Mark Muyanga

A large number of adolescents with hearing impairment experience socio-emotional and structural challenges that may put them at risk for depression. However, depression is often undiagnosed among them due to lack of appropriate, culturally relevant tools for its assessment. This study set out to determine the prevalence of depression and its associated factors in this vulnerable population. A cross-sectional study was conducted among adolescents aged 10–17 years with hearing impairment, attending three primary schools of the deaf across Kampala City in Uganda. Depression was assessed using the Mini International Neuropsychiatric Interview for children and adolescents (MINI-KID), which underwent linguistic adaptation and translation into Ugandan Sign Language through a collaborative process involving sign language teachers and students, and administered in video format to ensure clarity and inclusion. Data were analyzed with Stata version 17. Modified Poisson regression with robust standard errors was used to examine associations. A total of 116 adolescents participated (mean age = 14.5 ± 1.9 years; 51.7% female). The lifetime prevalence of depression was 60.3%, with point prevalence at 34.5%. Depression was more frequent among females, though these differences were not statistically significant. Living in father-only households was associated with higher likelihood of depression (IRR = 2.11, 95% CI: 1.60–2.77 p < 0.001), while not experiencing or witnessing excessive disciplinary measures at school was associated with a lower likelihood of depression (IRR = 0.65, 95% CI: 0.49–0.87, p = 0.003). Using a linguistically adapted version of the MINI-KID, we found that depression is highly prevalent among adolescents with hearing impairment in Kampala. Strengthening family support, improving access to sign language-trained professionals, and implementing inclusive school-based interventions are key to identifying and managing depression in this population.

Background: A large number of adolescents with hearing impairment experience socio-emotional and structural challenges that may put them at risk for depression. However, depression is often undiagnosed among them due to lack of appropriate, culturally relevant tools for its assessment. This study set out to determine the prevalence of depression and its associated factors in this vulnerable population. Methods: A cross-sectional study was conducted among adolescents aged 10 to 17 years with hearing impairment, attending three primary schools of the deaf across Kampala City in Uganda. Depression was assessed using the Mini International Neuropsychiatric Interview for children and adolescents (MINI-KID), which underwent linguistic adaptation and translation into Ugandan Sign Language through a collaborative process involving sign language teachers and students, and administered in video format to ensure clarity and inclusion. Data were analyzed with Stata version 17. Modified Poisson regression with robust standard errors was used to examine associations. Results: A total of 116 adolescents participated (mean age = 14.5 ± 1.9 years; 51.7% female). The lifetime prevalence of depression was 60.3%, with point prevalence at 34.5%. Depression was more frequent among females, though these differences were not statistically significant. Living in father-only households (IRR = 2.11, 95% CI: 1.60–2.77 p < 0.001), and witnessing excessive disciplinary practices (IRR = 0.65, 95% CI: 0.49–0.87, p = 0.003), were significantly associated with depression. Conclusion: Using a linguistically adapted version of the MINI-KID, we found that depression is highly prevalent among adolescents with hearing impairment in Kampala. Strengthening family support, improving access to sign language-trained professionals, and implementing inclusive school-based interventions are key to identifying and managing depression in this population.

Background: Social protection programs, such as Uganda’s Senior Citizens Grant (SCG), are designed to provide financial support to improve the welfare of older adults. Neurocognitive impairment affects financial competence and may impair beneficiaries’ ability to manage financial resources effectively. However, evidence from low-income settings remains limited. This study therefore examined the association between neurocognitive impairment and financial competence in elderly Ugandans receiving social assistance grants. Methods: A cross-sectional study was conducted among 588 elderly SCG beneficiaries sampled from ten Ugandan districts. Data were collected between 4th October and 19th November 2024 during the scheduled SCG disbursement period. Neurocognitive impairment was assessed using the Mini-Mental State Examination. Financial competence was assessed across six domains: involvement in financial decision-making, saving, borrowing, investment knowledge, insurance knowledge, and retirement planning. Each domain was treated as a separate binary outcome. Binary Logistic regression was used to estimate adjusted odds ratios (aORs) for each outcome while controlling for sociodemographic, health, and functional variables. Results: The prevalence of neurocognitive impairment was 60.0% (95% CI: 56.0–63.9%). Engagement across different financial domains was generally low. Only about 27.0% were involved in financial decisions or reported saving (24.8%). Only 10.2% had taken a loan, 8.9% had investment knowledge, 4.1% had insurance knowledge, and 13.2% reported having any retirement plans. After adjustment, neurocognitive impairment was strongly associated with reduced odds of involvement in financial decisions in several domains, including financial decision-making (aOR 0.49, p<0.001), saving (aOR 0.62, p=0.022), investment knowledge (aOR 0.30, p<0.001), and insurance knowledge (aOR 0.13, p=0.002). Conclusions: Neurocognitive impairment is widespread among elderly Ugandans receiving SCG. The impairment is associated with multiple domains of financial competence, which may undermine individuals' ability to fully benefit from social protection interventions. Routine screening for neurocognitive impairment and tailored financial management support may enhance program effectiveness and safeguard older persons’ welfare.