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COVID-19 Related Mental Health Burdens: Impact of Educational Level and Relationship Status Among Low Income Earners of Western Uganda

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COVID-19 Related Mental Health Burdens: Impact of Educational Level and Relationship Status Among Low Income Earners of Western Uganda COVID-19 related mental health burdens: Impact of educational level and relationship status among low income earners of Western Uganda Lemuel Ann Monima ( [email protected] ) Kampala International University - Western Campus https://orcid.org/0000-0002-6998-1439 Ibe Michael Usman Kampala International University - Western Campus Kenneth Iceland Kasozi The University of Edinburgh Eric . Osamudiamwen Aigbogun, Jr Kampala International University - Western Campus Victor Archibong Bassey Kampala International University - Western Campus Josiah Ie Kampala International University - Western Campus Robinson Ssebuufu Kampala International University - Western Campus Adam Moyosore Afodun Kampala International University - Western Campus Swase Dominic Terkimbi Kampala International University - Western Campus Ngala Elvis Mbiydzenyuy The Copperbelt University School of Medicine Azeez Adeoye Kampala International University - Western Campus Joshua Ojodale Aruwa Kampala International University - Western Campus Odoma Saidi Kampala International University - Western Campus Fred Ssempijja Kampala International University - Western Campus John Tabakwot Ayuba Kampala International University - Western Campus Hope Onohuean Kampala International University - Western Campus Stellamaris Kembabazi Kampala International University - Western Campus Theophilus Pius Kampala International University - Western Campus Viola Nankya Kampala International University - Western Campus Kevin Matama Kampala International University - Western Campus Rachael Henry Ahmadu Bello University Helen Yusuf Ahmadu Bello University Susan Christina Welburn The University of Edinburgh Edinburgh Medical School Research Article Keywords: Mental healthcare, awareness, relationship status, educational level, COVID-19, Low-income earners, Western Uganda Posted Date: August 20th, 2020 DOI: https://doi.org/10.21203/rs.3.rs-61564/v1 License: This work is licensed under a Creative Commons Attribution 4.0 International License. Read Full License 1 COVID-19 related mental health burdens: Impact of educational level and 2 relationship status among low income earners of Western Uganda 3 Authors list l* 1* 2* 1 4 Ann Monima Lemuel , Ibe Michael Usman , Kenneth Iceland Kasozi , Eric Osamudiamwen Aigbogun, Jr. , Victor Archibong 5 Bassey1, Ifie Josiah1, Robinson Ssebuufu3, Adam Moyosore Afodun1, Swase Dominic Terkimbi1, Ngala Elvis Mbiydzenyuy4, Azeez 6 Adeoye1, Joshua Ojodale Aruwa1, Odoma Saidi1, Fred Ssempijja1, John Tabakwot Ayuba1, Hope Onohuean1, Stellamaris Kembabazi1, 7 Theophilus Pius5, Viola Nankya6, Kevin Matama7, Rachael Henry8, Helen Yusuf8, and Susan Christina Welburn2,9* 8 1. Faculty of Biomedicals Sciences, Kampala International University Western Campus, Bushenyi, Uganda 9 2. Infection Medicine, Deanery of Biomedical Sciences, College of Medicine and Veterinary Medicine, The University of 10 Edinburgh, Edinburgh, United Kingdom 11 3. Faculty of Clinical Medicine and Dentistry, Kampala International University Teaching Hospital, Bushenyi, Uganda 12 4. Department of Basic Medical Science, School of Medicine, Copperbelt University, Ndola Zambia 13 5. Department of Medical Laboratory Science, Kampala International University, Uganda 14 6. School of Nursing, Kampala International University Teaching Hospital, Bushenyi, Uganda 15 7. School of Pharmacy, Kampala International University Western Campus, Kampala, Uganda 16 8. Department of Human Anatomy, College of Medicine and Health Science, Ahmadu Bello University, Zaria, Nigeria 17 9. Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, International Campus, Zhejiang 18 University, Haining, China 19 20 *Corresponding Authors: 21 Ann Lemue email: [email protected] 22 Ibe Michael Usman email: [email protected] 23 Kenneth Iceland Kasozi email: [email protected] 24 Susan Christina Welburn email: [email protected] 25 Abstract 26 Introduction: The imposed COVID-19 lockdown is taking a toll mental health, with low-income earners considered particularly 27 affected. The study aimed to investigate level of education and relationship status on awareness of mental healthcare and explore how 28 these factors influence mental health among low income earners in Western Uganda. 29 Methods: A cross sectional descriptive study was undertaken among low-income earners in South Western Uganda. Data were collected 30 from two hundred and fifty-three (253) participants using a structured closed ended questionnaire. Anxiety, anger and depression were 31 assessed using a modified generalized anxiety disorder (GAD-7), Spielberger’s State-Trait Anger Expression Inventory-2 (STAXI-2) 32 and Beck Depression Inventory (BDI) item tools respectively. 33 Result: Most respondents were single male individuals with secondary level. Respondents with tertiary level of education and those 34 with partners had higher score (71.7% and 70.28% respectively) for awareness on mental healthcare. Respondents with primary 35 education level and individuals that were single had higher score (46.98% and 43.72% respectively) for anxiety. Respondents with 36 primary education level and those living with partners had higher mean score (56.44% and 56.21% respectively) for anger. Respondents 37 with no formal education and those who had lost partners had higher mean score (32.11% and 30.50% respectively) for depression. 38 Individuals without formal educational and primary education were observed to have a negative correlation (r2 = 47.4 and 6.4% 39 respectively) with awareness on mental healthcare, and the no formal group had positive correlation with anger and depression (r2 =1.9 40 and 0.3% respectively), while other groups were negatively correlated (r2 =10.1%). The group of single individuals had a negative 41 correlation with awareness on mental healthcare, anger and depression (r2 =1.9, 0.8 and 0.3% respectively), and a positive correlation 42 with anxiety (r2 =3.9%). 43 Conclusion: It is evident that education and relationship status influence awareness on mental healthcare and mental health state among 44 low income earners in Western Uganda. Therefore, we advocate for new approaches in mental healthcare awareness programs equipped 45 with robust strategy, which will focus on improving optimal mental health among these set of people. 46 47 Keywords: Mental healthcare, awareness, relationship status, educational level, COVID-19, Low-income earners, Western Uganda 48 INTRODUCTION 49 The world is now battling with a new type of virus that was identified by the Chinese Center for Disease Control and Prevention as the 50 causative agent of pneumonia-like infection which present with cough and high fever first reported amongst patients in Wuhan city of 51 China by the end of 2019 [1]; the virus, initially named 2019 nCoV by the World Health Organization (WHO) was later renamed severe 52 acute respiratory syndrome coronavirus-2 (SARS-CoV-2) by the International Committee on Taxonomy of Viruses [2]. In mid-February 53 2020, WHO announced an epidemic disease caused by SARS-CoV-2 as coronavirus disease 2019 (COVID-19). While respiratory 54 distress syndrome was initially reported as the primary pathology in patients with COVID-19, several systems have since been 55 implicated including the nervous system [3]. As at 6th of August 2020, over 18.6 million confirmed cases and 702 642 death were 56 reported globally. In Africa, 848 053 confirmed cases and 15 252 deaths were reported in WHO corona disease situation report [4]. 57 While the extent of the damage caused by the COVID-19 pandemic in Africa remains unknown, its impact on the socioeconomic and 58 mental health status is palpable. As for other coronaviruses, mental health symptoms (anxiety, depression and peritraumatic stress) have 59 been reported during this COVID-19 crisis [5]. The pandemic impacts on the physical human health, social and political patterns a 60 positive feedback that characteristically and indirectly inhibit the social, economic and political wellbeing of communities, societies and 61 nations. As the pandemic progresses, it is likely that mental health burden will increase as measures taken by the African governments 62 to mitigate the spread of the SARS-COV-2 virus, such as shelter-in-place order, banning public gatherings, closure of schools and social 63 distancing have a great impact on the lives of low income earners, earning $1,025 or less per month [6]. Strategies put in place to limit 64 the spread of COVID-19 expose low income earners to experience situations that could be a predisposing factor to poor mental health 65 outcomes, such as isolation and job loss [7]. 66 Public health emergencies can have psychological effects on college students, expressed as anxiety, fear, and worry; economic effects, 67 and effects on daily life, as well as delays in academic activities, have been positively associated with anxiety and social support was 68 negatively correlated with the level of anxiety [8]. Not only is education affected within this shelter-in-place and physical isolation, 69 intimate relationship and effective relationships among individuals are also affected. 70 The pandemic combined with social distancing is creating very stressful situations, and a fairly high number of people are exhibiting 71 mental health symptoms such as fear, irritability, depression or anxiety; unavoidable in the face of a perceived threat. he fear of 72 contracting the virus, negatively influences a rather well functioning romantic relationships as individuals
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