Prevalence and associated factors of mental disorders among prisoners in Mbarara municipality, southwestern Uganda: a cross-sectional study.

BACKGROUND: Research in high income countries reports higher prevalence of mental disorders among prisoners than in the general population. Lack of published data from low resource settings affects planning and eventual service provision to the prisoners. This study aimed to determine the burden of mental disorders and associated factors among prisoners in Mbarara municipality in southwestern Uganda. METHODS: This was a prison facility based cross sectional study among 414 inmates in Mbarara municipality. We consecutively enrolled them by simple random sampling from 3 prison facilities. Participants completed a sociodemographic and clinical factor questionnaire, and the M.I.N.I. Version 6.0. Data were analyzed using STATA 12.0. Univariate, bivariate and multivariate logistic regression analyses were conducted to determine the prevalence, and associated factors using the individual odds ratios with their 95% Confidence Intervals and P-values as a measure of association, clinical and statistical significance respectively. RESULTS: A total of 354 (86%) prison-inmates met criteria for a psychiatric disorder. Of these, 338 (95%) had one or more diagnoses. Major depression was the most common diagnosis (44%). Factors associated with mental disorders included history of traumatic brain injury (OR = 2.57; 95% CI = 1.22-5.42; P-value = 0.01), low income status (OR = 0.32; 95% CI = 0.16-0.63; P-value = 0.001) and authoritarian parenting (OR = 0.37; 95% CI = 0.18-0.75; P-value = 0.006). CONCLUSIONS: There is a high prevalence of psychiatric illness among prisoners in Mbarara municipality with most of them having more than one diagnosis. Majority of the prisoners with mental illness go undiagnosed and untreated.

A systematic review protocol of stigma among children and adolescents with epilepsy.

BACKGROUND: Epilepsy is a neurological condition that is highly prevalent among children and adolescents with 80% of the victims living in low- and middle-income countries (LMIC). Epilepsy is associated with high levels of both perceived and enacted stigma, which vary geographically and greatly affects the victims' quality of life and self-esteem. High rates of stigma are also a significant barrier to accessing medical care. Perceived and enacted epilepsy-related stigma is associated with various sociodemographic and clinical factors, which vary from place to place. Therefore, this review will determine the prevalence of stigma of epilepsy among children and adolescents and the associated factors worldwide. METHODS: We will search for literature in PubMed, EMBASE, PsycINFO, and CINAHL databases as well as grey literature. We will also search via Google Scholar to capture relevant literature that may not be in the searched databases. We will then screen reference lists of included studies for more studies. Studies that have documented the prevalence of epilepsy-related perceived or enacted stigma and the associated factors will be eligible for inclusion. Data will be extracted in duplicates using a pre-piloted tool consisting of study and participant characteristics as well as pre-determined factors associated with epilepsy. Heterogeneity will be assessed by a forest plot and quantified by I2 statistic, and in case it is high, results will be reported as a narrative and it will further be explored by subgroup analysis. In case of homogeneity, meta-analysis will be done. Bias will be assessed using a critical appraisal tool developed for prevalence studies. The strength of evidence among the studies will be assessed using the GRADE approach. DISCUSSION: Findings from this review will document the burden of stigma of epilepsy and the common contributing factors, which will form the building blocks of interventions that address this health challenge. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42017058957.

Crime, recidivism and mental disorders among prisoners in Mbarara municipality, southwestern Uganda.

INTRODUCTION: Mental disorders among prisoners have been linked to the type of crime and recidivism. Identification of the mental disorders associated with the different types of crimes and recidivism is essential in the planning and eventual service provision to the prisoners. This study aimed to determine the association between mental disorders, type of crime and recidivism among prisoners in Mbarara municipality in Uganda. METHODS: This was a prison facility based cross-sectional study among 414 male and female inmates in Mbarara municipality conducted from June to July 2017. Participants were enrolled from 3 prison facilities through simple random sampling. Sociodemographic-clinical factor questionnaires, and the M.I.N.I. Version 6.0 were completed by each participant. Bivariate and multivariate logistic regression analyses were conducted to determine the associations between the various mental disorders, type of crime and recidivism using the individual adjusted odds ratios at 95% CI. Data were analyzed using STATA 12.0. RESULTS: Of all the 414 participants in this study; 94% were male, 60% were aged 22-35 years, 89% were first-time offenders, and 64% had allegedly committed or been convicted of violent crimes. Social anxiety disorder was significantly associated with non-violent crimes. Major depression was more likely to occur in recidivists whereas panic disorders were more frequent among first-time offenders regardless of their gender. CONCLUSIONS: An association was established between the category of crime, recidivism, and type of mental disorder among prisoners participating in the study in Mbarara municipality, southwestern Uganda. Additional findings were that a majority of the prisoners with mental disorders seek health care services from the prison health facility and of these inmates, few are accessing psychiatric treatment.