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).

Test anxiety and its determinants among health sciences students at Mattu University: a cross-sectional study.

Background: Test anxiety is a particular type of anxiety that is marked by physical, cognitive, and behavioural symptoms when taking and performing tests. It is defined as "severe stress" before, during, and after exams and other assessments. Test anxiety could cause poor academic performance and increase dropout rates. This study aimed to determine the levels of test anxiety and its determinants among health sciences students at Mattu University. Methods: An institution-based cross-sectional study was conducted among 421 selected students from June 1 to June 30, 2021. The study utilized the Westside Test Anxiety, the Oslo Social Support Scale, the Rosenberg Self-esteem Scale, and the Kessler Scale to assess test anxiety, social support, self-esteem, and psychological distress, respectively. The collected data were entered into EpiData version 3.1 and then exported to STATA version 14.0 for analysis. A linear regression model was used to determine factors associated with test anxiety. The multiple regression assumptions were checked for each variable. Statistically significant effects were assumed for a p-value of less than 0.05 at a 95% confidence interval in the multiple linear regression analysis. Results: A total of 416 (99%) participants were completed out of the 420 questionnaires administered. The mean score of test anxiety among participants was 25.3 (SD: ±5.51). Tobacco use (ß: 1.028; 95% CI: 0.709-1.347), khat chewing (ß: 0.115; 95% CI: 0.038-0.192), self-esteem (ß: -0.049; 95% CI: -0.062-(-0.036)), psychological distress (ß: 0.022; 95% CI: 0.017-0.027), and physical activity (ß: -0.162; 95% CI: -0.224-(-0.099)) were shown to have a significant association with test anxiety. Conclusion: Test anxiety was common in the study area. Current substance use (tobacco use and khat chewing) and psychological distress were discovered to be factors that exacerbated test anxiety, whereas self-esteem and physical activity were discovered to be factors that alleviated test anxiety. Therefore, students and stakeholders need to work to discourage those factors that increase test anxiety while promoting factors that alleviate it.

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.