Suicide Ideation and Its Associated Factors among Men in Selected Compounds of Lusaka, Zambia

Background: Globally, it is estimated that more than 800,000 individuals die by suicide each year, making suicide one of the biggest causes of death worldwide. Additionally, suicide kills far more males than women, more so in developing regions that are characterized by economic distress due to low income. Although the number of suicide cases has been seen to increase from 2013 to date, limited studies provide information on the factors influencing the trend. Therefore, this study aimed at investigating the prevalence of suicidal ideation and factors associated with suicide in males in selected compounds of Lusaka. Methods: The study used an analytical quantitative cross- sectional study design that involved 367 men in Mtendere and Kaunda Square townships in Lusaka district, Zambia. A structured questionnaire was used to collect data from participants, which was analyzed using Statistical Package for Social Sciences (SPSS) version 26.0. The Chi-square, Fisher’s exact test and Wilcoxon rank sum tests were used to test relationships among variables at a five percent level of significance. Ethical approval and clearance was obtained from the National Health Research Authority. Results: Participants had a median age of 29 years (IQR, 27 - 32 years), 216 (58.9%) were single and 278 (75.8%) attained tertiary education. Under a quarter, 75 (20.4%) reported suicide ideations, and 97 (26.4%) reported low social support. For most participants, 347 (94.7%) experienced at least one stressful life event, and 359 (97.8%) experienced severe levels of stress. Under half, 170 (46.3%) were alcohol dependent, while 54 (14.7%) used alcohol harmfully. Suicide ideation was significantly associated with marital status (p Conclusion: Suicide ideation is relatively high among men in Mtendere and Kaunda Square townships, mainly influenced by marital status, education level, social support, stressful events alcohol abuse. Efforts must be channeled towards suicide awareness campaigns, and establishment of supportive environments in health facilities which can make it easy for men to open up about their struggles.

Front Line Health Workers’ COVID-19 Lived Experiences: A Case of Levy Mwanawasa Hospital in Lusaka, Zambia

Introduction: Frontline health workers who work in COVID-19 isolation treatment centers are susceptible to developing mental health issues due to the overwhelming workload and stress associated with their job. Thus understanding their lived experiences provides insights that helps alleviate health worker burnout and improving their quality of life thereby leading to an efficient delivery of health care services during a pandemic. Aim: To understand the lived experiences of front line health workers during the COVID-19 pandemics at Levy Mwanawasa Teaching University Hospital. Design and Methods: A qualitative interpretative phenomenological study design was used. Purposive sampling method was adopted to select the 14 participants who took part in the study. The data were collected through face-to-face, audio-taped interviews using an in-depth interview guide, after which the responses were transcribed verbatim before using NVIVO to generate codes. The data were analyzed using thematic method. Results: The lived experiences of the participants were found to be mainly negative with few positive experiences. Their lived experiences were mainly negative emotional and psychological experiences including fear, anger, depression, frustration, anxiety and sadness. The thoughts that were identified included thoughts of surviving through the pandemic, thoughts of getting infected, and dying. The frontline health workers also experienced some personal and professional changes as they offered health services in the COVID-19 wards. The personal changes reported included;social limitations and collapse of extra income business while the professional changes included a change in the way health services were delivered, a gain in knowledge and skills and shaping of a career path. The main challenges experienced were limited resources (man power, resuscitation equipment, drugs, personal protective equipment), limited literature on the disease and limited social interactions. Conclusion and Recommendations: Relevant stakeholders should come on board in order to offer support during a pandemic or a similar situation so as to better the experience of frontline health workers with particular attention directed towards the provision of adequate resources to enable them deliver their services effectively. Frontline health workers perspectives and opinions should be taken into account by the institution’s administrators and policymakers when planning for and managing a pandemic.

COVID-19 Pandemic through the Lenses of Nurses and Midwives in Zambia: Exploring Depression, Anxiety and Stress

Following the declaration of COVID-19 as an international health emergency, Zambia like many other countries implemented measures to limit human interaction and curb the spread of the disease. In the midst of these measures, nurses and midwives continue to provide care to suspected and confirmed cases of COVID-19, which puts them at risk of contracting the disease and compromising their psychological wellbeing. The aim of this study was to assess the levels of depression, anxiety, and stress experienced by nurses and midwives working in health facilities in two districts of Zambia during the COVID-19 pandemic. This descriptive cross-sectional study involving 187 nurses and midwives was conducted between July and December 2020 in selected health facilities in Lusaka and Chilanga Districts. The Depression Anxiety and Stress Scale (DASS) 21 was used to collect the data which was analysed using univariate analysis. Majority of the respondents were female (84%) and mean age at 30.1 (SD 9.05) years, 58.3 percent were married, and 50.84 percent had children. The mean work experience was 6.63 (SD 4.75) years, and 54 percent had worked for less than five years. Overall, 22.5 percent of nurses and midwives reported depression, 52.4 percent had anxiety and almost half (42.2%) had varying levels of stress. Anxiety and stress correlated significantly with working in COVID Isolation departments (P = 0.001). Strategies such as strict adherence to infection prevention measures, seeking help from family and friends and recognition by hospital management were a significant supportive measure (P < 0.001). Nurses and Midwives working directly with COVID-19 patients reported greater incidence of depression, anxiety and stress, similar to findings from previous research around the world. Therefore, efforts should be focused on developing and providing counselling and other support services to mitigate the effects of COVID-19 and enhance psychological wellbeing for health professions.

Mental Health Problems Experienced by HIV Positive Adolescents;A Case of Choma District, Zambia

Several scholars have reported high mental health problems among adolescents with Human Immunodeficiency Virus (HIV) globally. However, little is known about the mental health of this peculiar group of young people in Choma district. This study aimed to determine the mental health problems experienced by HIV positive adolescents in Choma District. Using the Strengths and Difficulties Questionnaire (SDQ), data were obtained from 103 HIV positive adolescents receiving treatment at Choma General Hospital plus a corresponding number of parents/care givers. Information about mental health services was obtained qualitatively from 10 nurses working in the mental health unit and the Antiretroviral (ART) clinic. The results showed that more than three quarters of the adolescents had mental health problems. Of this number, 57.3 percent had multiple mental health problems: predominantly emotional and peer problems. The study also found a statistically significant relationship between level of stigma and presence of mental health problems (X2 = 1.123, P = 0.003). In conclusion, the study demonstrated that multiple mental health problems particularly emotional and peer problems are prevalent among adolescents with HIV/AIDS yet are most often undiagnosed. In addition, adolescents with high levels of internalized stigma are more likely to have multiple mental health problems. The findings suggest the need to integrate psychiatric services into routine care of HIV infected adolescents, routine screening for mental health problems and provision of continued professional development among nurses managing these patients.

Predicting Postnatal Psychological Distress in a Zambian Cohort: Relationship between the EPDS and the GHQ-12

Postnatal mental distress is a public health problem and women screening positive of psychological distress who do not meet the diagnostic criteria for psychiatric disorder may be experiencing significant distress for which they might require assistance from mental health personnel. The risk of a woman experiencing psychological distress during the postnatal period can be predicted before it occurs. The study included 300 pregnant women who were selected systematically and on whom two assessments were conducted at two different points. The first assessment was conducted at 32-week gestation while the second one at six weeks following childbirth. The participants were assessed using the Edinburgh Postnatal Depression Scale (EPDS) and the General Health Questionnaire (GHQ-12). Analysis of Variance (ANOVA) was used to test the association between the EPDS and the GHQ-12 while logistic regression analysis was carried out in order to predict postnatal psychological distress. The results showed no significant difference between the socio-demographic characteristics and the EPDS score. A significant association was found between the GHQ-12 and EPDS scores (r = 0.545;p = 0.001). Logistic regression revealed that a single predictor, antenatal EPDS individual score, alone provided a highly adequate model and was statistically reliable in distinguishing between presence and absence of psychological distress in the postnatal period (&minus;2 log likelihood = 225.634;CI (1.035 - 1.173);X2 (1) 9.633, p = 0.002). The study revealed a correlation between EPDS score and GHQ-12 and that the EPDS can predict postnatal psychological distress using the data from the antenatal period. Therefore, patients who are found with antenatal psychological distress should be consistently evaluated throughout pregnancy and during the postnatal period to allow for early detection and intervention of postnatal psychological distress.