{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T06:04:53Z","timestamp":1788242693083,"version":"build-2803163510"},"reference-count":39,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2022,10,10]],"date-time":"2022-10-10T00:00:00Z","timestamp":1665360000000},"content-version":"unspecified","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Partners In Health\/Inshuti Mu Buzima","award":["No grant number"],"award-info":[{"award-number":["No grant number"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,10,2]]},"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We aimed to describe access to food and symptoms of depression among patients with chronic diseases or their caregivers, and assess associated factors during the COVID-19 lockdown in rural Rwanda.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting and participants<\/jats:title>\n                    <jats:p>A stratified random sampling technique was used to recruit 220 patients enrolled in the HIV, non-communicable diseases, mental health, paediatric development clinic and oncology programmes in three rural districts of Rwanda.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>Telephone-based interviews were conducted to collect data on the number of daily meals before and during the COVID-19, and depression was assessed using the Patient Health Questionnaire-9. We used logistic regression analysis to investigate factors associated with households reporting a reduction in daily meals and with the survey respondent reporting symptoms of depression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the participants, 19.1% reported a reduction in daily number of meals for either adults or children in their households during lockdown and 24.6% had depression. Reporting a reduction in daily meals was associated with the district of residence and estimated household\u2019s monthly income. Self-reported depression was significantly associated with negative experiences during lockdown, including reporting feeling depressed or fear (AOR 4.82; 95%\u2009CI 2.08 to 11.21), loneliness (AOR 4.33; 95%\u2009CI 1.32 to 14.13), reduction in daily meals (AOR 4.15; 95%\u2009CI 1.56 to 11.00) and lack of access to healthcare (OR 3.29; 95%\u2009CI 1.32 to 8.23).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings suggest that significant reduction in access to food affected rural Rwandans with chronic diseases during COVID-19 lockdown, and the lockdown effect varied by household\u2019s pre-pandemic level of vulnerability to food insecurity. Reduction in household meals, as well as other self-reported effects of the lockdown, were associated with worse psychological status of survey respondents. Economic and food support should be considered by governments and non-governmental organisations to protect those most vulnerable including patients with chronic diseases against the effects of pandemics and their associated containment measures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-054137","type":"journal-article","created":{"date-parts":[[2022,10,10]],"date-time":"2022-10-10T12:07:18Z","timestamp":1665403638000},"page":"e054137","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Food insecurity and level of depression among patients with chronic diseases, and associated factors during the COVID-19 lockdown: a cross-sectional study in rural Rwanda"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3996-9532","authenticated-orcid":false,"given":"Sabine","family":"Umutoniwase","sequence":"first","affiliation":[{"name":"Clinical, Partners In Health\/Inshuti Mu Buzima, Kigali, Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2683-9459","authenticated-orcid":false,"given":"Alphonse","family":"Nshimyiryo","sequence":"additional","affiliation":[{"name":"Research and Training, Partners In Health\/Inshuti Mu Buzima, Kigali, Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dale A","family":"Barnhart","sequence":"additional","affiliation":[{"name":"Research and Training, Partners In Health\/Inshuti Mu Buzima, Kigali, Rwanda"},{"name":"Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Symaque","family":"Dusabeyezu","sequence":"additional","affiliation":[{"name":"Clinical, Partners In Health\/Inshuti Mu Buzima, Kigali, Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Egide","family":"Mpanumusingo","sequence":"additional","affiliation":[{"name":"Clinical, Partners In Health\/Inshuti Mu Buzima, Kigali, Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evrard","family":"Nahimana","sequence":"additional","affiliation":[{"name":"Clinical, Partners In Health\/Inshuti Mu Buzima, Kigali, Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel M.","family":"Mubiligi","sequence":"additional","affiliation":[{"name":"Clinical, Partners In Health\/Inshuti Mu Buzima, Kigali, Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent K","family":"Cubaka","sequence":"additional","affiliation":[{"name":"Research and Training, Partners In Health\/Inshuti Mu Buzima, Kigali, Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,10,10]]},"reference":[{"key":"2025121511472438000_12.10.e054137.1","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1007\/s11684-020-0766-9","article-title":"COVID-19 containment: China provides important lessons for global response","volume":"14","author":"Zhang","year":"2020","journal-title":"Front Med"},{"key":"2025121511472438000_12.10.e054137.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30567-5"},{"key":"2025121511472438000_12.10.e054137.3","doi-asserted-by":"publisher","DOI":"10.1177\/0020764020942247"},{"key":"2025121511472438000_12.10.e054137.4","doi-asserted-by":"crossref","first-page":"e1380","DOI":"10.1016\/S2214-109X(20)30366-1","article-title":"Immediate impact of stay-at-home orders to control COVID-19 transmission on socioeconomic conditions, food insecurity, mental health, and intimate partner violence in Bangladeshi women and their families: an interrupted time series","volume":"8","author":"Hamadani","year":"2020","journal-title":"Lancet Glob Health"},{"key":"2025121511472438000_12.10.e054137.5","doi-asserted-by":"crossref","first-page":"100410","DOI":"10.1016\/j.gfs.2020.100410","article-title":"Covid-19 lockdowns, income distribution, and food security: an analysis for South Africa","volume":"26","author":"Arndt","year":"2020","journal-title":"Glob Food Sec"},{"key":"2025121511472438000_12.10.e054137.6","doi-asserted-by":"crossref","first-page":"1393","DOI":"10.1080\/03066150.2020.1823838","article-title":"This food crisis is different: COVID-19 and the fragility of the neoliberal food security order","volume":"47","author":"Clapp","year":"2020","journal-title":"J Peasant Stud"},{"key":"2025121511472438000_12.10.e054137.7","unstructured":"United Nations . 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