The prevalence and correlates of depression before and after the COVID-19 pandemic declaration among urban refugee adolescents and youth in informal settlements in Kampala, Uganda: A longitudinal cohort study

Logie, Carmen H.; Berry, Isha; Okumu, Moses; Loutet, Miranda; McNamee, Clara; Hakiza, Robert; Musoke, Daniel Kibuuka; Mwima, Simon; Kyambadde, Peter; Mbuagbaw, Lawrence

doi:10.1016/j.annepidem.2021.11.005

Cited by 20 publications

(27 citation statements)

References 44 publications

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Section: Discussionmentioning

confidence: 83%

“…These estimates are near the upper end of the range of results from a global systematic review of the effects of COVID-19 on psychological outcomes, where the prevalence of anxiety ranged from 6% to 51% and depression ranged from 15% to 48% across eight countries, though the majority of countries included in the review were upper-middle or high income (Xiong et al ., 2020 ). Our estimates are also on the high end of estimates from the few studies conducted in low-income countries, where the prevalence of depression or mental health symptoms ranged from 7% to 52% (Cénat et al ., 2021 ; Langsi et al ., 2021 ; Mamun et al ., 2021 ; Workneh et al ., 2021 ; Logie et al ., 2022 ). While we do not have data collected from before the start of the pandemic in Uganda, our estimates indicate higher rates of psychological distress compared to a 2018 study, which found that 31% of individuals reported moderate or severe mental distress in Uganda, as measured by the Kessler-6 scale (Sweetland et al ., 2019 ).…”

Section: Discussionmentioning

confidence: 99%

“…While we do not have data collected from before the start of the pandemic in Uganda, our estimates indicate higher rates of psychological distress compared to a 2018 study, which found that 31% of individuals reported moderate or severe mental distress in Uganda, as measured by the Kessler-6 scale (Sweetland et al ., 2019 ). Other previous studies in Uganda found the prevalence of depression to be between 17% and 28%, although differences in sampling and measurement tools make it difficult to directly compare estimates (Ovuga et al ., 2005 ; Logie et al ., 2022 ).…”

Section: Discussionmentioning

confidence: 99%

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Levels of depression, anxiety, and psychological distress among Ugandan adults during the first wave of the COVID-19 pandemic: cross-sectional evidence from a mobile phone-based population survey

et al. 2022

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Objectives Policy measures to slow the spread of coronavirus disease 2019 (COVID-19), such as curfews and business closures, may have negative effects on mental health. Populations in low- and middle-income countries (LMICs) may be particularly affected due to high rates of poverty and less comprehensive welfare systems, but the evidence is scarce. We evaluated predictors of depression, anxiety, and psychological distress in Uganda, which implemented one of the world's most stringent lockdowns. Methods We conducted a mobile phone-based cross-sectional survey from December 2020 through April 2021 among individuals aged 18 years or over in Uganda. We measured depression, anxiety, and psychological distress using the Patient Health Questionnaire (PHQ)-2, the Generalized Anxiety Disorder (GAD)-2, and the PHQ-4. We applied linear regression to assess associations between experiences of COVID-19 (including fear of infection, social isolation, income loss, difficulty accessing medical care, school closings, and interactions with police) and PHQ-4 score, adjusted for sociodemographic characteristics. Results 29.2% of 4066 total participants reported scores indicating moderate psychological distress, and 12.1% reported scores indicating severe distress. Distress was most common among individuals who were female, had lower levels of education, and lived in households with children. Related to COVID-19, PHQ-4 score was significantly associated with difficulty accessing medical care, worries about COVID-19, worries about interactions with police over lockdown measures, and days spent at home. Conclusions There is an urgent need to address the significant burden of psychological distress associated with COVID-19 and policy responses in LMICs. Pandemic mitigation strategies must consider mental health consequences.

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Levels of depression, anxiety, and psychological distress among Ugandan adults during the first wave of the COVID-19 pandemic: cross-sectional evidence from a mobile phone-based population survey

et al. 2022

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“…We found a higher burden of acute sickness among refugees than hosts in this setting, though no difference in chronic care burden. This is a surprising finding, as while it is often suggested refugees have greater need for mental health and psychosocial support [ 43 ], there is little discussion of greater acute care needs [ 44 ]. The burden of both acute and chronic sickness increased with household wealth, which may be due to wealthier households being more likely to report these conditions [ 45 ], or due to greater health care seeking resulting in higher levels of diagnosis [ 46 ].…”

Section: Discussionmentioning

confidence: 99%

Assessing equity of access and affordability of care among South Sudanese refugees and host communities in two districts in Uganda: a cross-sectional survey

King

Prabhakar

Singh

et al. 2022

BMC Health Serv Res

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Background The vast majority of refugees are hosted in low and middle income countries (LMICs), which are already struggling to finance and achieve universal health coverage for their own populations. While there is mounting evidence of barriers to health care access facing refugees, there is more limited evidence on equity in access to and affordability of care across refugee and host populations. The objective of this study was to examine equity in terms of health needs, service utilisation, and health care payments both within and between South Sudanese refugees and hosts communities (Ugandan nationals), in two districts of Uganda. Methods Participants were recruited from host and refugee villages from Arua and Kiryandongo districts. Twenty host villages and 20 refugee villages were randomly selected from each district, and 30 households were sampled from each village, with a target sample size of 2400 households. The survey measured condition incidence, health care seeking and health care expenditure outcomes related to acute and chronic illness and maternal care. Equity was assessed descriptively in relation to household consumption expenditure quintiles, and using concentration indices and Kakwani indices (for expenditure outcomes). We also measured the incidence of catastrophic health expenditure- payments for healthcare and impoverishment effects of expenditure across wealth quintiles. Results There was higher health need for acute and chronic conditions in wealthier groups, while maternal care need was greater among poorer groups for refugees and hosts. Service coverage for acute, chronic and antenatal care was similar among hosts and refugee communities. However, lower levels of delivery care access for hosts remain. Although maternal care services are now largely affordable in Uganda among the studied communities, and service access is generally pro-poor, the costs of acute and chronic care can be substantial and regressive and are largely responsible for catastrophic expenditures, with service access benefiting wealthier groups. Conclusions Efforts are needed to enhance access among the poorest for acute and chronic care and reduce associated out-of-pocket payments and their impoverishing effects. Further research examining cost drivers and potential financing arrangements to offset these will be important.

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“…In 2020, the World Health Organization (WHO) declared COVID-19 a pandemic and has since had detrimental effects on population health and well-being worldwide [1]. The uncertainties and unpredictable nature of the pandemic resulted in individuals experiencing various forms of mental health problems such as depression, anxiety, psychosocial dysfunction, dissociation disorders, substance abuse, and insomnia.…”

Section: Introductionmentioning

confidence: 99%

Association between recent COVID-19 diagnosis on depression and anxiety symptoms among slum residents in Kampala, Uganda

Wafula

Ninsiima

Mendoza

et al. 2022

Preprint

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Background An increase in mental health problems has been reported since the beginning of the COVID-19 pandemic. However, little is known about the prevalence of depressive and anxiety disorders, and how recent COVID-19 diagnosis may influence risk of these conditions especially in low-income settings. In this study, we assessed the association between recent COVID-19 diagnosis and depressive and anxiety symptoms among residents in an urban slum setting in Uganda. Methods A cross-sectional study was conducted among 284 individuals in a slum settlement in Kampala, Uganda between April and May 2022. We assessed generalized anxiety and depression symptoms using two validated questionnaires. 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. People with recent COVID-19 diagnosis were more likely to be depressed (53.1%) than those with no recent diagnosis (31.4%). 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%). 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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The prevalence and correlates of depression before and after the COVID-19 pandemic declaration among urban refugee adolescents and youth in informal settlements in Kampala, Uganda: A longitudinal cohort study

Cited by 20 publications

References 44 publications

Levels of depression, anxiety, and psychological distress among Ugandan adults during the first wave of the COVID-19 pandemic: cross-sectional evidence from a mobile phone-based population survey

Levels of depression, anxiety, and psychological distress among Ugandan adults during the first wave of the COVID-19 pandemic: cross-sectional evidence from a mobile phone-based population survey

Assessing equity of access and affordability of care among South Sudanese refugees and host communities in two districts in Uganda: a cross-sectional survey

Association between recent COVID-19 diagnosis on depression and anxiety symptoms among slum residents in Kampala, Uganda

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