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

Introduction: Despite 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. Methods: Studies 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). Results: Originally, 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. Conclusion: These 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 registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=299711, CRD42022299711.

Perinatal suicidal behavior in sub-Saharan Africa: A study protocol for a systematic review with meta-analysis.

BACKGROUND: Perinatal mental illnesses are predominant during gestation and continue for a year after delivery. According to the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10), suicide is classified as a direct cause of death among the maternal population. The occurrence of suicidal behavior among perinatal women was considered the main contributor to the burden of the disorder. Hence, the current study will develop a protocol for a systematic review as well as a meta-analysis on estimating the prevalence and determinants of perinatal suicidal behavior in Sub-Saharan African countries. METHODS: PubMed/MEDLINE, Scopus, EMBASE, PsycINFO, and the Web of Science electronic databases will be searched for studies reporting primary data. The second search strategy will be done with Google Scholar, using a combination of the medical subject headings and keywords as the search terms. The studies will be classified into included, excluded, and undecided categories. The studies will be judged based on the eligibility criteria. Heterogeneity will be checked by using the I2 test (Cochran Q test) at a p-value of 0.05 and assuming that the I2 value is > 50%. Publication bias will be checked using a funnel plot, Beg's rank, and Eggers linear statistical tests. A subgroup analysis and sensitivity test will be carried out. The risk of bias will be assessed using the Joanna Briggs Institute (JBI), and the quantitative analysis will determine whether or not to proceed based on the results. DISCUSSION: This protocol's comprehensive review is expected to generate sufficient evidence on the prevalence of suicidal behavior and its determinants among women during the perinatal period in Sub-Saharan African countries over the last two decades. Hence, this protocol will be imperative to collect and combine empirical data on suicidal behavior during the perinatal period, and doing so will help to provide essential implications or better evidence to plan different kinds of interventions considering determinants expected to impact the burden of suicidal behavior during the perinatal period. SYSTEMATIC REVIEW REGISTRATION: PROSPERO (CRD42022331544).

Perceived stress and its psychosocial and clinical correlates among patients with pulmonary tuberculosis: A cross-sectional study.

Background: Although various psychosocial consequences of pulmonary tuberculosis (PTB) have been thoroughly evaluated, perceived stress has not been well studied. Aim: This study assessed perceived stress and its psychosocial and clinical correlates. Methods: An institution-based cross-sectional study was conducted among 410 PTB patients. Data were analyzed by Statistical Package for the Social Sciences (SPSS) v23. Independent sample t-test and Pearson correlation were used to test the association between perceived stress and other variables. Assumptions of linear regression were checked. Multiple regression analysis was done to identify statistically significant association at P < 0.05. Results: Anxiety, perceived social support, and stigma were found to have significant association with perceived stress in multiple regression analysis. Perceived social support and duration of treatment were negatively significantly associated with perceived stress. Patients with PTB had high perceived stress, and moderate to strong significant correlation was observed among variables. Conclusion: Interventions tailored at addressing various psychosocial aspects of tuberculosis (TB) are needed.

Facebook addiction and affected academic performance among Ethiopian university students: A cross-sectional study.

Addiction is an extreme craving for and commitment to something, physically or psychologically. Currently, addiction to social media is the main emerging technology addiction, especially among the young generation. The main aim of the current study was to evaluate the status of Facebook addiction and its relation to academic performance and other correlates among university students. A cross-sectional study was conducted among 422 students from December 1-30, 2021, and Facebook addiction was examined with the Bergen Facebook Addiction Scale (BFAS). The Rosenberg Self-Esteem Scale (RSES), Hospital Anxiety and Depression Scale (HADS), and Study Habit Questionnaire (SHQ) were employed to assess self-esteem, anxiety and depression symptoms, and study habits, respectively. Systematic random sampling was used to recruit the subjects, and the data were analyzed by SPSS version 23.0. Statistics such as percentages, frequencies, mean ± SD, and mean differences were calculated. Multiple regression analysis was performed, and all the required assumptions were checked. The statistical significance was declared at a p-value < 0.05 and a 95% CI. Results revealed that, the mean age of the students was 23.62 (SD = ±1.79) and 51.6% of the participants were male. The majority of the participants were addicted to Facebook, and Facebook addiction was positively linked with factors like lower academic achievements and the symptoms of anxiety and depression. In conclusion, Facebook addiction was found to be higher among study participants, and it is negatively affecting their academic performances. Similarly, it was associated with affected mental well-being and reduced self-esteem. It is better for the legislative body of the university to put firm policies in place for promoting safe use and reducing the detrimental effects of this problem among students.

Knowledge, attitude, and its correlates of the community toward mental illness in Mattu, South West Ethiopia.

Background: The magnitude of mental health conditions in the general population was high in low-resource settings like Ethiopia. This was accompanied by little evidence on knowledge, attitudes, and related determinants in the general population. Therefore, the current survey is planned to assess the knowledge, attitude, and related factors of the community toward mental illness in Mattu, South West Ethiopia. Objectives: Our study aimed to assess the knowledge, attitude, and related factors of the community toward mental illness in Mattu, South West Ethiopia. Methods: A community-based cross-sectional survey was conducted in South West Ethiopia, Mattu town from 1 April-20 June, 2022 using a systematic random sampling, a multistage stratified technique from 649 households, and employed an interviewer-administered pre-tested semi-structured English version questionnaire. Epi-data Version 3.1 and SPSS-V-23.3 were employed for data entry and analysis respectively. A statistically significant association was declared at a P-value ≤ 0.05 at a 95% confidence interval. Results: In the current study, poor knowledge regarding, and unfavorable attitudes toward, mental illness among study respondents were 28% (182) 95% CI (24.3, 31.6) and 60.4% (392) 95% CI (56.5, 64.3), respectively. After controlling for potential confounders, being self-employed was independently associated with poor knowledge [AOR = 3.1, 95%CI (1.65, 4.28)]. Moreover, current use of substances [AOR = 1.64 95%CI (1.09, 5.98)] and not hearing information about mental illness from social media have been shown to be associated in the final model with an unfavorable attitude [AOR = 3.44 95%CI (1.98, 5.99)]. Conclusion and recommendation: About one-third and more than one-half of the study participants showed poor knowledge and an unfavorable attitude, respectively. Compared to similar global and local findings, there was better community knowledge and a poor attitude toward mental illness in the area. Unfavorable attitudes toward mental illness were found to be exacerbated by participants not hearing about it on social media and by current substance use. Moreover, being self-employed was independently associated with poor knowledge of mental illness. Hence, all concerned stakeholders need to enhance mental health advocacy to improve public knowledge and attitude toward mental illness through media campaigns with a special focus on common substances. In addition, due attention should be given to self-employed groups of society to reduce the impacts of mental health conditions.

Attitude Towards COVID-19 Vaccination Among Healthcare Workers: A Systematic Review.

INTRODUCTION: Availability and accessibility of a safe COVID-19 vaccine do not necessarily guarantee an effective means to mitigate the pandemic. However, the fragile hero's or health care worker's attitude toward the vaccine is of paramount importance to promote its acceptance. So, the current review aims to provide the latest assessment of healthcare workers' attitudes toward the COVID-19 vaccination and its contributing factor worldwide. METHODS: Peer-reviewed surveys in English indexed via an electronic database in Google Scholar, Science Direct and PubMed were systematically searched. The review was carried out per the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA-2009) and registered on PROSPERO (CRD42021265534). RESULTS: Originally 8039 articles were searched from three databases PubMed, Science direct, and Google scholar. Finally, 24 studies met the inclusion criteria and made the root for the estimates of the attitude of COVID -19 vaccinations. In about two-thirds of the studies, respondents showed a positive attitude (≥50%) toward COVID-19 vaccination. However, in about one-quarter of the studies, a negative attitude (<50%) against vaccination was reported. Factors related to the attitude of healthcare workers toward COVID-19 vaccination include age, sex, profession, concerns about the safety of vaccines and fear of COVID-19, trust in the accuracy of the measures taken by the government, flu vaccination during the previous season, comorbid chronic illness, history of recommendation, and depression symptoms in the past week. CONCLUSION: Although most studies report that healthcare workers have a positive attitude toward COVID-19 vaccination, quite a few surveys mention negative attitudes towards the use of vaccines, which may reflect missed opportunities or challenges for the international efforts aimed at mitigating the pandemic. Still, we need to continue to make more efforts to change the attitudes of the uncertain healthcare workers to increase the uptake of the vaccine and deal with the multi-faceted impact of infection.

Psychological Distress Among Health Care Workers in Health Facilities of Mettu Town During COVID-19 Outbreak, South West Ethiopia, 2020.

Background: During any of the infectious disease outbreak, health care workers were at increased risk of being infected, and psychological distress was a common phenomenon. Therefore, the study aimed to assess the psychological distress related to COVID-19 among healthcare workers in Mettu town. Methods: A cross sectional study was conducted from May 1-15, 2020 using convenient sampling techniques among 127 health care providers during COVID-19 pandemic in the Mettu town. Self-administered questionnaire was used to collect information. Depression and anxiety were evaluated as subscales from the Depression Anxiety Stress Scale (DASS-21). Psychological distress related to COVID-19 was measured using the Impact of Event Scale Revised (IES-R). Data analysis were done using SPSS version 24. Chi-square test was used to find the association between the outcome and demographic variables. Multivariable logistic regression analyses were used to evaluate the significance of the association at P-value < 0.05. Result: Using IES-R scale, 40.2% of the participants reported to have the symptoms of psychological distress. The majority of the participants reported mild psychological distress (37%) followed by moderate psychological distress (29%). The multivariate logistic regression analysis revealed that the odds of psychological distress were found to be higher among health care providers who reported to have depressive symptoms, and those who used alcohol, khat and tobacco in the past 3 months shows a significant association with psychological distress. Conclusion: Our findings revealed that the COVID-19 pandemic had exerted major psychological distress on health care providers. So the findings, seek attention for early psychological intervention needed to manage psychological distress in health care providers regarding identified factors.

Health-related quality of life among Ethiopian pregnant women during COVID-19 pandemic.

OBJECTIVE: To explore the quality of life and its association with perceived social support and pandemic fear among pregnant women. METHODS: Cross-sectional study was conducted among 384 pregnant mothers at southwest Ethiopia from August 1, 2020, to August 15, 2020. Participants were included by consecutive sampling. Quality of life was assessed by short version of WHO quality of life. Social support and fear of COVID-19 were evaluated by Multidimensional Scale of Perceived Social Support (MSPSS) and fear of COVID-19 scale (FCoV-19S), respectively. Data were analyzed by SPSS version 23.0. Frequency and percentage for categorical variables, and mean ± SD for continuous variables were calculated. Independent sample t test and ANOVA were employed to compare the groups of normally distributed variables. Multiple regressions were performed, and Pearson correlation (r) was used to explore the relationships. Statistical significance was declared at p < .05, and 95% CI was calculated. RESULTS: The mean age of the participants was 31.3 ± 7.7, and 40.4% of them were between the ages of 25-34. The mean scores of participants those living with <5 family members and those living with ≥5 family members were significantly different [t(382) = 3.09, p = .002]. Participants with primary education have significantly high mean score of WHOQOL-BREF from those participants with no formal education (p = .028, MD = -1.9). Moderate negative correlation was observed between the scores of WHOQOL-BREF and FCoV-19S. All the components of MSPSS had positively associated with WHOQOL-BREF score at significant level. On final model, FCoV-19S score has uniquely accounted for 19.4% of variance in WHOQOL-BREF. CONCLUSIONS: Perceived social support has positively linked to QOL among pregnant women during COVID-19 pandemic. Pandemic-related fear has negative association with QOL and may be considered independent contributor of decreased quality of life in this population.

Perceived stigma among patient with pulmonary tuberculosis at public health facilities in southwest Ethiopia: A cross-sectional study.

OBJECTIVES: Although tuberculosis (TB) related stigma has a significant impact on the diagnosis, patient adherence with treatment, and recovery from the disease, there is limited evidence from Ethiopia regarding perceived stigma among patient with pulmonary tuberculosis (PTB).The purpose of this study was to assess perceived stigma and associated factors among patient with PTB on treatment in southwest Ethiopia. METHODS: Institution-based cross-sectional study was conducted from April to May 2019 among 410 patient with PTB. Data were collected by using the perceived tuberculosis stigma scale. Epi data v3.1 and SPSSv23 were used for data entry and analysis. Multivariable logistic regression models were fitted to identify factors associated with perceived stigma. Results are presented as adjusted odds ratios (AORs) with 95% confidence intervals (CIs). RESULT: Prevalence of perceived stigma among patient with Pulmonary tuberculosis was 57.1% (95% CI: 52.2, 61.7). Poor social support (AOR = 2.41; 95% CI: 1.06, 5.48), above a month duration of illness (AOR = 2.48; 95% CI: 1.33, 4.64), high perceived stress (AOR = 1.95; 95% CI:1.09, 3.49), current khat use (AOR = 1.88; 95% CI:1.05, 3.37), and presence of depression (AOR = 8.18; 95% CI:4.40, 15.22) were significantly associated with perceived stigma. Patient with HIV co-infection were 5.67 times (AOR = 5.67; 95% CI: 2.32, 13.87) more likely to have Perceived stigma than their counterparts. CONCLUSION: TB related stigma was reported by more than half of the study participant. Stigma reduction measures are needed to lower TB related stigma perceived by the patient, the level of distress associated with it, and to promote the psychological wellbeing of patient with TB.

Depression, Anxiety and Associated Factors Among Chronic Medical Patients Amid COVID-19 Pandemic in Mettu Karl Referral Hospital, Mettu, Ethiopia, 2020.

BACKGROUND: COVID-19 has had a devastating impact on the mental health condition of the world's population. Although the direct effect of COVID-19 on the mental health status of chronic medical patients is well understood, the burden of depression and anxiety on patients with chronic medical conditions is not well studied yet. Therefore, the study aimed to assess the prevalence of depression, anxiety and associated factors among chronic medical patients amid the COVID-19 pandemic in Mettu Karl Referral Hospital, Mettu, Ethiopia. METHODS: A facility-based cross-sectional study was conducted from June 1 to July 30, 2020 among chronic medical patients in Mettu Karl Referral Hospital, Ethiopia. Consecutive sampling technique was applied with a total of 423 samples. Quantitative data were employed by using structured questionnaires. Descriptive statistical procedures, bivariate and multivariate logistic regressions with odds ratios and 95% confidence interval (CI) were employed. The statistical significance was declared at p value < 0.05. RESULTS: The findings showed that the prevalence of depression and anxiety among chronic medical patients was 55.7% and 61.8%, respectively. Female gender (AOR = 1.66, 95% CI (1.06, 2.59)), poor social support (AOR = 1.94, 95% CI (1.10, 3.42)), widowed/divorced (AOR = 3.92, 95% CI (1.59, 9.64)), separated (AOR = 3.66, 95% CI (1.64, 8.19)), and longer duration of illness (AOR = 1.82, 95% CI (1.15, 2.89)) were significantly associated with depression, whereas earlier age at onset of illness, having more than three co-morbid diagnoses, tobacco use and poor social support were found to have significant association with anxiety among chronic medical patients amid the COVID-19 pandemic in Ethiopia. CONCLUSION: The magnitude of concurrent depression and anxiety in the current study was high. Strategies for prompt identification and treatment of depression and anxiety should be developed among medically ill patients.

Prevalence and Associated Factors of Depression and Anxiety Among Patients with Pulmonary Tuberculosis Attending Treatment at Public Health Facilities in Southwest Ethiopia.

BACKGROUND: Depression and anxiety are the most commonly occurring psychiatric comorbidities among patients with pulmonary tuberculosis (PTB). Co-occurring anxiety and depression in PTB patients result in poor adherence to anti-tuberculosis medication. This in turn results in lower success rate of treatment and an upsurge in morbidity and mortality. Despite this problem existing globally, little has been explored in southwest Ethiopia. OBJECTIVE: The aim of this study was to assess the prevalence and associated factors of depression and anxiety among patients with pulmonary tuberculosis receiving treatment at public health facilities in southwest Ethiopia. MATERIALS AND METHODS: A facility-based cross-sectional study was conducted from April to May 2019. Data were collected from 410 PTB patients using hospital anxiety and depression scale (HADS). Epi data version 3.1 and SPSS version 23 were used to enter and analyze data respectively. Multiple logistic regressions were fitted to identify the strength of association between outcome and explanatory variables. P <0.05 was considered statistically significant. RESULTS: Prevalence of depression and anxiety among PTB patients were 229 (55.9 %) and 224 (54.6%), respectively. High perceived stress [AOR=3.61 (1.99, 6.53)], perceived stigma [AOR=10.13 (5.52, 18.63)], being in an intensive phase of treatment [AOR= 3.33 (1.83, 6.07)], and low body mass index [AOR=2.07 (1.13, 3.80)] were significantly associated with depression. Being female [AOR=2.42 (1.39, 4.22)], perceived stigma [AOR=3.58 (1.99, 6.42)], high perceived stress [AOR=4.40 (2.52, 7.69)], and family history of mental illness [AOR=2.66 (1.19, 5.94)] had significant association with anxiety. CONCLUSION: More than half of the study participants were found to have probable depression and anxiety. This indicates the need to pay attention to the mental health condition of patients with PTB, particularly to those with identified risk factors.