, mental health problem effects on students, help sought for their problem and mental health programs, suggested approaches for mental health promotion strategies, and roles of different individuals and institutions. The result of the qualitative study was also utilized for the development of a questionnaire for the quantitative phase and as input for the development of the mental health promotion strategy of students in higher education in Ethiopia. In this study, 303 (37.6%) of the respondents have not flourished positive mental health with a confidence interval of CI (34.2, 41.0); while 502 (62.4%) of the respondents have flourishing positive mental health with a confidence interval of CI (59.0, 65.8). Current family breakdown of students’ biological parental marital condition, 500-1000km distance of university from family hometown, having had a history of substance use in the last 12 months, having low perceived social support, having low daily spiritual experiences, and not having any monthly financial support showed statistically significant negative association to flourishing positive mental health. A strategy for the promotion of the mental health of learners in higher education institutions was developed and described. The study reveals substantially low flourishing positive mental health among the students due to different factors in a higher institution. The absence of mental health programs was also indicated as a major problem. The developed strategies will empower students to maintain psychological well-being and enable higher institutions to promote the well-being of the learners by establishing safe and supportive learning and campuses.Health StudiesD. Phil. (Public Health

Predictors of Intestinal Parasitic Infection among Food Handlers Working in Madda Walabu University, Ethiopia: A Cross-Sectional Study

Background. Intestinal parasitic infection is one of the major health problems globally. It is more common in developing countries including Ethiopia. So, adequate evidence is needed regarding the predictors of intestinal parasitic infection. This study was aimed at determining the predictors of intestinal parasitic infection among food handlers working in Madda Walabu University, Ethiopia. Methods. An institution-based cross-sectional study was conducted from 15 May to 10 June 2017 among 198 symptom-free food handlers. Data on sociodemographic variables were collected through face-to-face interview using a structured questionnaire. Stool samples were collected immediately after the interview using labeled wide-mouthed plastic container and clean wooden applicator. Direct wet-mount method and formal-ether concentration techniques were performed to identify intestinal parasites. The data were analyzed using SPSS version 21.0. Descriptive statistics and crude and adjusted odds ratios with 95% confidence interval (CI) were calculated. p value of <0.05 was considered to declaration level of significance. Result. The response rate was 98% (198/202). The overall prevalence of intestinal parasites was 25.3% (50/198). The top three intestinal parasites found in this study were Ascaris lumbricoides 7.6% (15/198), Entamoeba histolytica/dispar 7.6% (15/198), and hookworm 5.6% (11/198). Inadequate handwashing practice (AOR: 13.876; 95% CI: 4.129, 46.632), inadequate knowledge about foodborne diseases (AOR: 3.596; 95% CI: 1.438, 8.989), lack of training on proper food handling (AOR: 5.960; 95% CI: 1.450, 24.497), and untrimmed fingernail (AOR: 2.939; 95% CI: 1.368, 6.135) were independent predictors of intestinal parasitic infection. Conclusion. High prevalence of intestinal parasites was observed among symptom-free food handlers who could be unobservable source of disease transmission. Inadequate handwashing, untrimmed fingernail, inadequate knowledge, and lack of training were independent predictors of intestinal parasitic infection in this study. This implies the need for timely and adequate training and enforcement of regular medical checkup system for food handlers