scholarly journals Domestic violence, food insecurity and mental health of pregnant women in the COVID-19 lockdown in Cape Town, South Africa

2020 ◽  
Author(s):  
Zulfa Abrahams ◽  
Sonet Boisits ◽  
Marguerite Schneider ◽  
Martin Prince ◽  
Crick Lund
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
South Africa ◽  
Psychological Distress ◽  
Food Insecurity ◽  
Pregnant Women ◽  
Poisson Regression ◽  
Common Mental Disorders ◽  
Cape Town ◽  
Perinatal Women

Abstract Introduction Common mental disorders (CMD) such as depression and anxiety are associated with low household income, food insecurity and intimate partner violence in perinatal women. The national COVID-19 lockdown in South Africa resulted in increased levels of poverty and food insecurity. We aimed to explore the relationship between CMDs, food insecurity and experiences of violence among pregnant women during the COVID-19 lockdown.Methods Perinatal women, attending 14 healthcare facilities in Cape Town, were enrolled in the study during baseline data collection before the COVID-19 lockdown. During the lockdown period, fieldworkers telephonically contacted the perinatal women who were enrolled in the study and had provided contact details. The following data was collected from those who consented to the study: socio-demographic information, mental health assessment, food insecurity status and experiences of abuse. Poisson regression was used to model the associations of a number of risk factors with the occurrence of CMDs.Results Of the 2149 women enrolled in the ASSET study, 885 consented to the telephonic interviews. We found that 12.5% of women had probable CMDs and 43% were severely food insecure. Psychological distress increased significantly during the lockdown period, compared to before the COVID-19 outbreak. The strength of the association between key risk factors measured during the lockdown and psychological distress increased during the COVID-19 lockdown. Using multivariate Poisson regression modelling, we showed that the risk of CMDs was almost three times more likely in women who were severely food insecure or who experienced psychological or sexual abuse. Conclusions This study provides evidence of the effect of the COVID-19 lockdown on the mental health status of perinatal women living in low resource settings in Cape Town, and highlights how a crisis such as the COVID-19 lockdown amplifies the psycho-social risk factors associated with CMDs in perinatal women.

scholarly journals The relationship between common mental disorders (CMDs), food insecurity and domestic violence in pregnant women during the COVID-19 lockdown in Cape Town, South Africa

2021 ◽  
Author(s):  
Zulfa Abrahams ◽  
Sonet Boisits ◽  
Marguerite Schneider ◽  
Martin Prince ◽  
Crick Lund
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Domestic Violence ◽  
Mental Disorders ◽  
Food Insecurity ◽  
Poisson Regression ◽  
Common Mental Disorders ◽  
Cape Town ◽  
The Relationship ◽  
Perinatal Women

Abstract Purpose We aimed to explore the relationship between common mental disorders (CMDs), food insecurity and experiences of domestic violence among pregnant women attending public sector midwife obstetric units and basic antenatal care clinics in Cape Town during the COVID-19 lockdown. Methods Perinatal women, attending 14 healthcare facilities in Cape Town, were enrolled in the study during baseline data collection before the COVID-19 lockdown. During the lockdown period, fieldworkers telephonically contacted the perinatal women who were enrolled in the study and had provided contact details. The following data were collected from those who consented to the study: socio-demographic information, mental health assessment, food insecurity status and experiences of domestic violence. Poisson regression was used to model the associations of a number of risk factors with the occurrence of CMDs. Results Of the 2149 women enrolled in the ASSET study, 885 consented to telephonic interviews. We found that 12.5% of women had probable CMDs and 43% were severely food insecure. Psychological distress increased significantly during the lockdown period, compared to before the COVID-19 outbreak. Using multivariate Poisson regression modelling, we showed that the risk of CMDs was increased in women who were severely food insecure or who experienced psychological or sexual abuse. Conclusions This study provides evidence of the effect of the COVID-19 lockdown on the mental health status of perinatal women living in low-resource settings in Cape Town and highlights how a crisis such as the COVID-19 lockdown amplifies the psycho-social risk factors associated with CMDs in perinatal women.

scholarly journals Food insecurity and common mental disorders in perinatal women living in low socio-economic settings in Cape Town, South Africa during the COVID-19 pandemic: a cohort study

2021 ◽  
Author(s):  
Zulfa Abrahams ◽  
Crick Lund
Keyword(s):  
Mental Health ◽  
South Africa ◽  
Mental Disorders ◽  
Food Insecurity ◽  
Common Mental Disorders ◽  
Cape Town ◽  
Baseline Risk ◽  
Multivariable Logistic Regression Analysis ◽  
Perinatal Women

Abstract Background Common mental disorders (CMDs) such as depression and anxiety are highly prevalent during the perinatal period, and are associated with poverty, food insecurity and domestic violence. We used data collected from perinatal women at two time-points during the COVID-19 pandemic to test the hypotheses that (1) socio-economic adversities at baseline would be associated with higher CMD prevalence at follow-up and (2) worse mental health at baseline would be associated with higher food insecurity prevalence at follow-up. Methods Telephonic interviews were conducted with perinatal women attending healthcare facilities in Cape Town, South Africa. Multivariable logistic regression analysis was used to model the associations of baseline risk factors with the prevalence of household food insecurity and CMD at 3 months follow-up. Results At baseline 859 women were recruited, of whom 217 (25%) were pregnant, 106 (12%) had probable CMD, and 375 (44%) were severely food insecure. At follow-up (n=634), 22 (4%) were still pregnant, 44 (7%) had probable CMD, and 207 (33%) were severely food insecure. In the multivariable regression model, after controlling for confounders, the odds of being food insecure at follow-up were greater in women who were unemployed [OR=2.05 (1.46-2.87); p<0.001] or had probable CMD [OR=2.37 (1.35-4.18); p=0.003] at baseline; and the odds of probable CMD at follow-up were greater in women with psychological distress [OR=2.81 (1.47-5.39); p=0.002] and abuse [OR=2.47 (1.47-4.39); p=0.007] at baseline. Conclusions This study highlights the complex bidirectional relationship between mental health and socioeconomic adversity among perinatal women during the COVID-19 pandemic.

scholarly journals Food insecurity and common mental disorders in perinatal women living in low socio-economic settings in Cape Town, South Africa during the COVID-19 pandemic: a cohort study

2021 ◽  
Author(s):  
Zulfa Abrahams ◽  
Crick Lund
Keyword(s):  
Mental Health ◽  
South Africa ◽  
Cohort Study ◽  
Mental Disorders ◽  
Food Insecurity ◽  
Common Mental Disorders ◽  
Household Food Insecurity ◽  
Household Food ◽  
Perinatal Women

Abstract Objective: Common mental disorders (CMDs) such as depression and anxiety are highly prevalent during the perinatal period, and are associated with food insecurity, domestic violence and lack of social support. This study explores the relationship between household food insecurity, mental health status and several adverse social and economic factors experienced by perinatal women during the COVID-19 pandemic.Design: Cohort study, using telephonic interviews at two time-points, three months apart. Logistic regression analysis was used to model the associations of several baseline risk factors with the occurrence of household food insecurity at follow-up as the outcome.Setting: Midwife obstetric units or basic antenatal care units in Cape Town, South Africa.Participants: The sample comprised of 880 perinatal women at baseline and 660 women at follow-up. Results: At baseline 23% were pregnant, 54% were unemployed, 13% had a probable CMD, 43% were severely food insecure and 21% experienced domestic abuse in the past year. Of the 660 women interviewed at follow-up, 71% were unemployment, 3.5% were pregnant, 7% had a probable CMD, and 32% were severely food insecure. In the multivariate regression model, after controlling for ethnicity, number of children, being HIV-infected, and having a planned pregnancy, the odds of being food insecure were greater in women who were unemployed (OR=1.88; p=0.001) or had probable CMD (OR=2.20; p=0.019) at baseline. Conclusions: This study highlights a range of socio-demographic and mental health related variables that predict food insecurity among perinatal women during the COVID-19 pandemic.

scholarly journals The epidemiology of common mental disorders in Libya: a systematic review

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Mansour Abdulshafea ◽  
Abdul Hakim Rhouma ◽  
Nadeem Gire ◽  
Ali AlMadhoob ◽  
Usman Arshad ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Mental Disorders ◽  
Common Mental Disorders ◽  
Epidemiological Data ◽  
Mental Health Research ◽  
Middle Income ◽  
Prevalence Studies ◽  
The Status ◽  
Associated Risk Factors

Abstract Introduction There has been a global increase in the prevalence of common mental disorders (CMD), particularly in conflict hotspots. The limited amount of resources is one of the key barriers to effective treatment within Low- and Middle-income countries (LAMICs). The lack of service provision for mental health disorders in LAMICs has resulted in limited opportunities to conduct mental health research. Libya is a North African country that has suffered from ongoing conflict with the current political unrest in Libya further impacting the mental health of the population. Main text The aim of this review is to conduct a synthesis of evidence regarding the estimated prevalence and associated risk factors of CMD in Libya. A search was completed in the academic databases; PubMed, Medline, EMBASE, PsychINFO, CINHAL, and the Institute for Development, Research, Advocacy and Applied Care (IDRAAC) from inception to March 2020. Only studies that investigated prevalence and associated risk factors of CMD in Libya were included. A total of 219 studies were identified of which 15 met the inclusion criteria for the review. There were (n = 3) papers investigated the prevalence of depression, (n = 4) studies were focused on stress-related disorders and the remaining papers looked at both anxiety and depression. Statistically, sample sizes of the included studies ranged from (n = 41–13,031) for the prevalence studies (mean = 1188.6, median = 233). Conclusion The status of Libya as a conflict hotspot has led to a reduced level of epidemiological data on mental health, with a vital need to conduct research in CMD. Libya requires better clinical governance which can allow for more scientific research into CMD and enabling the Libyan government to develop evidence-based policy initiatives for CMD.

scholarly journals Psychological Distress among College Students: Role of Food Insecurity and Other Social Determinants of Mental Health

2020 ◽  
Vol 17 (11) ◽  
pp. 4118 ◽  
Author(s):  
Monideepa B. Becerra ◽  
Benjamin J. Becerra
Keyword(s):  
Mental Health ◽  
College Students ◽  
Psychological Distress ◽  
Health Status ◽  
Food Insecurity ◽  
Physical Health ◽  
Social Determinant ◽  
Physical Health Status ◽  
Gender Specific

Food insecurity is a major social determinant of health and an assessment of how it may impact college students’ mental health is imperative, as well as differential associations by self-identified gender. A cross-sectional survey was used among college students of a mid-size minority-serving institution with a final sample size of 302 participants aged 18 years or above. Descriptive, bivariate, and multivariable regressions were conducted, by gender, to assess the role of food insecurity (United States Department of Agriculture (USDA) six-item questionnaire), on mental health outcomes (Kessler-6 scale and self-perception). All the statistical analyses were conducted in SPSS version 24 (IBM, Corp.; Armonk, NY, USA) with an alpha less than 0.05 used to denote significance. Among those with food insecurity, the odds of reporting psychological distress (odds ratio (OR) = 3.645, p < 0.05) and an average to very poor self-perceived mental health status (OR = 2.687, p <0.05) were higher compared to their food-secure counterparts, with the results consistent in a gender-specific analysis as well. Compared to men, however, women had higher odds of psychological distress (OR = 2.280, p < 0.05), as well as reporting average to very poor self-perceived mental health statuses (OR = 2.700, p < 0.05). Among women, any alcohol use in the past 12 months (OR = 2.505, p < 0.05) and a low self-perceived physical health status (OR = 3.601, p < 0.05) were associated with an average to very poor self-perceived mental health status. Among men, a low perceived physical health status was associated with higher odds of psychological distress (OR = 3.477, p < 0.05). The results of our study highlight that food insecurity should be considered a social determinant of mental health wellbeing. In addition, gender-specific trends in mental health highlight the need for targeted interventions for prevention and treatment.

scholarly journals Colonisation with pathogenic drug-resistant bacteria and Clostridioides difficile among residents of residential care facilities in Cape Town, South Africa: a cross-sectional prevalence study

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Jason September ◽  
Leon Geffen ◽  
Kathryn Manning ◽  
Preneshni Naicker ◽  
Cheryl Faro ◽  
...  
Keyword(s):  
Risk Factors ◽  
South Africa ◽  
Residential Care ◽  
Cape Town ◽  
Resistant Bacteria ◽  
Antibiotic Prescribing ◽  
Cross Sectional ◽  
Residential Care Facilities ◽  
Care Facilities ◽  
Stool Samples

Abstract Background Residential care facilities (RCFs) act as reservoirs for multidrug-resistant organisms (MDRO). There are scarce data on colonisation with MDROs in Africa. We aimed to determine the prevalence of MDROs and C. difficile and risk factors for carriage amongst residents of RCFs in Cape Town, South Africa. Methods We performed a cross-sectional surveillance study at three RCFs. Chromogenic agar was used to screen skin swabs for methicillin-resistant S. aureus (MRSA) and stool samples for extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E). Antigen testing and PCR was used to detect Clostridiodes difficile. Risk factors for colonisation were determined with logistic regression. Results One hundred fifty-four residents were enrolled, providing 119 stool samples and 152 sets of skin swabs. Twenty-seven (22.7%) stool samples were positive for ESBL-E, and 13 (8.6%) residents had at least one skin swab positive for MRSA. Two (1.6%) stool samples tested positive for C. difficile. Poor functional status (OR 1.3 (95% CI, 1.0–1.6)) and incontinence (OR 2.9 (95% CI, 1.2–6.9)) were significant predictors for ESBL-E colonisation. MRSA colonization appeared higher in frail care areas (8/58 v 5/94, p = 0.07). Conclusions There was a relatively high prevalence of colonisation with MDROs, particularly ESBL-E, but low C. difficile carriage, with implications for antibiotic prescribing and infection control practice.

scholarly journals Perspectives on the psychological and emotional burden of having gestational diabetes amongst low-income women in Cape Town, South Africa

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Lorrein Shamiso Muhwava ◽  
Katherine Murphy ◽  
Christina Zarowsky ◽  
Naomi Levitt
Keyword(s):  
Mental Health ◽  
South Africa ◽  
Gestational Diabetes ◽  
Focus Groups ◽  
Lived Experiences ◽  
Cape Town ◽  
Psychological Burden ◽  
Pregnancy And Postpartum ◽  
The Impact ◽  
Depth Interviews

Abstract Background The diagnosis of gestational diabetes mellitus (GDM) may affect women’s mental wellbeing, functioning and quality of life, with potentially negative effects on treatment adherence. Identifying and addressing the psychological and emotional needs of women with GDM, could have benefits for sustainable long-term behavioural change following the affected pregnancy. This study explored the lived experiences of women with GDM and the impact of GDM on their experience of pregnancy and sense of well-being. Methods Purposive sampling was used to recruit women who had been diagnosed with GDM in their previous pregnancy and received antenatal care at a tertiary hospital in Cape Town, South Africa. This was a descriptive qualitative study using a combination of focus groups and in-depth interviews for an in- depth exploration of women’s lived experiences of GDM, their context and perceived needs. Data analysis followed an iterative thematic analysis approach. Results Thirty-five women participated in nine focus groups and five in-depth interviews. Women discussed the emotional and psychological burden of having GDM, highlighting (i) their initial emotional reactions to receiving a GDM diagnosis, (ii) their experience of adjusting to the constraints of living with GDM (iii) their feelings of apprehension about childbirth and their maternal role and (iv) their feelings of abandonment in the post-partum period once the intensive support from both health system and family ends. Conclusions The current biomedical model used in the management of GDM, is highly foetal-centric and fails to acknowledge important psychological factors that contribute to women’s overall wellbeing and experience of pregnancy. These results demonstrate the importance of incorporating mental health support in the management and care for women with GDM in public health services, along with facilitating emotional support from partners and family members. Based on our findings, we recommend routine mental health and psychosocial vulnerability screening and monitoring for women diagnosed with GDM throughout pregnancy and postpartum to improve prognoses.

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