Impact of the COVID-19 pandemic on depression, anxiety, and stress in secondary school students in the Eastern Province, Rwanda

Abstract

Background: There exist a variety of psychological problems caused by COVID-19. These health concerns comprising depression, anxiety and stress behave as the drivers of poor health quality among the students from secondary schools after they experience the abovementioned pandemic. Despite the fact that the epidemic stuck schools, it nonetheless had harmful effects on people of all ages. It has been highlighted that there has been no research on secondary school students for examining mental health issues as the effects of the epidemic. Hence, this study looked at the prevalence of mental health conditions specifically depression, anxiety, and stress among the students from the secondary school as well as the factors that contribute to these conditions. Methods: We carried out a cross-sectional study with 384 students from the secondary school in the Eastern Province, Rwanda. Descriptive and analytical analyses were used to indicate the prevalence of the psychological distresses and their associated factors. Bivariate analysis and multivariate based on the odds ratio were used to indicate the associated factors of anxiety, depression, and stress. For statistical analyses, 95% for the confidence intervals and 5% for the statistical significance levels were considered to determine the level of associations. Results: Our results reported than more than a half of respondents represented no stress (69.8%). But 7.6% had mild stress, 12% for moderate stress and 10.7% for severe stress. Regarding depression, majority (49.2%) had no depression while 18%, 10.2%, 16.7% and 6% had mild, moderate, severe and extremely severe depression respectively. A majority (32.5%) had no anxiety, but 16.4% were in mild range, 20.6% in moderate anxiety, 7.6% in severe anxiety and 22.7% classified as extremely anxiety. Experiencing domestic violence increased the odds to have depression [OR=4.25; 95%CI (1.55; 11.68), p=0.005] compared to not experiencing it. Those who were positively tested the COVID-19 had higher risk of depression [OR=4.44; 95%CI (1.8; 10.91), p<0.001] than to their counterparts. The students tested COVID-19 had higher to experience anxiety [OR=3.38; 95%CI (1.34; 8.51), p<0.01] than their counterparts. The students who experienced domestic violence were at greater risk of anxiety [OR=2.36; 95%CI (1.13; 4.96), p=0.022] than their counterparts. Students from the 9th grade [OR=3.13; 95%CI (1.01; 9.75), p=0.049] and 12th grades [OR=3.61; 95%CI (1.69; 7.71), p<0.001] were more likely to be stressed than those from the 7th grade. The students infected COVID-19 had higher risks to have stress [OR=5.91; 95%CI (1.14; 30.71), p=0.003] than their counterparts. Conclusion: Our findings highlighted a high prevalence of the mental health outcome among the students from the secondary schools. Gender, domestic violence, being covid-19 patient, grade, experiencing physical symptoms especially, breathing difficulties, exposure to chills, dizziness, and sore throat were the most consistent determinants of depression, anxiety, and stress. As results, developing appropriate mental health strategies and strengthening health system with the purpose to address these factors is critical among the students.