Burden of post-traumatic stress disorder acute exacerbations during the commemorations of the genocide against Tutsis in Rwanda: a cross-sectional study.

Journal: The Pan African medical journal

Volume: 30

Issue: 

Year of Publication: 2019

Affiliated Institutions:  National Institutes of Health, Bethesda, MD, United States. University Teaching Hospital of Kigali, Kigali, Rwanda. School of Healthcare, Vancouver Career College, Burnaby, Canada. University Teaching Hospital of Butare, Huye, Rwanda. Centre for Health Services and Policy Research, School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.

Abstract summary 

Following the 1994 genocide against Tutsis in Rwanda, the prevalence of post-traumatic stress disorder (PTSD) is high. In a period of seven days every year in April, Rwandans gather to mourn the victims of the genocide. During this commemoration period, survivors living with chronic PTSD experience PTSD acute exacerbations (PAE). We assessed factors associated with severe PAE during the annual commemoration period of the genocide against Tutsis in Rwanda.We carried out a retrospective cross-sectional study that included people who had PAE during the commemoration week in April 2011 across Huye District in Rwanda. Our outcome measure was PAE categorized into three levels: < 15 minutes, 15-30 minutes, and > 30 minutes. Ordinal logistic regression analyses were performed to identify factors associated with severe PAE.We enrolled 383 people with PAE, of whom 71.8% were female and 53.5% were aged 20-45 years. All participants reported history of PAE, of which 59.8% had experienced more than two PAE during the previous commemoration periods. 33.2% had PAE that lasted > 30 minutes. History of PAE (> twice) (OR = 1.86; 95% CI = 1.27-2.75) and having lost a partner in genocide (OR = 2.19; 95% CI = 1.01-4.81) were associated with severe PAE, after adjusting for sex and age.Our findings suggest that PAE is frequent during the commemoration periods. People who reported having more prior PAE and being widow (er) were more likely to have severe PAE. While history of PAE and bereavement status are non-modifiable factors, our findings could help identify and target these people who are at risk for severe PAE.

Authors & Co-authors:  Kabakambira Jean Damascene JD Uwera Gladys G Hategeka Marthe M Kayitesi Marie Louise ML Malu Célestin Kaputu Kalala CKK Hategeka Celestin C

Study Outcome 

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Statistics
Citations :  Baingana Florence, Al'Absi Mustafa, Becker Anne, Pringle Beverly. Global research challenges and opportunities for mental health and substance-use disorders. Nature. 2015;527(7578):S172–7.
Authors :  6
Identifiers
Doi : 216
SSN : 1937-8688
Study Population
Female
Mesh Terms
Acute Disease
Other Terms
Post-traumatic stress disorder;Rwanda;genocide;mental health;post-traumatic stress disorder acute exacerbation
Study Design
Study Approach
Country of Study
Rwanda
Publication Country
Uganda