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An exploratory study assessing psychological distress of indigents in Burkina Faso: a step forward in understanding mental health needs in West Africa.

ABSTRACT: Poverty is known as an important determinant of health, but empirical data are still missing on the relationships between poverty, other adverse living conditions, and psychological distress, particularly in low-income countries. This study aimed to assess mental health needs and psychological distress among the poorest in rural settings in Burkina Faso where food security and access to water, electricity, schooling, and healthcare are limited.We randomly selected 2000 individuals previously identified as indigents by a community-targeting process. Interviewers visited participants (n = 1652) in their homes and completed a questionnaire on mental health variables that included presence and intensity of anxious, depressive, psychotic, and aggressive symptoms, as well as level of psychological distress. Descriptive statistics, Spearman correlations, and logistic regressions were performed.In all, 40.2% of the sample reported 10 or more anxious/depressive symptoms in the past 30 days, and 25.5% reported having experienced at least one psychotic symptom over their lifetime, 65.6% of whom had had those symptoms for many years. The number of anxious and depressive symptoms was significantly associated with the level of psychological distress (r = 0.423, p < .001). Predictors of distress level included: poor health condition (F(1) = 23.743, p <. 001), being a woman (F(1) = 43.926, p < .001), not having any income (F(1) = 16.185, p < .001), having begged for food in the past 30 days (F(1) = 12.387, p < .001), being illiterate, and being older (F(1) = 21.487, p < .001). Approximately one third of respondents reporting anxious/depressive or psychotic symptoms (28.2 and 30.0%, respectively) had not talked about their symptoms to anyone in their social network.These results suggest alarmingly high levels of psychological distress and reported symptoms among the poorest in rural settings in Burkina Faso, which can be explained by their difficult living conditions. However, these results must be interpreted from a transcultural perspective to avoid decontextualized misinterpretations. Ethnographic works are needed to document the larger context within which these distress results can be analyzed.

SUBMITTER: Pigeon-Gagne E

PROVIDER: S-EPMC5557325 | biostudies-other | 2017 Aug

REPOSITORIES: biostudies-other

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Project description:BackgroundIn Burkina Faso, stunting affects children and is a public health problem. We studied the association between stunting and child's neuro-psychological outcomes at 6-8 years of age in rural Burkina Faso using the Kaufman Assessment Battery for Children, 2nd edition (KABC-II), the Children's Category Test 1 (CCT-1) and the Test of Variable of Attention (TOVA).MethodsWe re-enrolled children of a previously community-based Exclusive breastfeeding trial in Burkina Faso. We assessed a total of 532 children aged 6-8 years using KABC-II for memory (Atlantis and Number Recall subtests), spatial abilities (Conceptual Thinking, Face Recognition and Triangle subtests), reasoning (Block Counting subtest), general cognition and CCT-1 for cognitive flexibility. A total 513 children were assessed using the TOVA to measure attention and inhibition. We calculated the Cohen's d to examine the effect size and conducted a linear regression to examine the association.ResultsThe proportion of stunting was 15.6% (83/532). Stunted children performed significantly poorer for memory (Atlantis and Number Recall), spatial abilities (Conceptual Thinking, Face Recognition and Triangle), general cognition and attention with a small effect size compared to non-stunted children. Children who were exposed scored significantly higher errors for cognitive flexibility and inhibition with a small effect size compared to unexposed children. At standardized and unstandardized multivariable regression analysis, stunted children performed significantly poorer for Atlantis (p = 0.001), Number Recall (p = 0.02), Conceptual Thinking (p = 0.01), Triangle (p = 0.001), general cognition (p ≤ 0.0001) and attention (p = 0.04) compared to non-stunted children. Children who were exposed scored significantly higher errors for cognitive flexibility (p = 0.02) and for inhibition (p = 0.02) compared to unexposed children. We adjusted all the results for age, schooling, sex, playing, father education, mother employment and promotion of previous exclusive breastfeeding.ConclusionStunting is associated with poorer neuro-psychological outcomes among children in rural Burkina Faso. Initiatives related to prevention need to be established and advice on nutrition need to be provided.

Project description:Highlights • Severe dengue was common in this sudy.• In contrast to multiple prior studies, the risk of severe dengue was greater for patients with primary dengue compared to those with secondary infection.• Additional risk factors for severe dengue included age, male sex, haemoglobin S, diabetes, and hypertension. Case mapping showed that dengue cases were more concentrated in sectors located in the centre of the city and close to the health centres. Introduction Although dengue is the most common arbovirus infection worldwide, studies of severe dengue in Africa are lacking, and risk factors for severe dengue have been insufficiently described. This study was conducted in the context of the 2016 dengue epidemic in Burkina Faso to determine the prevalence of severe dengue, identify factors associated with severe dengue, and perform mapping of dengue cases in the country's capital, Ouagadougou. Methods This cross-sectional study was conducted from November 2015 to January 2017. Data were collected in 15 public and private health centres, and included sociodemographic, clinical and patient outcome variables. Dengue was diagnosed using SD Bioline Dengue Duo rapid diagnostic tests. Data were analysed using Epi-Info Version 7. Logistic regression was used to identify predictors of severe dengue. P<0.05 was considered significant. Dengue case mapping was performed using Geographic Information System software (ArcGIS). Results Of the 811 patients who tested positive for dengue, 609 (75%) had early dengue (AgNS1 positive) and 272 (33.5%) had severe dengue. Patient age ranged from 1 to 83 years (median 30.5 years) and 393 (48.3%) were female. Renal failure (13.1%) and severe bleeding (10.6%) were the most common signs of severe dengue. Risk factors for severe dengue included age, male sex, haemoglobin S, diabetes, hypertension, and primary dengue. Dengue cases were more concentrated in sectors located in the centre of the city and close to the health centres. Conclusion Dengue is increasingly common in Africa and factors associated with severity should be sought systematically as soon as a patient tests positive. Additional studies are needed to determine if the factors found to be associated with severity can be used to identify patients at risk for dengue-related complications, and to provide early and specialized management to reduce morbidity and mortality related to dengue in Africa.

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An exploratory study assessing psychological distress of indigents in Burkina Faso: a step forward in understanding mental health needs in West Africa.

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