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Mental and physical health in Rwanda 14years after the genocide

Munyandamutsa, Naasson ; Mahoro Nkubamugisha, Paul ; Gex-Fabry, Marianne ; Eytan, Ariel

In: Social Psychiatry and Psychiatric Epidemiology, 2012, vol. 47, no. 11, p. 1753-1761

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    Title
    • Mental and physical health in Rwanda 14years after the genocide
    Author
    • Munyandamutsa, Naasson. Psychosocial Consultation Centre, Kigali, Rwanda
    • Mahoro Nkubamugisha, Paul. Psychosocial Consultation Centre, Kigali, Rwanda
    • Gex-Fabry, Marianne. Department of Psychiatry, University Hospitals of Geneva, 2, Chemin du Petit-Bel-Air, 1225, Geneva, Switzerland
    • Eytan, Ariel. Department of Psychiatry, University Hospitals of Geneva, 2, Chemin du Petit-Bel-Air, 1225, Geneva, Switzerland
    Document Type
    • Postprint
    Language
    • English
    Published in
    • Social Psychiatry and Psychiatric Epidemiology, 2012, vol. 47, no. 11, p. 1753-1761. Springer-Verlag
    Other Version
    OAI-PMH Identifier
    • oai:doc.rero.ch:313196
    Summary
    Purpose: To examine the socio-demographic determinants of post-traumatic stress disorder (PTSD) and its association with major depressive episode and self-perceived physical and mental health in a large random sample of the Rwandan population 14years after the 1994 genocide. Methods: Using the Mini International Neuropsychiatric Interview and Medical Outcomes Study 36-Item Short-Form (SF-36) translated in Kinyarwanda, we interviewed 1,000 adult residents from the five provinces of Rwanda. Socio-demographic data and specific somatic symptoms were also recorded. Data analysis included 962 questionnaires. Results: Participants were predominantly female (58.9%), aged between 16 and 34years (53.2%), with a low level of education (79.7% below secondary school). Prevalence of PTSD was estimated to be 26.1%. In multivariable analysis, factors associated with PTSD were being aged between 25 and 34years, living in extreme poverty, having endured the murder of a close relative in 1994, being widowed or remarried, having lost both parents and living in the South Province. Participants who fulfilled diagnostic criteria for PTSD were significantly more often affected with major depression (68.4 vs. 6.6%, P<0.001) and substance dependence (7.6 vs. 3.5%, P=0.013) than respondents without PTSD. They scored significantly lower on all SF-36 subscales. Somatic symptoms such as hiccups, fainting and loss of speech or hearing delineated a specific pattern of post-traumatic stress syndrome. Conclusions: PTSD remains a significant public health problem in Rwanda 14years after the genocide. Facilitating access to appropriate care for all those who need it should be a national priority