Risk factors towards self-destructive behaviour among fresh students at Makerere University

It has been suggested that some individuals are suicide prone; and that such individuals can be detected long before they commit suicide. This paper reports the risk factors associated with potential self-destructive behaviour among a group of freshwomen at Makerere University. A suicide proneness questionnaire; the Umzimkulu suicide Proneness Inventory (USPI); was completed by 619 students admitted to the University in the academic year 1992/93. The results indicate that students' propensity to self-destructive behaviour was significantly related to the history of suicide behaviour among the students; or their relatives; and the presence of a probable depressive disorder as indicated by scores above at least 60 on each of SR; AL; AS; and PDW; scales on the questionnaire. The paper describes in detail the development of the USPI; and the theory underlying the study. Implications for improving counselling services for students at Makerere University are highlighted

The Impact of HIV on Transmission of Tuberculosis in Ugandan Households

To examine the effect of HIV infection old infectiousness of TB. Design: Cross-sectional prevalence study of household contacts to smear positive TB patients. Methods: HIV-infected and non-infected index TB cases with sputum smear positive TB; were enrolled from a major TB clinic at Mulago Hospital in Kampala; Uganda. All full-time household contacts of the index cases were evaluated by: medical history and physical examination; Mantoux purified protein derivative (PPD) skin tests; chest x-ray; BCG vaccination status; HIV test (in consenting subjects); TB symptoms and demographic and household environment. a contact with signs and/or symptoms of TB underwent a complete work-up for active TB. The main outcome measures were PPD positively and active TB. APPD skin-test readingor=5mm was considered positive. Results: 699 contacts of 170 index TB cases were included in this analysis. 319 (46) were contacts of 82 HIV+index TB cases. No significant differences were noted in the proportion of PPD positively; between contacts of HIV-infected and those pf the HIV-non-infected index cases [79versus 79; P=0.984]. Risk factors for PPD-positivity in contacts were: AFB smear grade of the index case [Odds Ratio (OR) = 1.7; 95CI: 1.16-2.37]; cavitary disease in the index case [OR=5.9; 95CI: 2.53-14.0]; age of the contact [OR = 1.1; 95CI: 1.05-1.10]; and household size [OR=0.9;95CI:0.85-0.96]. Risk factors for active TB in contacts were: cavitary disease in the index case [OR = 2.0;95CI: 1.07-3.58]; age of the contact [OR = 1.1; 95CI:0.89-0.96]; HIV status of the contact [OR=5.9;95CI:1.69-21.9]; and sharing of bed or bedroom with the index case [OR=2.5; 95CI: 1.54-3.92]. Conclusion: Transmission of M. tuberculosis within households was comparable among HIV-infected and non-infected index TB cases. However; transmission differed depending on: whether the index case had cavitary disease; the sputum AFB smear; household sixe and age of the contact. HIV-infected contacts; children and intimate contacts of the index cases were at increased risk of having active TB at the time of household evaluation

Prediction of self-destructive behavior among Makerere University students

Student suicides at Makerere University have occured sporadically and no systematic programme of suicide prevention has been developed. In addition; no clear guidelines have been worked out to guide the operations of the University counselling centre. A study on the predictability of suicide behaviour among students was conducted from October 1992 to June 1995. Study objectives included the identification of possible characteristics of suicidal students; the determination of the proportion of students who will seek counselling services at the University hospital in the course of their studies; and the identification of characteristics of counsellees. Study participants were the entire group of the 1992/93 academic year intake. Six hundred and nineteen students consented to complete a self-adminsitered questionnaire; especially designed to identify suicidal and or depressed persons. The students were then followed up for three years during which data on student attendance at the counselling centre were collected. The results were analysed using the EPIINFO computer software. The results indicated that some students (at least 5.5) who enrolled at Makerere University annually will probably require counselling services early at the time of their enrollment at the University. The following recommendations are made to improve counselling services for students: all students should be inducted at the time of their entry the University; counselling services should be made attractive to students; students should be involved in providing counselling services; particularly at emergency level; a prompt and attractive referral system for students requiring psychiatric care should be established; a telephone hot-line to be managed by the students should be established and; further research is needed to improve counselling services for students at Makerere University