PTSD remains a major problem in Rwanda

By Mark Cowen, Senior medwireNews Reporter

Post-traumatic stress disorder (PTSD) remains a significant public health problem in Rwanda after the civil war and genocide of 1994, researchers report.

In a 2008 survey of 962 individuals (58.9% women), aged 16 years and older, from the five provinces of Rwanda, the team found that over a quarter met the criteria for PTSD.

The findings "underline the necessity of additional efforts toward facilitating mental health care accessibility for the most vulnerable subpopulations [in Rwanda]," say Ariel Eytan (University Hospitals of Geneva, Switzerland) and colleagues.

Overall, 40.0% of respondents were exposed to the murder of a close relative in 1994, with 26.8% having lost a brother or sister, 16.4% a father, 13.3% a mother, 6.2% a child, and 6.1% a spouse.

Using the Mini International Neuropsychiatric Interview (MINI), the researchers found that 26.1% of respondents tested positive for PTSD, with a respective 20.5% and 30.0% of male and female participants affected by the disorder.

In multivariable analysis, factors significantly associated with PTSD were living in extreme poverty (odds ratio [OR]=2.26), being widowed (OR=2.00), having remarried (OR=2.26), having lost both parents (OR=1.92), having endured the murder of a close relative in 1994 (OR=1.92), and living in the South province (OR=2.29).

In addition, participants aged 25-34 years at the time of the survey (ie, aged 11-20 years during the 1994 genocide) were more likely to have PTSD than those in other age groups (OR=2.06).

Furthermore, the researchers found that 22.7% of participants met MINI criteria for a major depressive episode (MDE) in the past month, with 17.8% testing positive for both PTSD and a MDE.

Indeed, participants with PTSD were significantly more likely to have experienced a MDE in the past month than those without PTSD, at rates of 68.4% versus 6.6%.

The team also reports that respondents with PTSD had significantly lower Short Form-36 physical (41.5 vs 46.0) and mental (34.1 vs 43.6) component summary scores than those without PTSD, indicating significantly poorer physical and mental health.

Eytan and colleagues conclude in Social Psychiatry and Psychiatric Epidemiology: "This study confirms that PTSD is still highly prevalent in the Rwandan population 14 years after the genocide. It is strongly associated with depression and lower perceived physical health."

They add: "Facilitating access to appropriate care for all those who need it should be a national priority."

Licensed from medwireNews with permission from Springer Healthcare Ltd. ©Springer Healthcare Ltd. All rights reserved. Neither of these parties endorse or recommend any commercial products, services, or equipment.