Last data update: May 06, 2024. (Total: 46732 publications since 2009)
Records 1-2 (of 2 Records) |
Query Trace: Muniina PN[original query] |
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Conflict-related violence and mental health among self-settled Democratic Republic of Congo female refugees in Kampala, Uganda - a respondent driven sampling survey
Familiar I , Muniina PN , Dolan C , Ogwal M , Serwadda D , Kiyingi H , Bahinduka CS , Sande E , Hladik W . Confl Health 2021 15 (1) 42 BACKGROUND: Violence and traumatic events are highly prevalent among refugees, but less is known about the impact of these experiences among self-settled refugees in the country of asylum. We evaluated the association between traumatic experiences and PTSD and depression symptoms among female Democratic Republic of Congo (DRC) refugees living in Kampala, Uganda. METHODS: Participants were recruited using respondent driven sampling in one refugee service center in Kampala, Uganda. Eligibility criteria included: Congolese nationality, age 18+ years, self-settled in Kampala for at least 6 months, refugee status or documentation of application for refugee status. Only data from female participants were included in this analysis. Depression symptoms were screened with the Patient Health Questionnaire-2, and symptom criteria for PTSD and traumatic experiences were evaluated with the Harvard Trauma Questionnaire. Logistic regression models were performed to separately assess associations between mental health outcomes (PTSD and depression), rape and non-sexual violence. RESULTS: Five hundred eighty women with a mean age of 33 years were interviewed. Among participants, 73% (95% CI:67-78%) met symptom criteria for PTSD, 57% (95% CI: 51-63%) for depression, and 65% reported thoughts of ending one's life. 79% of women reported experience of rape, for over half (54%) it occurred more than once, and 82% were gang raped. Crude and adjusted odds ratios (ORs) show that PTSD was most strongly associated with being raped (OR = 2.43, p < 0.01), lacking shelter (OR = 2.86, p < 0.01), lacking food or water (OR = 2.53, p = 0.02), lacking access to health care (OR = 2.84, p < 0.01), forced labor (OR = 2.6, p < 0.01), extortion and/or robbery (OR = 3.08, p < 0.01), experiencing the disappearance/kidnapping of a family member or friend (OR = 2.72, p < 0.01), and witnessing the killing or murder of other people (OR = 3.28, p < 0.01). Depression was significantly associated with several traumatic experiences including rape (OR = 2.3, p = 0.01), and experiencing the disappearance/kidnapping of a child or spouse (OR = 1.99, p = 0.01). CONCLUSIONS: Refugee women self-settled in Kampala reported high lifetime experiences of violence and traumatic events including rape, as well as high rates of PTSD and depression. Future programming addressing self-settled refugees and their settlement in host countries may benefit from including local and national integration strategies. |
Task shifting for initiation and monitoring of antiretroviral therapy for HIV-infected adults in Uganda: The SHARE Trial
Sekiziyivu AB , Bancroft E , Rodriguez EM , Sendagala S , Muniina PN , Sserunga MN , Kiragga NA , Musaazi J , Musinguzi J , Sande E , Bartholow B , Dalal S , Tusiime JB , Kambugu A . J Acquir Immune Defic Syndr 2020 86 (3) e71-e79 BACKGROUND: With countries moving towards the World Health Organization's "Treat All" recommendation, there is need to initiate more HIV-infected persons on antiretroviral therapy (ART). In resource-limited settings, task shifting is one approach that can address clinician shortages. SETTING: Uganda METHODS:: We conducted a randomized controlled trial to test if nurse-initiated and monitored antiretroviral therapy (NIMART) is non-inferior to clinician-initiated and monitored ART (CIMART) in HIV-infected adults in Uganda. Study participants were HIV-infected, ART-naïve, and clinically stable adults. The primary outcome was a composite endpoint of any of the following: all-cause mortality, virological failure, toxicity, and loss to follow up at 12 months post-ART initiation. RESULTS: Over half of the study cohort (1,760) was female (54.9%). The mean age was 35.1 years (standard deviation 9.51). Five hundred and thirty-three (31.6%) participants experienced the composite endpoint. At 12 months post-ART initiation, NIMART was non-inferior to CIMART. The intention-to-treat site-adjusted risk differences for the composite endpoint were -4.1 (97.5% CI = -9.8 to 0.2) with complete case analysis (CCA) and -3.4 (97.5% CI = -9.1 to 2.5) with multiple imputation analysis (MIA). Per-protocol site-adjusted risk differences were -3.6 (97.5% CI = -10.5 to 0.6) for CCA and -3.1 (-8.8 to 2.8) for MIA. This difference was within hypothesized margins (6%) for non-inferiority. CONCLUSIONS: Nurses were non-inferior to clinicians for initiation and monitoring of ART. Task shifting to trained nurses is a viable means to increase access to ART. Future studies should evaluate NIMART for other groups (e.g., children, adolescents, and unstable patients). |
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