TY - JOUR
T1 - War-Affected South Sudanese in Settings of Preflight, Flight, and Resettlement
T2 - a Systematic Review and Meta-analysis of Trauma-Associated Mental Disorders
AU - Tutlam, Nhial T.
AU - Chang, Jen Jen
AU - Byansi, William
AU - Flick, Louise H.
AU - Ssewamala, Fred M.
AU - Betancourt, Theresa S.
N1 - Publisher Copyright:
© The Author(s), under exclusive licence to Springer Nature Switzerland AG 2022. Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
PY - 2024/9
Y1 - 2024/9
N2 - Background: South Sudanese have experienced prolonged exposure to conflict and displacement regionally and globally, with studies in different settings yielding vastly inconsistent rates of trauma-associated mental disorders. This systematic review and meta-analysis aimed to synthesize the methodological approach and quality, trauma exposure, risk and protective factors, and aggregate available data on the prevalence of trauma-associated mental disorders among South Sudanese in different settings to gain better understanding of the impact of war trauma in this population. Methods: Guided by the new (2020) Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement, we conducted a systematic review and meta-analysis of all studies published from 1981 to 2021.The main inclusion criteria were as follows: studies published in English, present prevalence rates on anxiety, depression, and/or posttraumatic stress disorder (PTSD), and number of traumatic events, and have a sample size of 30 or more. We calculated pooled prevalence, 95% confidence intervals, and I2 statistic to test heterogeneity between studies in MedCalc statistical software. Results: We reviewed a total of nine reports from eight unique studies with total of 6138 participants. All studies were cross-sectional in design with six designated as low quality and two as moderate quality. South Sudanese experienced on average nine war-related traumatic events. Consequently, the overall pooled rates of trauma-associated mental disorders are high: anxiety = 25.2% (95% CI: 14.0, 38.5); depression = 24.2% (8.4, 45.0); and PTSD = 34.0% (29.0, 39.1). Overall prevalence of PTSD was 40% in both preflight and flight settings; however, aggregate rate of just 14% was recorded in resettlement settings. Risk factors include female gender, advanced age, severity, and recency of traumatic events, and cultural adjustment difficulties. Protective factors include urban residency, social support, religion, higher annual household income, household possessions, and history of migration. Conclusions: This systematic review and meta-analysis reveals that prolonged exposure to war trauma has negatively impacted the psychological wellbeing of South Sudanese in refugee camps and those still in their homeland. However, the prevalence appears to be lower among those resettled in developed countries.
AB - Background: South Sudanese have experienced prolonged exposure to conflict and displacement regionally and globally, with studies in different settings yielding vastly inconsistent rates of trauma-associated mental disorders. This systematic review and meta-analysis aimed to synthesize the methodological approach and quality, trauma exposure, risk and protective factors, and aggregate available data on the prevalence of trauma-associated mental disorders among South Sudanese in different settings to gain better understanding of the impact of war trauma in this population. Methods: Guided by the new (2020) Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement, we conducted a systematic review and meta-analysis of all studies published from 1981 to 2021.The main inclusion criteria were as follows: studies published in English, present prevalence rates on anxiety, depression, and/or posttraumatic stress disorder (PTSD), and number of traumatic events, and have a sample size of 30 or more. We calculated pooled prevalence, 95% confidence intervals, and I2 statistic to test heterogeneity between studies in MedCalc statistical software. Results: We reviewed a total of nine reports from eight unique studies with total of 6138 participants. All studies were cross-sectional in design with six designated as low quality and two as moderate quality. South Sudanese experienced on average nine war-related traumatic events. Consequently, the overall pooled rates of trauma-associated mental disorders are high: anxiety = 25.2% (95% CI: 14.0, 38.5); depression = 24.2% (8.4, 45.0); and PTSD = 34.0% (29.0, 39.1). Overall prevalence of PTSD was 40% in both preflight and flight settings; however, aggregate rate of just 14% was recorded in resettlement settings. Risk factors include female gender, advanced age, severity, and recency of traumatic events, and cultural adjustment difficulties. Protective factors include urban residency, social support, religion, higher annual household income, household possessions, and history of migration. Conclusions: This systematic review and meta-analysis reveals that prolonged exposure to war trauma has negatively impacted the psychological wellbeing of South Sudanese in refugee camps and those still in their homeland. However, the prevalence appears to be lower among those resettled in developed countries.
KW - Anxiety
KW - Depression
KW - PTSD
KW - Refugees
KW - South Sudanese
KW - War trauma
UR - https://www.scopus.com/pages/publications/85134486241
U2 - 10.1007/s40609-022-00227-w
DO - 10.1007/s40609-022-00227-w
M3 - Article
C2 - 39588290
AN - SCOPUS:85134486241
SN - 2196-8799
VL - 11
SP - 193
EP - 210
JO - Global Social Welfare
JF - Global Social Welfare
IS - 3
ER -