District Hospital Trauma Mental Health Screening Interpreter Language Concordance and Post-Traumatic Stress Disorder Detection Among Congolese Survivors in Ugandan Referral Clinics: A Multilevel Analysis of Communication Mediation

District hospital trauma mental health screening in Ugandan referral clinics depends on interpreter-mediated communication with Congolese survivors, yet the pathway by which language concordance shapes post-traumatic stress disorder detection remains theoretically underspecified. The framework integrates evidence on interpreter use in trauma care, the linguistic demography of Congolese refugee populations in Uganda, and multilevel mediation analysis to specify how concordance operates through three mechanisms: semantic accuracy, relational trust, and disclosure facilitation. The analysis distinguishes direct concordance effects from mediated effects and identifies cross-level interactions with trauma symptom severity and interpreter role clarity. The framework proposes testable propositions and a design for multilevel structural equation estimation with clinic-level random intercepts. The contribution is a mechanism-based specification that reframes interpreter language concordance from a background variable to a modifiable structural determinant of detection equity, with implications for screening protocols, interpreter staffing, and the interpretation of detection disparities in humanitarian referral settings.