17 research outputs found
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Prevalence of depression in Uganda: a systematic review and meta-analysis
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]: 26.7â34.1, 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
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Suicidal behaviors and associated factors among medical students in Africa: a systematic review and meta-analysis
Background: Suicide behaviors are common among medical students, and the prevalence rates might vary across various regions. Even though various systematic reviews have been conducted to assess suicidal behaviors among medical students in general, no review has ever assessed or carried out a sub-analysis to show the burden of suicidal behaviors among African medical students which was fulfilled in the present study.
Method: A systematic review and meta-analysis of prevalence studies among African medical students from PubMed, Scopus, PsycINFO, African Journals Online, and Google Scholar databases. A total of 204 publications were identified. The studies' selection, data extraction, and methodological evaluation were performed, and meta-analysis was performed based on the random effects model.
Results: Data were obtained from 14 eligible studies, including 8585 medical students in Africa. The pooled prevalence of lifetime suicidal behaviors was 18.7% for suicidal ideation (95% CI: 14.1%-23.3; I 2 = 94.37%; p < 0.001), 3.8% for suicidal plans (95% CI: 2.7%-4.8%; I 2 = 0.03%; p < 0.001), and 5.5% for suicide attempts (95% CI: 3.8%-7.2%; I 2 = 89.47%; p < 0.001). The factors associated with suicidal ideations were female gender, use of alcohol, depression, and use of khat. Only depression was associated with suicide attempts.
Limitations: The review involved few studies, and not all African regions were represented.
Conclusion: Suicidal behaviors, particularly suicide attempts, are high among medical students in Africa. However, very few studies are done in the region to clearly quantify the burden and its associated factors
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Involvement and burden of informal caregivers of patients with mental illness: the mediating role of affiliated stigma
Background: The fear and lack of understanding of mental illness can lead to stigma. The stigma of mental illness affects not only individuals who suffer from it, but also the caregivers. Stigma among caregivers can lead to delay in seeking care, poor adherence to treatment and a high risk of relapse. Caregivers of patients with mental illness are at an increased risk of distress due to the burden to stigma and caregiving burden. An increase in caregiversâ burden can lead to a reduction in caregiversâ involvement. There is a relationship between caregiversâ involvement, burden, and affiliated stigma. The present study examined the mediating role of affiliated stigma in the relationship between caregiversâ burden and involvement among informal caregivers of hospital-admitted patients with mental illness in Uganda.
Methods: A cross-sectional study was conducted among 428 informal caregivers (mean age: 39.6 years [SD±14.6]; females = 62.1%). Information was collected regarding sociodemographic characteristics, affiliated stigma, and the involvement and burden of informal caregivers.
Results: The findings indicate that affiliated stigma serves as a full mediator between the caregiverâs roles and involvement (ÎČ=15.97, p<0.001). Being female increased the caregiversâ burden of caregiving (ÎČ= -0.23, p<0.001).
Conclusion: The findings in the present study suggest that intervention to address affiliated stigma among caregivers of patients with mental illness should be incorporated into mainstream mental health care to reduce the caregiving burden
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Suicide related to the COVID-19 pandemic in India: a systematic review
Background: The suicide rate has increased during the pandemic in India. Moreover, several studies, especially press-media reporting suicide studies have been conducted but no systematic review has been attempted in this context. Therefore, the present study systematically investigated the risk factors associated with suicidal behaviors, and the method of suicide during the COVID-19 pandemic in India.
Methods: Following the PRISMA guidelines, a systematic search was performed to include papers published up until September 30, 2022. From an initial 144 papers, 18 studies which met the inclusion criteria were included in the present review. The Piersonâs method was used for quality assessment of the included studies in the present review.
Results: The risk factors associated with suicide comprised: (i) socio-demographic factors (e.g., being aged between 31 and 50 years, male, married, unemployed), (ii) behavior and health-related factors (e.g., unavailability of alcohol and alcohol withdrawal symptoms, poor state of physical health and health issues, family disputes, relationship complexities, and sexual harassment), (iii) COVID-19-related factors (e.g., fear of COVID-19, COVID-19 test results, quarantine or isolation, financial hardship due to the pandemic, having influenza-like symptoms, experiencing stigmatization and ostracism despite testing negative, separation from family due to transport restrictions, misinterpreting other illness symptoms as COVID-19, saving the village from infection, watching COVID-19 videos on social media, online schooling, perceived stigma toward COVID-19, and being suspected of having COVID-19), and (iv) psychopathological stressors (depression, loneliness, stress, TikTok addiction, and poor mental health, suicidal tendencies, helplessness, and worrying). Hanging was the most common method of suicide. In addition, jumping from high buildings, poisoning, drowning, burning, cutting or slitting throat or wrists, self-immolation, medication overdose, electrocution, pesticide, and gun-shot were also used to carry out the suicide.
Conclusions: Findings from this research suggest multiple reasons for suicide during the COVID-19 pandemic and knowledge of such factors could aid in developing suicide prevention strategies focusing the most vulnerable cohorts inside and outside India
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How has the COVID-19 pandemic impacted internet use behaviors and facilitated problematic internet use? A Bangladeshi study
Background: The COVID-19 pandemic-related âstay-at-homeâ and confinement orders has led individuals to be more engaged with technology use (e.g., internet use). For a minority of individuals, excessive use can become problematic and addictive. However, the investigation of problematic internet use in the COVID-19 context is only just emerging. Therefore, the present study investigated the changes in internet use behaviors and addiction rates in comparison with prior Bangladeshi studies.
Methods: An online cross-sectional study was carried out among a total of 601 Bangladeshi students between October 7 and November 2, 2020. The survey included questions relating to socio-demographic, behavioral health, online use behaviors, and psychopathological variables.
Results: A quarter of the participants (26%) reported having low levels of internet addiction, whereas 58.6% were classed as having moderate internet addiction and 13% severe internet addiction. A total of 4% of the sample were classed as being at risk of severe internet dependency (i.e., scoring over â„ 80 on IAT). Risk factors for internet addiction included smartphone addiction, Facebook addiction, depression, and anxiety. However, the final hierarchical regression model comprising all variables explained a total of 70.6% variance of problematic internet use.
Conclusion: Based on the present findings, it is concluded that individuals are at elevated risk of problematic internet use like other psychological impacts that have been reported during the COVID-19 pandemic. Therefore, risk-reducing measures and healthy control use strategies should be implemented for vulnerable individuals
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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
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 18â22 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 (Ï2 = 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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Suicidal behaviours among Ugandan university students: a cross-sectional study
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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Prevalence and factors associated with depression and suicidal ideation during the COVID-19 pandemic among university students in Uganda: a cross-sectional study
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) = 1.13â2.81, p = 0.012], and having a history of sexual abuse (aOR = 2.06, 95% CI = 1.10â3.84, p = 0.023). Factors associated with reducing the risk of depression were: satisfaction with current academic performance (aOR = 0.50, 95% CI = 0.32â0.79, p = 0.003), and being in the fifth year of academic study (aOR = 0.16, 95% CI = 0.03â0.73, p = 0.018). Factors associated with suicidal ideation were: smoking cigarettes and/or marijuana (aOR = 4.83, 95% CI = 1.10â21.12, p = 0.037), and having financial tuition constraints (aOR = 1.85, 95% CI = 1.08â3.16, p = 0.024), However, satisfaction with current academic performance reduced the likelihood of suicidal ideation (aOR = 0.40, 95% CI = 0.23â0.70, 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
A synthesis of past, current and future research for protection and management of papyrus (Cyperus papyrus L.) wetlands in Africa
Papyrus wetlands (dominated by the giant
sedge Cyperus papyrus L.) occur throughout eastern,
central and southern Africa and are important for
biodiversity, for water quality and quantity regulation
and for the livelihoods of millions of people. To draw
attention to the importance of papyrus wetlands, a
special session entitled ââThe ecology of livelihoods in
papyrus wetlandsââ was organized at the 9th INTECOL
Wetlands Conference in Orlando, Florida in June
2012. Papers from the session, combined with additional
contributions, were collected in a special issue
of Wetlands Ecology and Management. The current
paper reviews ecological and hydrological characteristics
of papyrus wetlands, summarizes their ecosystem
services and sustainable use, provides an
overview of papyrus research to date, and looks at
policy development for papyrus wetlands. Based on
this review, the paper provides a synthesis of research
and policy priorities for papyrus wetlands and introduces
the contributions in the special issue. Main
conclusions are that (1) there is a need for better
estimates of the area covered by papyrus wetlands.
Limited evidence suggests that the loss of papyrus
wetlands is rapid in some areas; (2) there is a need for a
better understanding and modelling of the regulating
services of papyrus wetlands to support trade-off
analysis and improve economic valuation; (3) research
on papyrus wetlands should include assessment of all
ecosystem services (provisioning, regulating, habitat,
cultural) so that trade-offs can be determined as the
basis for sustainable management strategies (âwise
useâ); (4) more research on the governance, institutional
and socio-economic aspects of papyrus wetlands
is needed to assist African governments in
dealing with the challenges of conserving wetlands in
the face of growing food security needs and climate
change. The papers in the special issue address a
number of these issues
Simplifying Addiction
Mark Mohan Kaggwa Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, UgandaCorrespondence: Mark Mohan Kaggwa Email [email protected]: Addiction disorders/substance use disorders (SUD) are on the rise. However, many mental health care providers have never experienced SUD themselves, leading to higher chances of poor patient care through stigma, judgement, and the misunderstanding of patients. An alternative approach to understanding patients with addictive behaviors using a comparison of sex is discussed in this paper. Since most health care providers will have experienced sex, this analog can help mental health workers with no lived experience of SUD better understand their patients. This can help reduce stigma, misunderstanding, countertransference feeling, and the judgment of patients, thereby leading to better patient care.Keywords: addiction, sex, substance use disorder, neurobiology of addiction, sex neurobiology, opinion, mental health provider