Abstract
BackgroundThe signing of the Comprehensive Peace Agreement in January 2005 marked the end of the civil conflict in Sudan lasting over 20 years. The conflict was characterised by widespread violence and large-scale forced migration. Mental health is recognised as a key public health issue for conflict-affected populations. Studies revealed high levels of post-traumatic stress disorder (PTSD) amongst populations from Southern Sudan during the conflict. However, no studies have been conducted on mental health in post-war Southern Sudan. The objective of this study was to measure PTSD and depression in the population in the town of Juba in Southern Sudan; and to investigate the association ofdemographic, displacement, and past and recent trauma exposure variables, on the outcomes of PTSD and depression.MethodsA cross-sectional, random cluster survey with a sample of 1242 adults (aged over 18 years) was conducted in November 2007 in the town of Juba, the capital of Southern Sudan. Levels of exposure to traumatic events and PTSD were measured using the Harvard Trauma Questionnaire (original version), and levels of depression measured using the Hopkins Symptom Checklist-25. Multivariate logistic regression was used to analyse the association ofdemographic, displacement and trauma exposure variables on the outcomes of PTSD and depression. Multivariate logistic regression was also conducted to investigate which demographic and displacement variables were associated with exposure to traumatic events.ResultsOver one third (36%) of respondents met symptom criteria for PTSD and half (50%) of respondents met symptom criteria for depression. The multivariate logistic regression analysis showed strong associations of gender, marital status, forced displacement, and trauma exposure with outcomes of PTSD and depression. Men, IDPs, and refugees and persons displaced more than once were all significantly more likely to have experienced eight or more traumatic events.ConclusionThis study provides evidence of high levels of mental distress in the population of Juba Town, and associated risk-factors. Comprehensive social and psychological assistance is urgently required in Juba.
Highlights
The signing of the Comprehensive Peace Agreement in January 2005 marked the end of the civil conflict in Sudan lasting over 20 years
Up to four million people were forcibly displaced from their homes as internally displaced persons (IDPs) and they went mainly to Khartoum in the north, central Sudan, or the towns of Southern Sudan
Ethical approval for the study was provided by the Ministry of Health of the Government of Southern Sudan, and the London School of Hygiene and Tropical Medicine
Summary
The signing of the Comprehensive Peace Agreement in January 2005 marked the end of the civil conflict in Sudan lasting over 20 years. The signing of the Comprehensive Peace Agreement in January 2005 marked the end of the 20 year civil conflict in Sudan between the Government of Sudan in the north and rebel movements in southern Sudan led by the Sudan People's Liberation Army/Movement. This conflict marked a continuation of the 1955–1972 war between the south and north and was rooted in long-term political, economic and cultural grievances between the south and the Government of Sudan. There were up to one million refugees, living mainly in camps and cities in Kenya, Uganda, Central Africa Republic, Ethiopia, Egypt and other neighbouring countries The majority of these displaced persons have returned to Southern Sudan
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