Trauma and PTSD in East Africa: Key findings from the PTSD follow up of the neuro GAP- Psychosis case control study

Background : African populations face a disproportionately high burden of trauma and PTSD, however, there is limited knowledge of the genetic and environmental risk architecture of PTSD in persons of African descent.

Methods: This is a follow-up to the NeuroGAP - Psychosis case-control study assessing the genetics of mental illness in Sub-Saharan Africa. Cases were defined as having a psychotic disorder. We have been collecting data in hospitals/clinics in Uganda (N=3756, 49% male, 47% cases) and Kenya (N=1898, 52% male, 54% cases) since May 2022. We used the LEC-5 to assess trauma exposure and PC-PTSD-5 and PTSD Checklist for PTSD symptoms. We conducted bivariate analysis and regression analysis to test associations, and qualitative content analysis to explore culturally relevant traumas.

Results: In the Kenyan sample, 88% of participants endorsed at least one traumatic event, and 31% endorsed 4 or more traumatic events (out of 17 events). In the Ugandan sample, 65% of participants endorsed at least one and 24% endorsed 4 or more traumatic events. Severe human suffering was reported as the worst trauma in the Kenyan sample, especially among females and cases with psychosis. Illness and physical assault were reported as the worst traumas in the Ugandan sample including among cases, controls and males. Unwanted sexual experiences, sudden accidental death and severe human suffering were associated with the highest odds of PTSD diagnosis.

Conclusions: Our findings reveal the commonly endorsed and worst traumatic events and their impact on PTSD symptoms in the Kenyan and Ugandan samples, with key implications for phenotyping and genotyping analyses.