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Search Results: 1 - 10 of 2715 matches for " Eugene Kinyanda "
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Prevalence and risk factors of major depressive disorder in HIV/AIDS as seen in semi-urban Entebbe district, Uganda
Eugene Kinyanda, Susan Hoskins, Juliet Nakku, Saira Nawaz, Vikram Patel
BMC Psychiatry , 2011, DOI: 10.1186/1471-244x-11-205
Abstract: A cross-sectional study was undertaken among 618 respondents attending two HIV clinics in Uganda.Prevalence of MDD was 8.1%. Factors associated with MDD at univariate analysis only were female gender, family history of mental illness, negative coping style, alcohol dependency disorder, food insecurity and stress; not associated with MDD were social support, neurocognitive impairment, CD4 counts and BMI. Factors independently associated with MDD were psychosocial impairment, adverse life events, post traumatic stress disorder, generalised anxiety disorder and life-time attempted suicide.Psychological and social factors were the main risk factors of MDD among ambulatory HIV positive persons with no evidence for the role of the neurotoxic effects of HIV. Treatment approaches for MDD in this patient group should be modeled on those used among non-HIV groups.The increasing access to highly effective antiretroviral therapy (ART) for people living with HIV (PLWHA) even in low income countries including in sub-Saharan Africa has delayed HIV disease progression and prolonged survival bringing into sharp focus issues of quality of life including their mental wellbeing [1,2]. One of the major causes of psychiatric morbidity in HIV/AIDS is major depressive disorder (MDD), with studies from Africa reporting point prevalence rates of MDD of between 3% to 54% [3-8].Most of these studies however were small, used non-locally validated screening scales to diagnose MDD and rarely examined risk factors.Studies in the west have pointed to a multifactorial aetiology of MDD in HIV/AIDS including psychological, social and biological factors [9,10]. How much of these factors operate in the African socio-cultural environment is not fully known. The few studies that have been undertaken in sub-Saharan African point to the following risk factors for MDD in HIV/AIDS female gender, older age, unemployment, negative life events, childhood trauma, impaired function, poor social support, poor quali
The prevalence and characteristics of suicidality in HIV/AIDS as seen in an African population in Entebbe district, Uganda
Eugene Kinyanda, Susan Hoskins, Juliet Nakku, Saira Nawaz, Vikram Patel
BMC Psychiatry , 2012, DOI: 10.1186/1471-244x-12-63
Abstract: A cross-sectional study was undertaken among 618 respondents attending two HIV clinics in semi-urban Uganda. A structured questionnaire was used to collect data on demographic, social, psychological and clinical factors. Correlates of suicidality were assessed using mulitvariable logistic regression.Prevalence of ‘moderate to high risk for suicidality’ (MHS) was 7.8 % and that of life-time attempted suicide was 3.9 %. Factors associated with MHS at univariate analysis were: female gender, food insecurity, increasing negative life events, high stress score, negative coping style, past psychiatric history, psychosocial impairment, diagnoses of post-traumatic stress disorder, generalised anxiety disorder and major depressive disorder. Factors independently associated with MHS in multivariate models were female gender, increasing negative life events, a previous psychiatric history, and major depressive disorder.These results are in agreement with the stress-vulnerability model where social and psychological stressors acting on an underlying diathesis (including previous and current psychiatric morbidities) leads to suicidality. These results identify potential targets to mitigate risk through treatment of psychiatric disorders and promoting greater adaptation to living with HIV/AIDS.Suicidality, which for purposes of this study includes both significant suicidal ideation and attempted suicide, is one of the psychiatric problems associated with HIV/AIDS [1]. A consideration of suicidality in HIV/AIDS is important not only because it predicts future attempted suicide and completed suicide, it has also has been associated with poor quality of life, poor adherence with ART (antiretroviral therapy) and non-disclosure of HIV status to significant others [1,2]. The few African studies on suicidality in HIV/AIDS have reported the following prevalence rates: 12.4 % for suicidal ideation among patients attending a specialized HIV/AIDS clinic in pre-ART Uganda; 17.1 % for the 12
Prevalence of severe mental distress and its correlates in a population-based study in rural south-west Uganda
Eugene Kinyanda, Laban Waswa, Kathy Baisley, Dermot Maher
BMC Psychiatry , 2011, DOI: 10.1186/1471-244x-11-97
Abstract: This study set out to investigate SMD and it's associated factors in a rural population-based cohort in south-west Uganda.6,663 respondents aged 13 years and above in a general population cohort in southwestern Uganda were screened for probable SMD and possible associated factors.0.9% screened positive for probable SMD. The factors significantly associated with SMD included older age, male sex, low socio-economic status, being a current smoker, having multiple or no sexual partners in the past year, reported epilepsy and consulting a traditional healer.SMD in this study was associated with both socio-demographic and behavioural factors. The association between SMD and high risk sexual behaviour calls for the integration of HIV prevention in mental health care programmes in high HIV prevalence settings.Governments in sub-Saharan Africa including those in Uganda, Liberia and Southern Sudan are slowly realizing that mental illness makes a significant contribution to the overall health burden which is projected to rise. Governments have therefore started to include mental health in the minimum health care package to be delivered through an integrated approach in the existing primary health care system [1-3]. Mental illness encompasses a broad range of conditions of varying degrees of severity. Severe mental distress (SMD) for purposes of this paper refers to all mental and neurological problems that are associated with severe disturbance in behaviour, thought or speech as seen in a sub-Saharan African socio-cultural setting. The underlying philosophy behind the use of this term was the need to capture all forms of severe psychological disturbances as seen at community level in an sub-Saharan African setting, where in the majority, the communities still believe that these illnesses are due to non-medical causes. We also desired to use a category amendable to use by non-medical interviewers.SMD as conceived in this study and in this socio-cultural setting may be due to th
An escape from agony: A qualitative psychological autopsy study of women's suicide in a post-conflict Northern Uganda
Dorothy Kizza,Birthe Loa Knizek,Eugene Kinyanda,Heidi Hjelmeland
International Journal of Qualitative Studies on Health & Well-Being , 2012, DOI: 10.3402/qhw.v7i0.18463
Abstract: We set out to investigate suicide among women in a post-conflict context in Northern Uganda using qualitative psychological autopsy interviews. Three to five relatives and friends for each of the three suicides recruited were interviewed (N=11). Through interpretative phenomenological analysis (IPA) we found that the women all had been through traumatic experiences attributable to the protracted war/conflict between the rebel groups and Ugandan Government armed forces. Nevertheless, the decision of self-inflicted death seemed to have been due to a combination of unpleasant experiences/events that prevailed within the last 3 months prior to the suicide. These experiences are summarized in two broad themes: No control in life and No care. Changes in the traditional gender roles, men's quest for their lost masculinity, and women's attempt to fight for their rights that was perceived as a cultural transgression contributed to the women's suicides.
Ugandan Men's Perceptions of What Causes and What Prevents Suicide
Birthe Loa Knizek,Eugene Kinyanda,Vicki Owens,Heidi Hjelmeland
Journal of Men, Masculinities and Spirituality , 2011,
Abstract: Suicidal behavior is illegal in Uganda. There are no reliable public suicide statistics, but studies indicate that the rates of both suicide and nonfatal suicidal behavior are higher for men than for women. This study examined Ugandan men's perceptions of what causes and what prevents suicide as well as their attitudes towards suicide and suicide prevention, including religiosity. Knowledge about this is important as the country is now planning suicide prevention strategies. A majority (26 percent) of men believed that suicide was a response to illness/disease and problems with relationships (24 percent), followed by perceived pressure (10 percent), lack of control (9 percent) and economic hardship (8 percent). These men also endorsed negative attitudes towards suicide, including when suicide is precipitated by an incurable disease. Most men believed that suicide could be prevented via health care services (45 percent) and education (22 percent), while only a few explicitly mentioned an improvement of the socioeconomic conditions. These findings are interpreted in light of the ideological demands of being a man and the socioeconomic reality making this difficult or impossible.
Vulnerability to high risk sexual behaviour (HRSB) following exposure to war trauma as seen in post-conflict communities in eastern uganda: a qualitative study
Wilson Muhwezi, Eugene Kinyanda, Margaret Mungherera, Patrick Onyango, Emmanuel Ngabirano, Julius Muron, Johnson Kagugube, Rehema Kajungu
Conflict and Health , 2011, DOI: 10.1186/1752-1505-5-22
Abstract: We did a cross-sectional qualitative study of 3 sub-counties in Katakwi district and 1 in Amuria in Uganda between March and May 2009. We collected data using 8 FGDs, 32 key informant interviews and 16 in-depth interviews. We tape-recorded and transcribed the data. We followed thematic analysis principles to manage, analyse and interpret the data. We constantly identified and compared themes and sub-themes in the dataset as we read the transcripts. We used illuminating verbatim quotations to illustrate major findings.The commonly identified HRSB behaviours include; transactional sex, sexual predation, multiple partners, early marriages and forced marriages. Breakdown of the social structure due to conflict had resulted in economic destruction and a perceived soaring of vulnerable people whose propensity to HRSB is high. Dishonour of sexual sanctity through transactional sex and practices like incest mirrored the consequence of exposure to conflict. HRSB was associated with concentration of people in camps where idleness and unemployment were the norm. Reports of girls and women who had been victims of rape and defilement by men with guns were common. Many people were known to have started to display persistent worries, hopelessness, and suicidal ideas and to abuse alcohol.The study demonstrated that conflicts disrupt the socio-cultural set up of communities and destroy sources of people's livelihood. Post-conflict socio-economic reconstruction needs to encompass programmes that restructure people's morals and values through counselling. HIV/AIDS prevention programming in post-conflict communities should deal with socio-cultural disruptions that emerged during conflicts. Some of the disruptions if not dealt with, could become normalized yet they are predisposing factors to HRSB. Socio-economic vulnerability as a consequence of conflict seemed to be associated with HRSB through alterations in sexual morality. To pursue safer sexual health choices, people in post-confl
Validation of brief screening tools for depressive and alcohol use disorders among TB and HIV patients in primary care in Zambia
Nathaniel Chishinga, Eugene Kinyanda, Helen A Weiss, Vikram Patel, Helen Ayles, Soraya Seedat
BMC Psychiatry , 2011, DOI: 10.1186/1471-244x-11-75
Abstract: This was a cross-sectional study in 16 primary level care clinics. Consecutive sampling was used to select 649 participants who started TB treatment or ART in the preceding month. Participants were first interviewed using the CES-D and AUDIT, and subsequently with a psychiatric diagnostic interview for current major depressive disorder (MDD) and alcohol use disorders (AUDs) using the Mini-International Neuropsychiatric Interview (MINI). The diagnostic accuracy was calculated using the Area Under the Receiver Operating Characteristic curve (AUROC). The optimum cut-off scores for clinical use were calculated using sensitivity and positive predictive value (PPV).The CES-D and AUDIT had high internal consistency (Cronbach's alpha = 0.84; 0.98 respectively). Confirmatory factor analysis showed that the four-factor CES-D model was not a good fit for the data (Tucker-Lewis Fit Index (TLI) = 0.86; standardized root-mean square residual (SRMR) = 0.06) while the two-factor AUDIT model fitted the data well (TFI = 0.99; SRMR = 0.04). Both the CES-D and AUDIT demonstrated good discriminatory ability in detecting MINI-defined current MDDs and AUDs (AUROC for CES-D = 0.78; AUDIT = 0.98 for women and 0.75 for men). The optimum CES-D cut-off score in screening for current MDD was 22 (sensitivity 73%, PPV 76%) while that of the AUDIT in screening for AUD was 24 for women (sensitivity 60%, PPV 60%), and 20 for men (sensitivity 55%, PPV 50%).The CES-D and AUDIT showed high discriminatory ability in measuring MINI-defined current MDD and AUD respectively. They are suitable mental health screening tools for use among TB and ART patients in primary care in Zambia.Mental health disorders, human immunodeficiency virus (HIV) and tuberculosis (TB) have a profound impact on public health in sub-Saharan Africa [1], yet there are limited data on the interaction between major depressive disorders (MDDs), alcohol use disorders (AUDs) with HIV [2] and TB in this region. Many sub-Saharan African cou
Prevalence and Correlates of Alcohol Dependence Disorder among TB and HIV Infected Patients in Zambia
Rebecca O’Connell, Nathaniel Chishinga, Eugene Kinyanda, Vikram Patel, Helen Ayles, Helen A. Weiss, Soraya Seedat
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0074406
Abstract: Objectives To determine the prevalence and correlates of alcohol dependence disorders in persons receiving treatment for HIV and Tuberculosis (TB) at 16 Primary Health Care centres (PHC) across Zambia. Methods 649 adult patients receiving treatment for HIV and/or TB at PHCs in Zambia (363 males, 286 females) were recruited between 1st December 2009 and 31st January 2010. Data on socio-demographic variables, clinical disease features (TB and HIV), and psychopathological status were collected. The Mini International Neuropsychiatric Interview (MINI) was used to diagnose alcohol dependence disorder. Correlates of alcohol dependence were analyzed for men only, due to low prevalence in women. Univariable and multivariable logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI), using general estimating equations to allow for within-PHC clustering. Results The prevalence of alcohol dependence was 27.2% (95%CI: 17.7-39.5%) for men and 3.9% (95%CI: 1.4-0.1%) for women. Factors associated with alcohol dependence disorder in men included being single, divorced or widowed compared with married (adjusted OR = 1.47, 95%CI: 1.00-2.14) and being unemployed (adjusted OR=1.30, 95%CI: 1.01-1.67). The highest prevalence of alcohol dependence was among HIV-test unknown TB patients (34.7%), and lowest was among HIV positive patients on treatment but without TB (14.1%), although the difference was not statistically significant (p=0.38). Conclusions Male TB/HIV patients in this population have high prevalence of alcohol dependence disorder, and prevalence differs by HIV/TB status. Further work is needed to explore interventions to reduce harmful drinking in this population.
Health and functional status among older people with HIV/AIDS in Uganda
Francien Scholten, Joseph Mugisha, Janet Seeley, Eugene Kinyanda, Susan Nakubukwa, Paul Kowal, Nirmala Naidoo, Ties Boerma, Somnath Chatterji, Heiner Grosskurth
BMC Public Health , 2011, DOI: 10.1186/1471-2458-11-886
Abstract: The cross-sectional survey consisted of 510 participants aged 50 years and older, equally divided into five study groups including; 1) HIV infected and on antiretroviral therapy (ART) for at least 1 year; 2) HIV infected and not yet eligible for ART; 3) older people who had lost a child due to HIV/AIDS; 4) older people who have an adult child with HIV/AIDS; 5) older people not known to be infected or affected by HIV in the family. The participants were randomly selected from ongoing studies in a rural and peri-urban area in Uganda. Data were collected using a WHO standard questionnaire and performance tests. Eight indicators of health and functioning were examined in an age-adjusted bivariate and multivariate analyses.In total, 198 men and 312 women participated. The overall mean age was 65.8 and 64.5 years for men and women respectively. Men had better self-reported health and functional status than women, as well as lower self-reported prevalence of chronic diseases. In general, health problems were common: 35% of respondents were diagnosed with at least one of the five chronic conditions, including 15% with depression, based on algorithms; 31% of men and 35% of women had measured hypertension; 25% of men and 21% of women had poor vision test results. HIV-positive older people, irrespective of being on ART, and HIV-negative older people in the other study groups had very similar results for most health status and functioning indicators. The main difference was a significantly lower BMI among HIV-infected older people.The systematic exploration of health and well being among older people, using eight self-reported and objective health indicators, showed that basic health problems are very common at older ages and poorly addressed by existing health services. HIV-infected older people, however, whether on ART or not yet on ART, had a similar health and functional status as other older people.Older people are affected by the HIV/AIDS epidemic in various ways. Until r
War related sexual violence and it's medical and psychological consequences as seen in Kitgum, Northern Uganda: A cross-sectional study
Eugene Kinyanda, Seggane Musisi, Christine Biryabarema, Isaac Ezati, Henry Oboke, Ruth Ojiambo-Ochieng, Juliet Were-Oguttu, Jonathan Levin, Heiner Grosskurth, James Walugembe
BMC International Health and Human Rights , 2010, DOI: 10.1186/1472-698x-10-28
Abstract: This paper examines the specific long term health consequences of war related sexual violence among rural women living in two internally displaced person's camps in Kitgum district in war affected Northern Uganda who accessed the services of an Isis-Women's International Cross Cultural Exchange (Isis-WICCE) medical intervention.The study employed a purposive cross-sectional study design where 813 respondents were subjected to a structured interview as part of a screening procedure for an emergency medical intervention to identify respondents who required psychological, gynaecological and surgical treatment.Over a quarter (28.6%) of the women (n = 573) reported having suffered at least one form of war related sexual violence. About three quarters of the respondents had 'at least one gynaecological complaint' (72.4%) and 'at least one surgical complaint' (75.6%), while 69.4% had significant psychological distress scores (scores greater than or equal to 6 on the WHO SRQ-20). The factors that were significantly associated with war related sexual violence were the age group of less than or equal to 44 years, being Catholic, having suffered other war related physical trauma, and having 'at least one gynaecological complaint'. The specific gynaecological complaints significantly associated with war related sexual violence were infertility, chronic lower abdominal pain, abnormal vaginal bleeding, and sexual dysfunction. In a multivariable analysis the age group of less than or equal to 44 years, being Catholic and having 'at least one gynaecological complaint' remained significantly associated with war related sexual violence.The results from this study demonstrate that war related sexual violence is independently associated with the later development of specific gynaecological complaints.Africa continues to experience some of the worst cases of war related sexual violence with the situation in some parts of the continent such as Eastern Democratic Republic of Congo charact
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