Risk assessment for yellow Fever in Western and north-Western provinces of zambia.

BACKGROUND: North-Western and Western provinces of Zambia were reclassified as low-risk areas for yellow fever (YF). However, the current potential for YF transmission in these areas is unclear. AIMS: To determine the current potential risk of YF infection. SETTING AND DESIGN: A cross sectional study was conducted in North-Western and Western provinces of Zambia. MATERIALS AND METHODS: Samples were tested for both YF virus-specific IgG and IgM antibodies by the ELISA and YF virus confirmation was done using Plaque Reduction Neutralization Test. The samples were also tested for IgG and IgM antibodies against other flaviviruses. RESULTS: Out of the 3625 respondents who participated in the survey, 46.7% were males and 9.4% were aged less than 5 years. Overall, 58.1% of the participants slept under an impregnated insecticide-treated net and 20.6% reported indoor residual spraying of insecticides. A total of 616 (17.0%) samples were presumptive YF positive. The prevalence for YF was 0.3% for long-term infection and 0.2% for recent YF infection. None of the YF confirmed cases had received YF vaccine. Prevalence rates for other flaviviruses were 149 (4.1%) for Dengue, 370 (10.2%) for West Nile and 217 (6.0%) for Zika. CONCLUSION: There is evidence of past and recent infection of YF in both provinces. Hence, they are at a low risk for YF infection. Yellow fever vaccination should be included in the EPI program in the two provinces and strengthen surveillance with laboratory confirmation.

Cannabis use and its socio-demographic correlates among in-school adolescents in Zambia.

BACKGROUND: Cannabis dependence in adolescents predicts increased risks of using other illicit drugs, poor academic performance and reporting psychotic symptoms. The prevalence of cannabis use was estimated two decades ago in Zambia among secondary school students. There are no recent estimates of the extent of the problem; further, correlates for its use have not been documented in Zambia. The objective of study was to estimate the current prevalence of cannabis use and its socio-demographic correlates among in-school adolescents. METHODS: We conducted secondary analysis of data that was obtained from the 2004 Zambia Global School-Based Health Survey. Logistic regression analysis was conducted to identify the socio-demographic factors associated with cannabis use. RESULTS: A total of 2,257 adolescents participated in the survey of which 53.9% were females. The overall prevalence of self reported ever-used cannabis was 37.2% (34.5% among males and 39.5% among females). In multivariate analysis, males were 8% (AOR = 0.92; 95% CI [0.89, 0.95]) less likely to have ever smoked cannabis. Compared to adolescents aged 16 years or older, adolescents aged 14 years were 45% (AOR = 1.45; 95% CI [1.37, 1.55]) more likely, and those aged 15 years were 44% (AOR = 0.56; 95% CI [0.53, 0.60]) less likely to report to have ever smoked cannabis. Other factors that were significantly associated with cannabis use were history of having engaged in sexual intercourse (AOR = 2.55; 95% CI [2.46, 2.64]), alcohol use (AOR = 4.38; 95% CI [4.24, 4.53]), and having been bullied (AOR = 1.77; 95% CI [1.71, 1.83]). Adolescents who reported being supervised by parents during free time were less likely to have smoked cannabis (AOR = 0.92; 95% CI [0.88, 0.95]). CONCLUSIONS: The use of cannabis is prevalent among Zambian in-school adolescents. Efforts to prevent adolescents' psychoactive drug use in Zambia should be designed considering the significant factors associated with drug use in the current study.

Self-inflicted serious injuries among adolescents in Zambia.

Injuries are a growing cause of morbidity and mortality in the world. Data from Southern Africa are limited, possibly because of limited research prioritization of the issue and pre-occupation with communicable diseases. This study was conducted to estimate the prevalence of, and assess factors associated with, self-inflicted serious injuries among in-school adolescents in Zambia. We used data collected from the 2004 Zambia Global School-Based Health Survey to estimate prevalence of self-inflicted serious injury within the past 12 months. Logistic regression analysis was conducted to assess the association between selected predictor variables and reported history of having seriously injured oneself. Out of 2,136 adolescents who participated in the Zambia 2004 Global School-based Student Health Survey, 927 (43.4%) reported seriously injuring themselves. Of these who reported injuries, 110 (11.9%) reported seriously injuring themselves on purpose. The following variables were associated with history of self inflicted injury: worry; sadness; suicidal behaviour; history of ever having been drunk and marijuana use. Reported history of injury and self-inflicted injury among in-school adolescents in Zambia are common. History of self-inflicted injury was associated with other lifestyle and psychological concerns among the study participants.

Prevalence and correlates of obesity among Lusaka residents, Zambia: a population-based survey.

BACKGROUND: Non-communicable lifestyle diseases are a growing public health concern globally. Obesity is a risk factor for premature mortality from cardiovascular diseases and diabetes as well as all-cause mortality. The objective of the study was to estimate the prevalence and associated factors for obesity among Zambian adults in Lusaka district. METHODS: A community-based study was done among adults in Zambia. Descriptive and co-relational analyses were conducted to estimate the prevalence of being obese as well as identify associated factors. RESULTS: A total of 1,928 individuals participated in the survey, of which 33.0% were males. About half of the participants were aged 25-34 years (53.2%), and about two-thirds had attended at least secondary level of education (63.9%). Overall, 14.2% of the participants (5.1% of males, and 18.6% of females) were obese. Significant factors associated with obesity were sex, age, education, cigarette smoking and blood pressure. Male participants were 55% (AOR = 0.45; 95% CI [0.29, 0.69]) less likely to be obese compared to female participants. Compared to participants who were of age 45 years or older, participants of age 25-34 years were 61% (AOR = 0.39 (95% CI [0.23, 0.67]) less likely to be obese. Compared to participants who attained college or university level of education, participants who had no formal education were 63% (AOR = 0.37; 95% CI [0.15, 0.91]) less likely to be obese; and participants who had attained secondary level of education were 2.22 (95% CI [1.21, 4.07]) times more likely to be obese. Participants who smoked cigarettes were 67% (AOR = 0.33; 95% CI [0.12, 0.95]) less likely to be obese compared to participants who did not smoke cigarettes. Compared to participants who had severe hypertension, participants who had moderate hypertension were 3.46 (95% CI [1.34, 8.95]) times more likely to be obese. CONCLUSIONS: The findings from this study indicate that Zambian women are more at risk of being obese. Prevention and control measures are needed to address high prevalence and gender inequalities in risks for non-communicable diseases in Zambia. Such measures should include policies that support gender specific approaches for the promotion of health behavior changes.

Prevalence and correlates for school truancy among pupils in grades 7-10: results from the 2004 Zambia Global School-based Health Survey.

BACKGROUND: There are limited data on the prevalence and associated factors of truancy in southern Africa. Yet truancy should attract the attention of public health professionals, educators and policy makers as it may be associated with adolescent problem behaviours. The objectives of the study were to estimate the prevalence and determine correlates of school truancy among pupils in Zambia. FINDINGS: We used data collected in 2004 in the Zambia Global School-based Health Survey. Logistic regression analysis was conducted to identify factors associated with truancy. A total of 2257 pupils participated in the survey of whom 53.9% were male. Overall 58.8% of the participants (58.1% of males and 58.4% of females) reported being truant in the past 30 days. Factors associated with truancy were having been bullied (AOR = 1.34, 95% CI [1.32, 1.36]), current alcohol use (AOR = 2.19, 95% CI [2.16, 2.23]), perception that other students were kind and helpful (AOR = 1.12, 95% CI [1.10, 1.14]), being male and being from the lowest school grade. Pupils whose parents or guardians checked their homework (AOR = 0.91 95% CI, [0.89, 0.92]) and those who reported parental supervision (AOR = 0.94, 95% CI [0.92-0.95]) were less likely to report being truant. CONCLUSIONS: We found a high prevalence of truancy among pupils in grades 7-10 in Zambia. Interventions aimed to reduce truancy should be designed and implemented with due consideration of the associated factors.

Victimization from bullying among school-attending adolescents in grades 7 to 10 in Zambia.

BACKGROUND: Among school- attending adolescents, victimization from bullying is associated with anxiety, depression and poor academic performance. There are limited reports on victimization from bullying in Zambia; we therefore conducted this study to determine the prevalence and correlates for victimization from bullying among adolescents in grades 7 to 10 in the country in order to add information on the body of knowledge on victimization from bullying. METHODS: The 2004 Zambia Global School-based Health Survey (GSHS) data among adolescents in grades 7 to 10 were obtained from the World Health Organization. We estimated the prevalence of victimization from bullying. We also conducted weighted multivariate logistic regression analysis to determine independent factors associated with victimization from bullying, and report adjusted odds ratios (AOR) and their 95% confidence intervals (CI). RESULTS: Of 2136 students who participated in the 2004 Zambia GSHS, 1559 had information on whether they were bullied or not. Of these, 1559 students, 62.8% (60.0% of male and 65.0% of female) participants reported having been bullied in the previous 30 days to the survey. We found that respondents of age less than 14 years were 7% (AOR=0.93; 95%CI [0.91, 0.95]) less likely to have been bullied compared to those aged 16 years or older. Being a male (AOR=1.07; 95%CI [1.06, 1.09]), lonely (AOR=1.24; 95%CI [1.22, 1.26]), worried (AOR=1.12; 95%CI [1.11, 1.14]), consuming alcohol (AOR=2.59; 95%CI [2.55, 2.64]), missing classes (AOR=1.30; 95%CI [1.28, 1.32]), and considering attempting suicide (AOR=1.20; 95%CI [1.18, 1.22]) were significantly associated with bullying victimization. CONCLUSIONS: Victimization from bullying is prevalent among in-school adolescents in grades 7 to 10 in Zambia, and interventions to curtail it should consider the factors that have been identified in this study.

Prevalence of hypertension and its correlates in Lusaka urban district of Zambia: a population based survey.

BACKGROUND: Hypertension is a leading cause for ill-health, premature mortality and disability. The objective of the study was to determine the prevalence and associated factors for hypertension in Lusaka, Zambia. METHODS: A cross sectional study was conducted. Odds ratios and their 95% confidence intervals were calculated to assess relationships between hypertension and explanatory variables. RESULTS: A total of 1928 individuals participated in the survey, of which 33.0% were males. About a third of the respondents had attained secondary level education (35.8%), and 20.6% of males and 48.6% of females were overweight or obese. The prevalence for hypertension was 34.8% (38.0% of males and 33.3% of females). In multivariate analysis, factors independently associated with hypertension were: age, sex, body mass index, alcohol consumption, sedentary lifestyle, and fasting blood glucose level. CONCLUSIONS: Health education and structural interventions to promote healthier lifestyles should be encouraged taking into account the observed associations of the modifiable risk factors.

Prevalence and socio-demographic correlates for serious injury among adolescents participating in the Djibouti 2007 Global School-based Health Survey.

BACKGROUND: Mental health and injury are neglected public health issues especially in low-income nations. The objective of the study was to determine the prevalence and socio-demographic correlates for serious injury in the last 12 months. FINDINGS: The study used data of the 2007 Djibouti Global School-based Health Survey. Logistic regression analysis was used to establish associations. Of the 1, 777 respondents, 61.1% (63.2% males and 57.8% females) reported having sustained serious injury (SSI). Compared to participants who were not bullied, those who reported being bullied 3-9 days per month were more likely to have sustained serious injury in the last 12 months (AOR = 1.27; 95% CI [1.06, 1.52] for 3-5 days of bullying victimization per month, and AOR = 3.19; 95% CI [2.28, 4.47] for 6-9 days per month. Adolescents who were engaged in physical fighting were 47% (AOR = 1.47, 95% CI [1.40, 1.55] more likely to have sustained serious injury compared to those who were not engaged in the fighting. Meanwhile, adolescents who used substances (cigarettes, other forms of tobacco or drugs) were 30% (AOR = 1.30, 95% CI [1.19, 1.42]) more likely to have sustained serious injury compared to those who did not use substances. CONCLUSIONS: Serious injury is common among adolescents in Djibouti, and we suggest that health workers attending to injured adolescents explore the patients' psycho-social environment. Further, we suggest longitudinal studies where reduction of substance use and bullying may be assessed if they have an impact in reducing serious injury among adolescents.

Self-reported poor oral hygiene among in-school adolescents in Zambia.

BACKGROUND: Dental health is a neglected aspect of adolescent health globally but more so in low-income countries. Secondary analysis using the 2004 Zambia Global School-Based Health Survey (GSHS) was conducted in which we estimated frequencies of relevant socio-demographic variables and explored associations between selected explanatory variables and self-reported poor oral hygiene (not cleaning or brushing teeth) within the last 30 days of the completion of questionnaire. FINDINGS: Most of the 2257 respondents were males (53.9%) and went hungry (82.5%). More than 4 in 10 respondents drank alcohol (42.2%) while 37.2% smoked cannabis. Overall 10.0% of the respondents reported to have poor oral hygiene. Male respondents were 7% less likely to report to have poor oral hygiene compared to females. Compared to respondents who never drank alcohol, those who drank alcohol were 27% more likely to report to have poor oral hygiene. Respondents who smoked cannabis were 4% more likely to report to have poor oral hygiene compared to those who did not smoke cannabis. Finally, respondents who went hungry were 35% more likely to report to have poor oral hygiene compared to those who did not go hungry. CONCLUSIONS: Results from this study indicate that female gender, alcohol drinking, cannabis smoking, and going hungry were associated with self-reported poor oral hygiene. The identification of these factors should guide the design and implementation of programs aimed to improve oral health among adolescents.

Occupational illnesses in the 2009 Zambian labour force survey.

BACKGROUND: Occupational health has received limited research attention in the Southern African Development Community (SADC). Much of the published data in this region come from South Africa and little has been reported north of the Limpopo. The present study was conducted to estimate the burden of occupational illnesses in Zambia and assess factors associated with their occurrence. METHODS: Data were obtained from the Zambian Labour Force Survey of 2009. Frequencies were used to estimate the prevalence of occupational diseases. Logistic regression analyses were conducted to determine the associations between demographic, social and economic factors and reported illness resulting from occupational exposures. Odds ratios (OR) from bivariate analyses and adjusted odds ratios (AOR) from the multivariate analysis together with their 95% Confidence Intervals (CI) are reported. RESULTS: Data on 59,118 persons aged 18 years or older were available for analysis, of which 29805 (50.4%) were males. The proportions of the sample that reported to have suffered from an occupational illness were 12.7% among males and 10.4% among females (p < 0.001). Overall the proportions of respondents who reported suffering from fatigue, fever and chest infections were 38.8%, 21.7% and 17.1%, respectively. About two thirds (69.7%) of the study participants had stayed away from work due to the illness suffered at work; there was no sex differences (p = 0.216). Older age, being male, lower education level, married/cohabiting or once married (separated/divorced/widowed), and paid employee or employer/self employed were positively associated with having suffered from illness. CONCLUSIONS: The findings from this study call for urgent effort for specific measures to prevent and mitigate the effects of occupational injuries. These interventions may include: public health campaigns, enforcement or change in work policies and regulations. Special attention may have to be made towards those who were more likely to suffer from occupational illnesses.

Compensation patterns following occupational injuries in Zambia: results from the 2009 Labour Survey.

BACKGROUND: Occupational injuries have received limited research attention in the Southern African Development Community. Much of the published data come from South Africa and little has been reported elsewhere within the region. The present study was conducted to estimate the prevalence rates of occupational injuries and compensation; and to determine factors associated with occupational injuries and compensation. METHODS: Data were obtained from occupational health and injury questions added to the Zambian Labour Force Survey of 2009 by the Work and Health in Southern Africa programme. Logistic regression analyses were conducted to determine the degree of association between demographic, social and economic factors on one hand and injury and compensation on the other. RESULTS: Data on 61871 study participants were available for analysis, of whom 4998 (8.1%) reported having been injured (10.0% of males, and 6.2% of females) due to work in the previous 12 months to the survey. Of those injured, 60.5% reported having stayed away from work as a result. The commonest type of injury was "open wound" (81.6%). Male gender, being married or married before, being a paid employee, working for a private company and household were positively associated with serious injuries. Injuries also varied by geographical area. Factors positively associated with receiving compensation for work-related injuries were: male gender, Copperbelt and North-Western provinces, and unpaid family worker. Employer/self employed and having less than 5 employees in a workplace were negatively associated with compensation. CONCLUSION: The prevalence of reported injury and its association with a significant level of absence from work, indicate that occupational hazards in Zambia have significant health and economic effects. Female workers should equally be compensated for injuries suffered as their male counterparts.

Prevalence and Predictors of Environmental Tobacco Smoke Exposure among Adolescents in Cambodia.

OBJECTIVE: To estimate the prevalence and predictors of environmental tobacco smoke (ETS) exposure among nonsmoking adolescents in Cambodia. MATERIALS AND METHODS: Analysis of data from the Global Youth Tobacco Survey (GYTS) conducted in 2003 in Cambodia. Data were analysed to obtain the prevalence of ETS exposure at home and elsewhere by age and gender. Logistic regression analysis was conducted to assess the association between ETS and gender, age, smoking status of parents and friends. RESULTS: 67.1% (64.0, 70.0) males and 67.4% (64.2, 70.5) females reported being exposed to ETS either at home or elsewhere. Adolescents who had one or both smoking parents had a more than three times the odds of ETS exposure at home (OR = 3.71; 95% CI (3.02, 4.57)). Those who had smoking friends were more likely to be exposed to ETS both at home and outside home (OR = 1.74; 95% CI (1.36, 2.24)). The overall proportion of adolescents exposed to ETS outside home was higher than those exposed at home (P < 0.001), suggesting that exposure in public areas was the main form of ETS among adolescents in Cambodia. CONCLUSIONS: Exposure to ETS is high among adolescent in Cambodia, which indicates an urgent need for specific measures, policies and regulations to protect nonsmoker Cambodian adolescents both within and outside home.

Cigarette smoking among school-going adolescents in Lithuania: Results from the 2005 Global Youth Tobacco Survey.

BACKGROUND: The majority of people who suffer morbidity due to smoking may have initiated smoking during adolescent period. The aim of this study is to determine the prevalence and associated factors for cigarette smoking among school-going adolescents in Lithuania. FINDINGS: Data from the Global Youth Tobacco Survey (GYTS) 2005 were used to conduct this study. Data were analyzed using SUDAAN software 9.03. Comparisons for categorical variables were done using the Pearson's Chi-square test. The cut of point for statistical significance was set at 5% level. Logistic regression analyses were conducted to determine factors associated with the outcome. Unadjusted odds ratios (OR) and adjusted odds ratios (AOR) together with their 95% confidence intervals (CI) are reported.Of the 1822 respondents, 35.8% males and 27.1% females reported being current cigarette smokers (p < 0.001). Having friends who smoke cigarettes was associated with smoking after controlling for age, gender, parental smoking status, and perception of risks of smoking (AOR = 3.76; 95% CI [2.33, 6.90] for some friends using tobacco; and AOR = 17.18; 95% CI [10.46, 28.21] for most or all friends using tobacco). Male gender and having one or both parents who smoke cigarettes were associated with smoking (AOR = 1.31; 95% CI [1.03, 1.66]) and AOR = 1.76; 95% CI [1.37, 2.27]) respectively). CONCLUSIONS: There is a high prevalence of cigarette smoking among Lithuanian adolescents. Male adolescents and adolescents who have friends or parents who smoke should be the main target for tobacco control in Lithuania.

Determinants of exposure to Environmental Tobacco Smoke (ETS) among non smoking adolescents (aged 11-17 years old) in Greece: results from the 2004-2005 GYTS Study.

The aim of the study is to investigate the determinants of exposure to ETS among Greek adolescents aged 11-17 years old. The GYTS questionnaire was completed by 5,179 adolescents. About 3 in 4 responders (76.8%) were exposed to ETS at home, and 38.5% were exposed to ETS outside of the home. Gender, age group, parental and close friends smoking status were significant determinants of adolescent's exposure to ETS. The results of the study could be valuable for the implementation of public health initiatives in Greece aiming to reduce the burden of adolescent's exposure to passive smoking.

Gender specific factors associated with having stopped smoking among in-school adolescents in Ukraine: results from the Global Youth Tobacco Survey 2005.

BACKGROUND: The prevalence of cigarette smoking in Ukraine is different between genders and is among the highest in the world. There is need to identify gender-specific factors that are associated with having stopped smoking among adolescents. FINDINGS: We used data from the Ukraine Global Youth Tobacco Survey 2005. We carried out a backward stepwise logistic regression analysis with having stopped smoking as the outcome.Altogether, 2800 adolescents reported having ever smoked cigarettes. Overall 64.1% (63.4% male, and 65.5% female) adolescents reported having stopped smoking. Male adolescents who stated that smoking decreases body weight were 25% more likely, while female adolescents were 9% less likely to stop smoking. While male adolescents who received support on how to stop smoking from a family member were 7% less likely, female adolescents were 60% more likely to stop smoking. Furthermore, while male adolescents who received a lecture on the harmful effects of smoking were 10% less likely, female adolescents were 9% more likely to stop smoking. Finally both male and female adolescents who were sure or most probably that they would not smoke a cigarette offered to them by their best friends were more likely, and those adolescents who were sure that smoking is harmful to health were less likely to stop smoking. CONCLUSIONS: Our study has identified some factors that are associated with having quit smoking that are gender-specific. We believe public health programs targeting adolescent smoking should consider these factors in their design and implementation of gender sensitive interventions.

Current use of smokeless tobacco among adolescents in the Republic of Congo.

BACKGROUND: Tobacco use is a leading cause of global morbidity and mortality. Much of the epidemiologic research on tobacco focuses on smoking, especially cigarette smoking, but little attention on smokeless tobacco (SLT). METHODS: Using data from the Republic of Congo Global Youth Tobacco Survey (GYTS) of 2006, we estimated the prevalence of SLT use among in-school adolescents. We also assessed the association between SLT use and cigarette smoking as well as the traditional factors which are associated with cigarette smoking among adolescents (e.g. age, sex, parental or peer smoking). Unadjusted odds ratios (OR) and adjusted odds ratios (AOR) together with their 95% confidence intervals (CI) were used to measure magnitudes of associations. RESULTS: Of the 3,034 respondents, 18.0% (18.0% males and 18.1% females) reported having used smokeless tobacco (chewing tobacco, sniff or dip) in the last 30 days. In multivariate analysis, no significant associations were observed between age and sex on one hand and current smokeless tobacco use on the other. Cigarette smokers were more than six times likely to report current use of smokeless tobacco (AOR = 6.65; 95% CI [4.84, 9.14]). Having parents or friends smokers was positively associated with using smokeless tobacco (AOR = 1.98; 95% CI [1.51, 2.59] for parents who smoked cigarettes, AOR = 1.82; 95% CI [1.41, 2.69] for some friends who smoked cigarettes, and AOR = 2.02; 95% CI [1.49, 2.47] for most or all friends who smoked cigarettes). Respondents who reported have seen tobacco advertisement on TV, billboards and in newspapers/magazines were 1.95 times more likely to report current use of smokeless tobacco (AOR = 1.95; 95% CI [1.34, 3.08]). Perception that smoking was harmful to health was negatively associated with current use of smokeless tobacco (AOR = 0.60; 95% CI [0.46, 0.78]). CONCLUSIONS: Prevention programs aimed to reduce teen [cigarette] smoking must also be designed to reduce other forms of tobacco use. The teenagers environment at home, at school and at leisure must also be factored in order to prevent their uptake or maintenance of tobacco use.

Exposure to environmental tobacco smoke among adolescents in Kampala-Uganda, 2002.

OBJECTIVE: To estimate the prevalence of environmental tobacco smoke (ETS) inside or outside the home among school-going adolescents in Kampala, Uganda. METHODS: Data from the Kampala Global Youth Tobacco Survey (GYTS) of 2002 was used. We estimated frequencies and proportions of self reported exposure to ETS by the study participants. With logistic analysis, we assessed the association between ETS (outcome) in the home or outside the home and the following variables: sex; parental smoking status; and whether best friend was a smoker or not. RESULTS: Of the 2427 non-smoker teenagers who participated in this study, 52.8% were females, 17.9% were exposed to ETS at home while 48.7% were exposed to ETS outside of the home. The majority of the participants (65.8%) were in favour of banning smoking in public places such as in hotels, taxi, in schools, on playgrounds, in discos, markets, and shops. Compared to female participants, males were more likely to be exposed to ETS outside of the home (OR=1.21; 95% CI (1.02, 1.441). Having parents and close friends who smoked cigarettes was positively associated with exposure to ETS at home or outside of the home. Responders whose parents smoked cigarettes were more than four times likely to be exposed to ETS at home than those whose parents were non-smokers (OR=4.88; 95% CI [3.76, 6.33]). CONCLUSION: Cultural factors may expose boys to ETS than girls. We also found that having parents who were smokers exposed adolescents to ETS outside the home and having best friends who smoked exposed adolescents to ETS. This may suggest that adolescents who are exposed to ETS in one way may also be at risk of exposure through other means.

Bullying victimization and physical fighting among Venezuelan adolescents in Barinas: results from the Global School-Based Health Survey 2003.

BACKGROUND: Violence among adolescents has untoward psycho-social and physical health effects among this age group. Most of the literature on this topic has been from high-income nations, and little information has come from middle- and low-income nations. This study was done to assess the relationship between physical fighting and bullying victimization among Venezuelan school-going adolescents in Barinas. METHOD: We used data from the 2003 Global School-Based Health Survey conducted among in-school adolescents in Barinas, Venezuela. We estimated the prevalence of bullying victimization and physical fighting. We also conducted Logistic regression analysis to assess the association between a selected list of explanatory variables and physical fighting. We hypothesized that there would be a dose-response relationship between physical fighting and number of times the adolescent reported being a bullied in the past 30 days. RESULTS: A total of 2,249 adolescent students participated in the survey. However data on sex (gender) were available for only 2,229 respondents, of whom 31.2 (47.4% males and 17.0% females) reported having been involved in a physical fight in the last 12 months. Some 31.5% (37.0% males and 27.0% females) reported having been bullied in the past 30 days. There was a dose-response relationship between bullying victimization and physical fighting (p-trend < 0.001). Compared to subjects who were not bullied, those who reported being bullied were more likely to engage in physical fighting after controlling for age, sex, substance use (smoking, alcohol drinking or drug use), and parental supervision. CONCLUSION: Physical fighting and bullying victimization experience is common among in-school adolescents in Barinas, Venezuela. The fact that victims of bullying were more likely to have engaged in physical fighting may be evidence supporting the notion that "violence begets more violence".

Factors associated with intimate partner violence among pregnant rural women in Rwanda.

INTRODUCTION: Intimate partner violence (IPV) is a major public health problem in Africa and internationally, with consequences that include physical injury, significant morbidity and even death. The Rwandan 2005 Demographic and Health Survey (DHS) reported a national prevalence of IPV among pregnant women of 10.2% but there were limited data available on the factors involved. The aim of this study was to determine the factors associated with and prevalence of IPV among pregnant Rwandese women in the rural southern province of Kabutare. METHODS: A total of 387 pregnant women attending antenatal clinics in the South Province of Rwanda answered a questionnaire which included items on demographics and IPV. Mean age and prevalence of IPV in the previous 12 months as well as lifetime IPV were assessed. Both univariate and multivariate odds of IPV exposure were estimated using logistic regression analysis. RESULTS: The mean age of the 387 participants was 29.4 years (SD 6.3 years). More than one in two participants reported lifetime verbal abuse (53.7%). Other forms of lifetime IPV included pulling hair (9.4%), slapping (18.2%), choking (6.5%), punching with fists (19.3%), throwing to the ground and kicking with feet (12.8%), and burning with a hot liquid (3.1%). In the multivariate analysis, alcohol use by male partner was positively associated with lifetime IPV (OR = 2.52; 95% CI [1.35, 4.71] for occasional drinkers, and OR = 3.85; 95% CI [1.81, 8.21] for heavy drinkers). Compared with subjects with no formal education, women who had elementary education were less likely to report lifetime IPV (OR = 0.30; 95% CI [0.11, 0.78]). CONCLUSION: Alcohol use by male partner and low education of women were positively associated with lifetime IPV. The high rates of IPV among Rwandan pregnant women indicate the need for urgent measures to prevent and curb domestic violence using public health education, an awareness campaign and policy advocacy.

Diarrhoea and acute respiratory infections prevalence and risk factors among under-five children in Iraq in 2000.

BACKGROUND: Diarrhoea and acute respiratory conditions are common medical conditions among under-five children in resource-limited and conflict situations. The present study was conducted to estimate the prevalence and associated factors for acute respiratory conditions and diarrhoea among children under the age of five years in Iraq in 2000. METHODS: Data for the Iraqi Multiple Indicator Cluster Survey were obtained from UNICEF. We estimated the prevalence of acute respiratory conditions and diarrhoea. Assessment of the associations between these two medical conditions on one hand and socio-demographic and environmental variables on the other was done using logistic regression analysis. Weighted analysis was conducted to account for complex survey design. RESULTS: A total of 14,676 children under the age of 5 years were reported by their mothers in the study. Of these 50.4% were males. About half (53.9%) of the children had complete vaccination status. Overall, 21.3% of the children had diarrhoea, and 6.9% had acute respiratory infection (ARI) in the last two weeks. In multivariate analysis, diarrhoea was associated with age of child, area of residence, maternal education, source of water, toilet facility, disposal of children' stool and disposal of dirty water. Compared to children aged 48-59 months, children in the age groups 6-11 months and 12-23 months were 2.22 (95%CI [2.02, 2.44]) and 1.84 (95%CI [1.71, 2.00]) times more likely, respectively, to have diarrhoea. Children whose mothers had no formal education were 11% (AOR = 1.11, 95%CI [1.04, 1.18]) more likely to have diarrhoea compared to children with mothers who had attained secondary level of education. Compared to children who belonged to households with unprotected well or river as the main source of water, children who belonged to households with piped water were 32% (AOR = 1.32, 95%CI [1.17, 1.48]) more likely to have diarrhoea while those who belonged to households with protected well were 26% (AOR = 0.74, 95%CI [0.62, 0.89]) less likely to have diarrhoea. Age of child, toilet facility, wealth, and sex of child were significantly associated with ARI. CONCLUSION: In a study of under-five children in Iraq in 2000, we found that history of diarrhoea and ARI were negatively associated with lower socio-economic status, adequate disposal of children's stool and dirty water, but the results were inconsistent in terms of access to potable water and sanitation facilities possibly due to non-functioning of water and sewage plants after the war. Improvement in water quality and sanitation are vital in the reduction of diarrhoeal diseases.