Clinical, Partners In Health/Inshuti Mu Buzima, Kigali, Rwanda
Research and Training, Partners In Health/Inshuti Mu Buzima, Kigali, Rwanda.
BMJ Open. 2022 Oct 10;12(10):e054137. doi: 10.1136/bmjopen-2021-054137.
We aimed to describe access to food and symptoms of depression among patients with chronic diseases or their caregivers, and assess associated factors during the COVID-19 lockdown in rural Rwanda.
A cross-sectional study.
A stratified random sampling technique was used to recruit 220 patients enrolled in the HIV, non-communicable diseases, mental health, paediatric development clinic and oncology programmes in three rural districts of Rwanda.
Telephone-based interviews were conducted to collect data on the number of daily meals before and during the COVID-19, and depression was assessed using the Patient Health Questionnaire-9. We used logistic regression analysis to investigate factors associated with households reporting a reduction in daily meals and with the survey respondent reporting symptoms of depression.
Of the participants, 19.1% reported a reduction in daily number of meals for either adults or children in their households during lockdown and 24.6% had depression. Reporting a reduction in daily meals was associated with the district of residence and estimated household's monthly income. Self-reported depression was significantly associated with negative experiences during lockdown, including reporting feeling depressed or fear (AOR 4.82; 95% CI 2.08 to 11.21), loneliness (AOR 4.33; 95% CI 1.32 to 14.13), reduction in daily meals (AOR 4.15; 95% CI 1.56 to 11.00) and lack of access to healthcare (OR 3.29; 95% CI 1.32 to 8.23).
Our findings suggest that significant reduction in access to food affected rural Rwandans with chronic diseases during COVID-19 lockdown, and the lockdown effect varied by household's pre-pandemic level of vulnerability to food insecurity. Reduction in household meals, as well as other self-reported effects of the lockdown, were associated with worse psychological status of survey respondents. Economic and food support should be considered by governments and non-governmental organisations to protect those most vulnerable including patients with chronic diseases against the effects of pandemics and their associated containment measures.
我们旨在描述 COVID-19 封锁期间，慢性病患者及其照护者的食物获取情况和抑郁症状，并评估相关因素。
一项横断面研究。
采用分层随机抽样技术，在卢旺达三个农村地区的艾滋病毒、非传染性疾病、心理健康、儿科发育诊所和肿瘤学项目中招募了 220 名患者。
通过电话访谈收集了 COVID-19 前和封锁期间每日用餐次数的数据，并使用患者健康问卷-9 评估抑郁症状。我们使用逻辑回归分析调查了与家庭报告每日用餐次数减少和调查对象报告抑郁症状相关的因素。
在参与者中，19.1%报告家庭中成人或儿童的每日用餐次数减少，24.6%有抑郁症状。报告每日用餐次数减少与居住地区和家庭月收入估计有关。自我报告的抑郁与封锁期间的负面经历显著相关，包括感到抑郁或恐惧（AOR 4.82；95%CI 2.08 至 11.21）、孤独（AOR 4.33；95%CI 1.32 至 14.13）、每日用餐次数减少（AOR 4.15；95%CI 1.56 至 11.00）和无法获得医疗保健（OR 3.29；95%CI 1.32 至 8.23）。
我们的研究结果表明，COVID-19 封锁期间，食物获取的显著减少影响了农村地区的慢性病患者，且封锁的影响因家庭在疫情前对食物不安全的脆弱性程度而异。家庭用餐次数减少以及封锁的其他自我报告影响与调查对象的心理状况恶化相关。政府和非政府组织应考虑提供经济和食物支持，以保护那些最脆弱的人群，包括慢性病患者，免受疫情及其相关防控措施的影响。
