Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.
Department of Medicine, Harvard Medical School, Boston, Massachusetts, United States of America.
PLoS One. 2023 Feb 3;18(2):e0281091. doi: 10.1371/journal.pone.0281091. eCollection 2023.
The COVID-19 pandemic has increased social and emotional stressors globally, increasing mental health concerns and the risk of psychiatric illness worldwide. To date, relatively little is known about the impact of the pandemic on vulnerable groups such as women and children in low-resourced settings who generally have limited access to mental health care. We explore two rounds of data collected as part of an ongoing trial of early childhood development to assess mental health distress among mothers of children under 5-years-old living in two rural areas of Zambia during the COVID-19 pandemic. We examined the prevalence of mental health distress among a cohort of 1105 mothers using the World Health Organization's Self-Reporting Questionnaire (SRQ-20) before the onset of the COVID-19 pandemic in August 2019 and after the first two infection waves in October-November 2021. Our primary outcome was mental health distress, defined as SRQ-20 score above 7. We analyzed social, economic and family level characteristics as factors modifying to the COVID-19 induced changes in the mental health status. At baseline, 22.5% of women were in mental health distress. The odds of mental health distress among women increased marginally over the first two waves of the pandemic (aOR1.22, CI 0.99-1.49). Women under age 30, with lower educational background, with less than three children, and those living in Eastern Province (compared to Southern Province) of Zambia, were found to be at highest risk of mental health deterioration during the pandemic. Our findings suggest that the prevalence of mental health distress is high in this population and has further worsened during COVID-19 pandemic. Public health interventions targeting mothers' mental health in low resource settings may want to particularly focus on young mothers with limited educational attainment.
COVID-19 大流行在全球范围内增加了社会和情绪压力源，增加了全球各地的心理健康问题和精神疾病风险。迄今为止，人们对大流行对弱势群体（如妇女和儿童）的影响了解甚少，这些群体在资源有限的环境中通常获得心理健康护理的机会有限。我们探讨了两轮数据，这些数据是正在进行的儿童早期发展试验的一部分，以评估在 COVID-19 大流行期间生活在赞比亚两个农村地区的 5 岁以下儿童的母亲的心理健康困扰。我们使用世界卫生组织的自我报告问卷（SRQ-20）在 2019 年 8 月 COVID-19 大流行之前和 2021 年 10 月至 11 月的前两波感染之后，对 1105 名母亲进行了队列研究，检查了心理健康困扰的发生率。我们的主要结局是心理健康困扰，定义为 SRQ-20 评分高于 7。我们分析了社会、经济和家庭层面的特征，这些特征是 COVID-19 引起的心理健康状况变化的调节因素。在基线时，有 22.5%的女性存在心理健康困扰。在大流行的前两波中，女性心理健康困扰的几率略有增加（aOR1.22，CI 0.99-1.49）。年龄在 30 岁以下、教育程度较低、孩子少于三个以及居住在赞比亚东部省（与南部省相比）的女性，在大流行期间被认为是心理健康恶化的高危人群。我们的研究结果表明，该人群中心理健康困扰的患病率较高，并且在 COVID-19 大流行期间进一步恶化。在资源有限的环境中针对母亲心理健康的公共卫生干预措施可能希望特别关注受教育程度有限的年轻母亲。
