Prevalence and co-existence of morbidity of posttraumatic stress and functional impairment among Burundian refugee children and their parents.
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ABSTRACT:
SUBMITTER: Scharpf F
PROVIDER: S-EPMC6807941 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Forcibly displaced children are at increased risk of violence and mental health disorders. In refugee contexts, schools are generally perceived as protective environments where children can build a sense of belonging and recover from trauma. Evidence shows that positive school climates can support student skills development and socio-emotional wellbeing and protect them against a host of adverse outcomes. However, schools are also places where children may experience violence, from both teachers and peers. Prevalence estimates of violence against children in humanitarian settings are scarce and evidence on the relationship between school climate and student outcomes in these contexts is non-existent. The aim of the study is to estimate the prevalence of school-based violence against children and to explore the association between perceptions of school climate and students' experiences and use of violence and their depression symptoms. We relied on data from a cross-sectional survey of students and teachers in all primary and secondary schools in Nyarugusu Refugee Camp in Tanzania, conducted as part of a cluster randomised controlled trial, to compute prevalence estimates and used mixed logistic regression analysis to assess the association between school climate and students' outcomes. We found that students in Nyarugusu experienced high levels of violence from both peers and teachers in both primary and secondary schools in the camp, with little difference between boys and girls. Nearly one in ten students screened positive for symptoms of depression. We found that opportunities for students and teachers to be involved in decision-making were associated with higher odds of violent discipline and teachers' self-efficacy was a significant protective factor against student depression symptoms. However, generally, school-level perceptions of school climate were not associated with student outcomes after adjusting for potential confounders. Our findings suggest that interventions to prevent and respond to teacher and peer violence in schools and to support students' mental health are urgently needed. Our results challenge the assumption that education environments are inherently protective for children and call for further investigation of norms around violence among students and teachers to better understand the role of school climate in refugee settings.
| S-EPMC9308201 | biostudies-literature
Project description:ObjectiveThe aim of this study was to investigate psychological stress in parents of children with esophageal atresia and to explore factors associated with the development of Posttraumatic Stress disorder (PTSD).DesignSelf-report questionnaires were administered to parents of children with EA. Domains included: (1) sociodemographic data, current personal difficulties, assessment scales for the quality of life and for the global health status of the child (2) French-validated versions of the Perinatal Posttraumatic Stress disorder Questionnaire and of the State-Trait Anxiety Inventory. Associations between PTSD and severity of the neonatal course, presence of severe sequelae at 2 years of age, and quality of life and global health status of children according to their parents' perception were studied.SettingA Tertiary care University Hospital.ResultsAmong 64 eligible families, 54 parents of 38 children (59%) participated to the study. PTSD was present in 32 (59%) parents; mothers were more frequently affected than fathers (69 vs 46%, p = 0.03). Four mothers (8%) had severe anxiety. PTSD was neither associated with neonatal severity nor with severe sequelae at 2 years. Parents with PTSD rated their child's quality of life and global health status significantly lower (7.5 vs 8.6; p = 0.01 and 7.4 vs 8.3; p = 0.02 respectively).ConclusionsPTSD is frequent in parents of children with esophageal atresia, independently of neonatal severity and presence of severe sequelae at 2 years of age. Our results highlight the need for a long-term psychological support of families.
| S-EPMC4783023 | biostudies-literature
Project description:Introduction:Tuberculosis remains one of the top 10 major causes of global mortality, imposing social-economic and medical challenges in Malaysia. Refugees sheltered in Malaysia are a high-risk population but basic health checks upon their arrival, including tuberculosis screening, are not practised. This study aimed to identify the prevalence and risk factors of tuberculosis and latent tuberculosis infection (LTBI) among refugee children in Malaysia. Methods:A cross-sectional study was performed in three refugee schools in the Klang Valley, Malaysia, using tuberculin skin tests or interferon-? release assays. Participants who tested positive were sent for further examination with chest radiography to confirm the tuberculosis diagnosis. Results:From April 2018 to April 2019, we screened 430 refugee children with a median age of 13.0?years. Most of the children were born in Myanmar (n=274, 63.7%) and Pakistan (n=60, 14.0%). No children were diagnosed with active tuberculosis but 55 of the children (12.8%) were diagnosed with LTBI. Children with LTBI were generally older (OR 3.01, 95% CI 1.71-5.29; p<0.001) than those without LTBI infection. Sex, history of bacille Calmette-Guérin vaccination and country of birth were not associated with increased risk of LTBI. Conclusion:The relatively high LTBI burden among refugee children in this study poses an indication of possible LTBI risk among this population nationwide, and thus would be an important group to target for preventive therapy. This provides a unique opportunity for researchers to further examine and implement well-structured preventive strategies in combating the endemic infectious disease in Malaysia.
| S-EPMC7061204 | biostudies-literature
Project description:BackgroundThere is an urgent need for evidence-based, scalable, psychological interventions to improve the mental health of adolescents affected by adversity in low-resource settings. Early Adolescents Skills for Emotions (EASE) was developed by the WHO as a brief, transdiagnostic, group intervention for early adolescents exhibiting internalising problems, delivered by trained and supervised lay providers. This study describes the cultural adaptation of EASE for Burundian adolescents living in Mtendeli refugee camps in Tanzania.MethodsA phased approach to adaptation of the EASE intervention and its implementation, was adopted and comprised of: (1) a desk review to synthesize existing research on mental health issues in conflict-affected Burundian communities, (2) a rapid qualitative assessment involving free listing and key informant interviews with multiple stakeholders, (3) cognitive interviews with end users, and (4) a two-part adaptation workshop involving the implementing partner staff, members of the refugee community and mental health experts. We applied the Bernal framework to systematically document and track adaptations across eight dimensions of the intervention.ResultsProblems associated with worry, stress, sadness, shame and fear were identified as amongst the most critical mental health concerns, alongside a range of experiences of different forms of violence (such as gender-based violence, violence when fleeing from their homes) and associated problems. Problems associated with violence that included past experiences of fleeing as well as ongoing problems of gender-based violence in the camp. The most significant adaptations that were required included providing options for low literacy of participants, safety planning to address the high prevalence of sexual violence, simplification of strategies for the benefit of the end users and of lay facilitators, and implementation changes to consider involvement of refugee incentive workers. A majority of changes were across dimensions of language, people, metaphors, content, methods and context, while there were fewer changes regarding the goals and concepts of EASE.ConclusionsThe approach to adaptation of a psychological intervention suggested both minor and major required changes. Adaptations based on the findings of this study are anticipated to enhance relevance and acceptability of the EASE intervention and its delivery for camp-residing Burundian refugees in Tanzania.
| S-EPMC8477522 | biostudies-literature
Project description:BackgroundDouble burden of malnutrition is a global problem posing a serious public health challenge especially in low- and middle-income countries including Ethiopia, where a high prevalence of under-nutrition continues to exist and overweight is increasing at an alarming rate. Although both under-nutrition and over-nutrition are investigated extensively in Ethiopia, evidence about the double burden of malnutrition especially at the individual level is very limited.ObjectiveTo assess the prevalence of the co-existence of overweight/obesity and stunting and associated factors among under-five children in Addis Ababa, Ethiopia at an individual level.MethodsInstitution-based cross-sectional study was conducted from May to June 2021 among 422 mothers to child pairs in Addis Ababa. Twenty-nine (30%) of the health centers in Addis Ababa were selected to take part in the study using a simple random sampling technique. The total sample size was allocated proportionally to each of the selected health centers based on their performances within 6 months prior to the study. A systematic random sampling method was used to select the study participants. An interviewer-administered structured questionnaire was used to collect data. Descriptive statistics and a hierarchical logistic regression model were used to characterize the study population and to identify factors that are associated with the outcome variable respectively. Odds ratio along with 95% CI were estimated to measure the strength of the association. The level of statistical significance was declared at a p-value less than 0.05.ResultsThe prevalence of the co-existence of overweight/obesity and stunting was 5.1% with 95% CI (2.9-7.1%). The hierarchical logistic regression analysis revealed that child age (6-23 months) [(AOR = 2.86, 95% CI: (1.02-8.04)], maternal education status (non-educated) [(AOR = 4.98, 95% CI: (1.33-18.66)], maternal age during birth (≥ 28 years) [(AOR = 0.22, 95% CI: (0.06-0.79)] and childbirth order (3+) [(AOR = 6.38, 95% CI: (1.03-39.7)] were significantly associated with the co-existence of overweight /obesity and stunting.Conclusion and recommendationsThe study revealed that the prevalence of the co-existence of overweight/obesity and stunting is low in Ethiopia. However, local and national nutrition policies and programs should be tailored and implemented to simultaneously address both under-nutrition and over-nutrition.
| S-EPMC9241306 | biostudies-literature
Project description:BackgroundParents of children with intellectual and developmental disorders often experience potentially traumatic events while caring for their children. Heightened posttraumatic stress (PTS) and posttraumatic growth (PTG) have been found in this population.ObjectiveWe aimed to explore risk and protective factors for their PTS and PTG.MethodA cross-sectional study was conducted with 385 parents (average age M = 43.14 years, SD = 7.40; 95.3% mothers).ResultsParenting trauma showed an adverse effect on developing PTS (beta = 0.25, p < .01) and a positive role in promoting PTG (beta = 0.16, p < .01). Social support was protective in its correlation with lower levels of PTS (beta = -0.12, p < .01) and higher levels of PTG (beta = 0.22, p < .01). Barriers to care were associated with increased PTS (beta = 0.23, p < .01), but unrelated to PTG (beta = .01, p = .855). Negative parenting showed a significant, but small, correlation with more severe PTS (beta = 0.11, p < .05), and was unrelated to PTG (beta = -0.09, p = .065).ConclusionsOur study increases the understanding of posttraumatic reactions in parents, predominantly mothers, of children with IDD and identified parenting-related trauma, social support, and barriers to mental health care as predictive factors of the reactions. More research is needed to confirm and validate the effects of the discussed factors. Although causation can not be inferred, prompt and adequate screening and therapeutic resources should be provided to those mothers who were exposed to multiple stressful caregiving events and had limited healthcare access and less support from their spouses, peers, and caregiving partners.HighlightsParents of a child with Intellectual and Developmental Disorders with parenting trauma had higher posttraumatic stress (PTS) and posttraumatic growth (PTG).Social support was related to lower PTS and higher PTG.Barriers to care were related to higher PTS but unrelated to PTG.
| S-EPMC9245730 | biostudies-literature
Project description:BACKGROUND:Thalassaemia is a chronic disease which requires lifelong treatment in a majority. Despite recent advances in the medical care, minimal attempts are made to improve psychological health in these patients. In this study, we aim to describe the psychological morbidity in patients with transfusion dependent ?-thalassaemia and their mothers in Sri Lanka. METHODS:This case control study was conducted in the three largest thalassaemia centres of Sri Lanka. All patients with transfusion dependent ?-thalassaemia aged 4-18 years were recruited as cases whilst a randomly selected group of children without chronic diseases were recruited as controls. Psychological morbidity of children was assessed using the Strengths and Difficulties Questionnaire and depressive symptoms of mothers was assessed by the Centre for Epidemiological Studies Depression Scale. RESULTS:288 transfusion dependent ?-thalassaemia patients and equal number of controls were recruited. Abnormal emotional, conduct, hyperactivity and peer relationship symptom scores were reported by 18%, 17%, 9% and 14% of patients with thalassaemia respectively. Prevalences of abnormal psychological symptom scores in all domains were significantly higher among patients compared to controls. Abnormal conduct symptoms were significantly more prevalent among patients with HbE ?-thalassaemia and those with suboptimal pretransfusion haemoglobin levels, lower transfusion volumes, hypothyroidism and undernutrition. Short stature was associated with abnormal emotional and hyperactivity scores. Depressive symptoms were significantly higher among mothers of patients with thalassaemia. Higher depressive symptom scores in mothers were significantly associated with abnormal emotional, conduct and peer relationship symptom scores in children. CONCLUSIONS:A higher proportion of patients with transfusion dependent ?-thalassaemia had abnormal psychological symptom scores. Abnormal conduct symptoms were more prevalent among patients with HbE ?-thalassaemia, those who were inadequately transfused and having hypothyroidism and undernutrition. Mothers of the children with transfusion dependent ?-thalassaemia had significantly higher depressive symptoms which were significantly associated with psychological symptoms among children.
| S-EPMC7012414 | biostudies-literature
Project description:Background: The global epidemic of pediatric obesity is well-known, but data on co-existence of obesogenic behaviors are limited. We aim to report the prevalence of and trends in the co-existence of obesogenic behaviors in adolescents from 15 countries. Methods: This study was based on the Global School-based Student Health Survey 2003-2017 and included 121,963 adolescents aged 12-15 years from 15 countries where at least 2 cross-sectional surveys were conducted. We used sampling weights and calculated the country-level prevalence of and trends in the co-existence of obesogenic behaviors (low fruit and vegetable intake, anxiety-induced insomnia, no physical activity, and sedentary behavior) during survey years. Pooled prevalence and trend estimates were calculated with random-effects models. Results: Pooled prevalence of exposure ≥ 1, ≥2, and ≥3 obesogenic behaviors was 88.2, 44.9, and 9.8% in the first survey and 88.4, 46.4, and 10.2% in the last survey, respectively. Plateauing, increasing, and decreasing trends in the co-existence of obesogenic behaviors were observed in different countries. Specifically, we identified a plateauing pooled trend in the exposure ≥ 1, ≥2, and ≥3 obesogenic behaviors [odds ratios (95% confidence intervals): 1.03 (0.93, 1.14), 1.05 (0.97, 1.13), and 1.06 (0.95, 1.18), respectively]. Conclusion: Trends in the prevalence of the co-existence of obesogenic behaviors varied significantly across different countries, but the prevalence remained high in most countries. These findings suggest the need for behavioral interventions to mitigate obesogenic behaviors in adolescents for overweight and obesity prevention.
| S-EPMC8100235 | biostudies-literature
Project description:ObjectiveAge-appropriate criteria for posttraumatic stress disorder (PTSD) in young children have been established. The present study investigated the long-term course of such PTSD and its predictors in young children.MethodsYoung children (aged 2-10 years) and parents/caregivers who had attended emergency departments after motor vehicle collisions (MVCs) between May 2004 and November 2005 were assessed at 2 to 4 weeks and 6 months post-MVC; 71 families were re-interviewed 3 years post-MVC. Participants were assessed according to standard DSM-IV criteria for PTSD and a well-validated alternative algorithm for diagnosing PTSD in young children (PTSD-AA). Demographic, trauma-related, and parental mental health variables and intellectual ability were also assessed at baseline.ResultsUsing an "optimal-report" procedure (a positive diagnosis according to parent or child for older children, or just parent for younger children), 7.0% met criteria for DSM-IV PTSD and 16.9% for PTSD-AA at 3 years. Using parent report alone, these rates were 1.4% and 2.8%, respectively. Parent-child agreement for PTSD and PTSD-AA was no better than chance (Cohen κ = -0.03 and -0.04, respectively). Baseline parent posttraumatic stress relating to the child's trauma, and not trauma severity, was correlated with optimal-report child PTSD-AA at each assessment (r values = 0.29-0.31) and accounted for unique variance in logistic regression models of this outcome at each assessment.ConclusionsPTSD-AA in young children can persist for years but is underrecognized by parents despite its being shaped to a large extent by parents' own acute traumatic stress in response to the child's trauma.
| S-EPMC5389449 | biostudies-literature
Project description:ObjectivesTo investigate whether posttraumatic stress symptoms (PTSS) are related to attentional bias towards cancer-related stimuli among parents of children recently diagnosed with cancer.MethodsSixty-two parents completed questionnaires measuring PTSS, depression, and anxiety and the emotional Stroop task via the Internet. The emotional Stroop task included cancer-related words, cardiovascular disease-related words, and neutral words.ResultsParticipants were split in two groups based on the median of PTSS: High-PTSS and Low-PTSS. There was a significant interaction between word-type and group and a planned contrast test of this interaction indicated that the High-PTSS group had longer response latencies on cancer-related words compared to the other word-type and group combinations.ConclusionsFindings suggest that PTSS are related to attentional bias towards cancer-related stimuli among parents of children recently diagnosed with cancer. Implications of this finding for the understanding of PTSS in this population, future research, and clinical practice are discussed.
| S-EPMC4817976 | biostudies-literature