Displacement-related stressors in a Sudanese war-affected community; identifying the impact of war exposure and ongoing stressors on trauma symptom severity: a national multi-center cross-sectional study

Abstract

Introduction: The ongoing armed conflict in Sudan that started April 2023 resulted in over 8 millions internally displaced persons (IDPs), in addition to the already previously displaced 3.8 millions. Post-traumatic stress disorder (PTSD) is one of the most documented mental health problems among IDPs. Additionally, factors such as personal safety concerns and financial losses have been identified as potential stressors contributing to the development of PTSD. Our study aimed to understand the relationship between displacement-related stressors and trauma symptom severity. Methods: This was an observational, multi-center cross-sectional study conducted across seven conflict-free states in Sudan. A pre-tested questionnaire assessing the displacement stressors and the Harvard trauma questionnaire (HTQ) were used to collect the data through face-to-face interviews. The data analysis was conducted using R software. A structural equation model was generated to visualize the comprehensive relationship between the study variables. Results: Most of the participants (N = 1470) were females (81.4%), married (63.9%), employed (42.5%), Muslims (93.0%) and previously displaced (54.1%), with a mean age of (35.25 ± 13.92) years old. The prevalence of PTSD was (34.5%) and it was significantly associated with gender (P = 0.003), religion (P < 0.001), level of education (P = 0.031), and number of displacements (P = 0.005). Personal safety concerns, financial loss and hardship, and personal hardships were positively correlated with PTSD symptoms severity. War exposure losses were negatively correlated with the severity of PTSD symptoms. Conclusion: The strong association between PTSD symptoms and personal safety concerns, financial loss and hardship, and personal hardships emphasizes the urgent need for targeted mental health interventions that could mitigate the impact of PTSD in Sudanese communities.