2013年肯尼亚尼扬扎省常见精神障碍及其相关危险因素——利用人口监测点的重复家庭调查评估自2004年以来的变化情况。

Common mental disorder in Nyanza province, Kenya in 2013 and its associated risk factors--an assessment of change since 2004, using a repeat household survey in a demographic surveillance site.

作者信息

Jenkins Rachel, Othieno Caleb, Ongeri Linnet, Sifuna Peter, Ongecha Michael, Kingora James, Kiima David, Omollo Raymond, Ogutu Bernhards

机构信息

Health Services and Population Research Department, Institute of Psychiatry, Kings College London, de Crespigny Park, London, SE 5 8AF, UK.

Department of Psychiatry, University of Nairobi, Nairobi, Kenya.

出版信息

BMC Psychiatry. 2015 Dec 9;15:309. doi: 10.1186/s12888-015-0693-5.

DOI:10.1186/s12888-015-0693-5

PMID:26651332

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4673710/

Abstract

BACKGROUND

Repeat household surveys are useful to assess change in prevalence over time, but there have been no repeat surveys of common mental disorder (CMD) in Kenya, or indeed sub-Saharan Africa. Therefore a repeat household survey of CMD and its associated risk factors was conducted in Maseno area, Kisumu county in Kenya, using a demographic surveillance site as the sample frame, in order to test the hypotheses that (a) the prevalence of CMD would increase between 2004 and 2013 due to the intervening political, social and economic pressures; (b) as in 2004, there would be no gender difference in prevalence of CMD.

METHODS

One thousand one hundred ninety households were selected, and 1158 adult participants consented to be interviewed with a structured epidemiological assessment while 32 refused to participate in the study interviews, giving a response rate of 97.3%.

RESULTS

The study found that the overall prevalence of CMD in 2013 was 10.3%. However, there were significantly higher rates of having any CMD in 2013 if one was female (OR 6.2, p < 0.001), divorced/widowed (OR 2.5, p < 0.003), aged over 60 (OR 2.3, p = 0.052), either self-employed (OR 3.3 p < 0.001) or employed (OR 3.3, p < 0.001), or belonged to the lowest asset quintile (OR 2.5, p = .0.004) after adjusting for other variables significant at the bivariate level. The overall prevalence in 2013 was consistent with that found in 2004, despite intervening political and community turbulence. However, this apparent consistency masks the development of a striking difference in prevalence between the genders. Over the decade 2004-13, the prevalence for men dropped from 10.9 to 3.8% (P = 0.001) and the prevalence for women increased from 10.8 to 17.5% (p = 0.001).

CONCLUSION

Common mental disorders continue to pose a significant public health burden in Kenya, and gender related vulnerability merits further research and is relevant for health worker training.

摘要

背景

重复进行家庭调查有助于评估患病率随时间的变化，但肯尼亚乃至撒哈拉以南非洲地区尚未对常见精神障碍（CMD）进行过重复调查。因此，在肯尼亚基苏木县马塞诺地区，以人口监测点为抽样框架，对CMD及其相关危险因素进行了重复家庭调查，以检验以下假设：（a）由于其间的政治、社会和经济压力，2004年至2013年期间CMD的患病率会上升；（b）与2004年一样，CMD患病率不存在性别差异。

方法

选取了1190户家庭，1158名成年参与者同意接受结构化流行病学评估访谈，32人拒绝参与研究访谈，应答率为97.3%。

结果

研究发现，2013年CMD的总体患病率为10.3%。然而，在对双变量水平上其他显著变量进行调整后，2013年女性（比值比6.2，p<0.001）、离婚/丧偶者（比值比2.5，p<0.003）、60岁以上者（比值比2.3，p=0.052）、个体经营者（比值比3.3，p<0.001）或受雇者（比值比3.3，p<0.001），或属于资产最低五分位数者（比值比2.5，p=0.004）患任何CMD的几率显著更高。尽管其间存在政治和社区动荡，但2013年的总体患病率与2004年的调查结果一致。然而，这种表面上的一致性掩盖了性别之间患病率惊人差异的发展。在2004 - 2013年这十年间，男性患病率从10.9%降至3.8%（P = 0.001），女性患病率从10.8%升至17.5%（p = 0.001）。