Objective: The prevalence of post-traumatic stress disorder (PTSD) and its risk factors among adult refugees in the context of war-related forced migration is well established. However, reliable data are lacking on war-related trauma among refugee children and adolescents residing in refugee settlements. This study estimated the magnitude of PTSD and its associated factors among children and adolescents in Nakivale refugee settlement, south-western Uganda.Method: We conducted a cross-sectional quantitative study among 325 adolescent (10-19-year-old) refugees, who were selected using a simple random sampling approach. The presence of PTSD was assessed by the Mini-International Neuropsychiatric Interview for Children and Adolescents. The main predictor variables were assessed by structured checklists for war trauma and post-migration using Kobol collect software. Data were exported to Stata 23 for analysis. The prevalence of PTSD was computed using descriptive statistics. Bivariate and multivariate logistic regression analyses were used to determine factors associated with PTSD.Results: The prevalence of PTSD in our study was 83% (269/325, 95% CI 0.782-0.867). Factors associated with PTSD included post-migration difficulties (OR = 4.11, 95% CI 2.52-8.43, p < .001) and exposure to war-related trauma (OR = 2.23, 95% CI 1.16-4.261, p = .016).Conclusion: The high prevalence of PTSD in our sample of refugee children and adolescents is associated with both war trauma and post-migration difficulties. This information is important for the psychological assessment and treatment of the children and adolescents living in the refugee settlement. Identification of potentially modifiable factors in post-migration conditions and acknowledgement of the effects of conflicts on health are of high priority from both societal and global perspectives.
Objetivo: La prevalencia del trastorno por estrés postraumático (TEPT) y sus factores de riesgo entre los refugiados adultos en el contexto de la migración forzada relacionada con la guerra está bien establecida. Sin embargo, se carece de datos fiables sobre el trauma relacionado con la guerra en refugiados niños y adolescentes residentes en un asentamiento de refugio. Este estudio estimó la magnitud del TEPT y sus factores asociados entre los adolescentes del asentamiento de refugio de Nakivale, en el suroeste de Uganda.
Método: Realizamos un estudio cuantitativo transversal con 325 adolescentes (10–19) refugiados seleccionados mediante un muestreo aleatorio simple. La presencia de TEPT se evaluó mediante la entrevista neuropsiquiátrica internacional MINI para niños y adolescentes. Las principales variables predictoras se evaluaron mediante listas de verificación estructuradas sobre trauma de guerra y postmigración utilizando el software Kobol Collect. Los datos se exportaron a Stata 23 para su análisis. La prevalencia del TEPT se calculó mediante estadística descriptiva, mientras que se emplearon análisis de regresión logística bivariada y multivariada para determinar los factores asociados con TEPT.
Resultados: La prevalencia del TEPT en nuestro estudio fue del 83% (269/325, IC = 0.782–0.867). Los factores asociados con el TEPT incluyeron dificultades posmigratorias (OR = 4.11; IC del 95%: 2.52–8.43, p < .001) y exposición a trauma relacionados con la guerra (OR = 2.23; IC del 95%: 1.16–4.261, p = .016).
Conclusión: La alta prevalencia del TEPT en nuestra muestra de niños y adolescentes refugiados se asocia tanto con trauma de guerra como dificultades posmigratorias. Esta información es importante para la evaluación y tratamiento psicológico de niños y adolescentes que viven en un asentamiento de refugio. La identificación de factores potencialmente modificables en las condiciones posmigratorias y el reconocimiento de los efectos de los conflictos sobre la salud son prioritarios desde una perspectiva social y global.
Keywords: Adolescentes; Adolescents; East Africa; PTSD; TEPT; Uganda; children; dificultades posmigratorias; guerra; niños; post-migration difficulties; refugees; refugiados; trauma; war; África Oriental.
The prevalence of PTSD is high among children and adolescents in a refugee settlement.War trauma and post-migration difficulties are associated with PTSD diagnosis.Reduction of post-migration challenges could reduce mental health suffering in this vulnerable group.