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2.
Violence Vict ; 34(2): 229-242, 2019 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-31019010

RESUMEN

Children's exposure to poly-victimization, which is the experience of multiple types of victimization, has been found to be associated with negative health outcomes and risk behaviors. We examined the collective effects of childhood sexual, physical, and emotional violence on selected self-reported health outcomes among young Kenyan females and males using the Violence Against Children Survey (VACS). Overall, 76.2% of females and 79.8% of males were victims of sexual, physical, or emotional violence prior to age 18, and one-third (32.9% and 34.5%, respectively) experienced two or more types of violence. Poly-victimization was significantly associated with current feelings of anxiety, depression, and suicidal thoughts in females and males, as well as self-reported fair or poor health in males (p < .05) as compared to those who experienced no violence. The study data demonstrate an urgent need to reduce all types of violence against children, as well develop appropriate strategies for its prevention.


Asunto(s)
Experiencias Adversas de la Infancia , Víctimas de Crimen/psicología , Salud Mental , Traumatismo Múltiple/psicología , Violencia/psicología , Adolescente , Adultos Sobrevivientes del Maltrato a los Niños/psicología , Niño , Humanos , Encuestas y Cuestionarios , Adulto Joven
3.
Child Abuse Negl ; 85: 9-16, 2018 11.
Artículo en Inglés | MEDLINE | ID: mdl-30201521

RESUMEN

This study seeks to assess the impact of economic factors on sexual, emotional, and physical violence on Nigerian children and adolescents aged 13-24 years. Data collected from the Nigerian Violence Against Children Survey (VACS), a national, cross-sectional household survey of females and males aged 13-24 years were used to examine sexual, emotional, and physical violence victimization. Data were collected on household economic status, e.g., flooring and roofing materials, transportation. A poverty index was developed using the Simple Poverty Scorecard™ for Nigeria to determine the impact that economic factors have on these violence measures. Children aged 13-17 years in households with high economic status (ES) were 1.81, 1.78, and 4.91 times, more likely to experience sexual, emotional, and physical violence, respectively, within the last 12 months than those in the lowest ES. Individuals aged 18-24 years in households with high ES were 1.62 and 1.41 times more likely to experience emotional and physical violence, respectively, prior to age 18 than those in the lowest ES. Individuals aged 18-24 years in households with middle or high ES were 1.65 and 1.96, respectively, times more likely to experience physical violence prior to age 18 than those in the lowest ES. Highest tertile ES was significantly associated with sexual, emotional, and physical violence among Nigerians aged 13-24 years. Further research is needed to determine the cause of increased violence amongst high ES households. Targeted interventions towards this ES class are recommended to reduce violence against children in Nigeria.


Asunto(s)
Maltrato a los Niños , Pobreza , Clase Social , Violencia , Adolescente , Adulto , Maltrato a los Niños/psicología , Víctimas de Crimen/estadística & datos numéricos , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Nigeria , Abuso Físico , Factores Socioeconómicos , Encuestas y Cuestionarios , Violencia/estadística & datos numéricos , Adulto Joven
4.
Child Abuse Negl ; 84: 45-52, 2018 10.
Artículo en Inglés | MEDLINE | ID: mdl-30041058

RESUMEN

The aim of the current analysis is to elucidate the link between childhood experiences of violence and physical intimate partner violence in young adulthood in a national survey of young Kenyan women. In 2010, we conducted the Violence against Children Survey in Kenya, collecting retrospective reports from 13 to 24 year old males and females (N = 2928). The analysis presented here focused on females aged 18-24 who ever had an intimate partner (n = 566). Young Kenyan women had statistically higher odds of experiencing physical intimate partner violence (IPV) in young adulthood if they had experienced any childhood violence (including sexual, emotional, or physical) [adjusted odds ratio (AOR) = 3.1 CI: 1.2-7.9, p = 0.02)], any childhood sexual violence (AOR = 2.5, CI 1.3-4.9, p = 0.006), or unwanted completed sex (including pressured or forced sex prior to age 18) (AOR = 4.3, CI: 2.3-8.3, p < 0.0001). Exposure to two (AOR = 3.9, CI: 1.2-12.2, p = 0.02) or three (AOR = 5.0, CI: 1.4-18.1, p = 0.01) types of violence in childhood was also associated with a significantly higher odds of experiencing adult physical IPV. Childhood violence is associated with increased odds of adult physical IPV among young women; efforts to prevent violence against children and provide appropriate care and support to adult survivors are critical to interrupt this cycle of violence.


Asunto(s)
Experiencias Adversas de la Infancia/estadística & datos numéricos , Violencia de Pareja/estadística & datos numéricos , Delitos Sexuales/estadística & datos numéricos , Adolescente , Adulto , Niño , Exposición a la Violencia/estadística & datos numéricos , Femenino , Humanos , Relaciones Interpersonales , Violencia de Pareja/psicología , Kenia/epidemiología , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Examen Físico , Prevalencia , Estudios Retrospectivos , Conducta Sexual/estadística & datos numéricos , Parejas Sexuales/psicología , Encuestas y Cuestionarios , Adulto Joven
5.
J Interpers Violence ; 33(11): 1710-1730, 2018 06.
Artículo en Inglés | MEDLINE | ID: mdl-29739289

RESUMEN

Adverse childhood experiences (ACEs) exhibit a dose-response association with poor health outcomes in adulthood, including HIV. In this analysis, we explored the relationship between ACEs and HIV sexual risk-taking behaviors among young adults in Malawi. We analyzed responses from sexually active 19- to 24-year-old males and females ( n = 610) participating in the Malawi Violence Against Children Survey. We tested the association between respondents' exposure to six ACEs (having experienced emotional, physical, or sexual violence; witnessing intimate partner violence or an attack in the community; one or both parents died) and infrequent condom use in the past year and multiple sexual partners in the past year. We used logistic regression to test the association between ACEs and these sexual risk-taking behaviors. A majority (82%) of respondents reported at least 1 ACE, and 29% reported 3+ ACEs. We found positive unadjusted associations between the number of ACEs (1-2 and 3+ vs. none) and both outcomes. In adjusted models, we found positive associations between the number of ACEs and infrequent condom use (adjusted odds ratio [aOR]: 2.7, 95% confidence interval [CI]: [1.0, 7.8]; aOR: 3.7, CI: [1.3, 11.1]). Among young adults in Malawi, exposure to ACEs is positively associated, in a dose-response fashion, with engaging in some sexual risk-taking behaviors. HIV prevention efforts in Malawi may benefit from prioritizing programs and policies aimed at preventing and responding to violence against children.


Asunto(s)
Experiencias Adversas de la Infancia/estadística & datos numéricos , Infecciones por VIH/epidemiología , Violencia de Pareja/estadística & datos numéricos , Asunción de Riesgos , Estudios Transversales , Femenino , Humanos , Malaui , Masculino , Oportunidad Relativa , Índice de Severidad de la Enfermedad , Delitos Sexuales/estadística & datos numéricos , Conducta Sexual/estadística & datos numéricos , Enfermedades de Transmisión Sexual/epidemiología , Violencia/estadística & datos numéricos , Adulto Joven
6.
Inj Prev ; 22 Suppl 1: i17-22, 2016 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-27044493

RESUMEN

OBJECTIVE: To describe the Violence Against Children Surveys (VACS). The survey is a national, household survey that systematically measures the prevalence, nature and consequences of sexual, physical and emotional violence against children. DESIGN: This report provides information about the history, implementation, ethical protections, utility, results, limitations, and future directions of the VACS work. RESULTS: The study has been implemented in 11 countries in Africa, Asia and the Caribbean, providing each of these countries with baseline data and momentum to address violence against children as a public health and human rights priority. These data are novel in each country, and VACS is well poised to contribute to an existing surveillance system or be used as the basis of a periodic surveillance system. CONCLUSIONS: Without ongoing surveillance to assess prevalence and the impact of policy, prevention and response programming, violence will likely continue to be overlooked as the linchpin public health crisis that it is, globally and in individual countries.


Asunto(s)
Maltrato a los Niños/prevención & control , Vigilancia de la Población/métodos , Violencia/prevención & control , Adolescente , África/epidemiología , Asia/epidemiología , Región del Caribe/epidemiología , Niño , Maltrato a los Niños/estadística & datos numéricos , Preescolar , Estudios Transversales , Femenino , Salud Global , Humanos , Masculino , Prevalencia , Salud Pública/métodos , Violencia/estadística & datos numéricos , Adulto Joven
7.
Violence Against Women ; 22(14): 1788-1807, 2016 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-26979505

RESUMEN

During a household survey in Tanzania, a nationally representative sample of females and males aged 13-24 years reported any experiences of sexual violence that occurred before the age of 18 years. The authors explore the prevalence, circumstances, and health outcomes associated with childhood sexual violence. The results suggest that violence against children in Tanzania is pervasive, with roughly three in 10 females and one in eight males experiencing some form of childhood sexual violence, and its health consequences are severe. Results are being used by the Tanzanian government to implement a National Plan of Action.

8.
AIDS Educ Prev ; 27(5): 474-87, 2015 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-26485236

RESUMEN

Prior research has established an association between sexual violence and HIV. Exposure to sexual violence during childhood can profoundly impact brain architecture and stress regulatory response. As a result, individuals who have experienced such trauma may engage in sexual risk-taking behavior and could benefit from targeted interventions. In 2009, nationally representative data were collected on violence against children in Tanzania from 13-24 year old respondents (n=3,739). Analyses show that females aged 19-24 (n=579) who experienced childhood sexual violence, were more likely to report no/infrequent condom use in the past 12 months (AOR=3.0, CI [1.5, 6.1], p=0.0017) and multiple sex partners in the past 12 months (AOR=2.3, CI [1.0, 5.1], p=0.0491), but no more likely to know where to get HIV testing or to have ever been tested. Victims of childhood sexual violence could benefit from targeted interventions to mitigate impacts of violence and prevent HIV.


Asunto(s)
Abuso Sexual Infantil/psicología , Condones/estadística & datos numéricos , Infecciones por VIH/diagnóstico , Infecciones por VIH/prevención & control , Asunción de Riesgos , Conducta Sexual/psicología , Adolescente , Niño , Abuso Sexual Infantil/estadística & datos numéricos , Femenino , Infecciones por VIH/epidemiología , Encuestas Epidemiológicas , Humanos , Masculino , Tamizaje Masivo , Prevalencia , Sexo Seguro , Conducta Sexual/estadística & datos numéricos , Parejas Sexuales , Encuestas y Cuestionarios , Tanzanía/epidemiología , Adulto Joven
9.
MMWR Morb Mortal Wkly Rep ; 64(21): 565-9, 2015 Jun 05.
Artículo en Inglés | MEDLINE | ID: mdl-26042646

RESUMEN

Sexual violence against children erodes the strong foundation that children require for leading healthy and productive lives. Globally, studies show that exposure to violence during childhood can increase vulnerability to a broad range of mental and physical health problems, ranging from depression and unwanted pregnancy to cardiovascular disease, diabetes, and sexually transmitted diseases, including human immunodeficiency virus (HIV). Despite this, in many countries, the extent of sexual violence against children is unknown; estimates are needed to stimulate prevention and response efforts and to monitor progress. Consequently, CDC, as a member of the global public-private partnership known as Together for Girls, collaborated with Cambodia, Haiti, Kenya, Malawi, Swaziland, Tanzania, and Zimbabwe to conduct national household surveys of children and youth aged 13-24 years to measure the extent of violence against children. The lifetime prevalence of experiencing any form of sexual violence in childhood ranged from 4.4% among females in Cambodia to 37.6% among females in Swaziland, with prevalence in most countries greater than 25.0%. In most countries surveyed, the proportion of victims that received services, including health and child protective services, was ≤10.0%. Both prevention and response strategies for sexual violence are needed.


Asunto(s)
Abuso Sexual Infantil/estadística & datos numéricos , Servicio Social/estadística & datos numéricos , Adolescente , Cambodia/epidemiología , Niño , Esuatini/epidemiología , Femenino , Haití/epidemiología , Humanos , Kenia/epidemiología , Malaui/epidemiología , Masculino , Prevalencia , Tanzanía/epidemiología , Adulto Joven , Zimbabwe/epidemiología
10.
Child Abuse Negl ; 44: 46-55, 2015 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-25882669

RESUMEN

Child sexual abuse (CSA) interventions draw from a better understanding of the context of CSA. A survey on violence before age 18 was conducted among respondents aged 13-17 and 18-24 years. Among females (13-17), the key perpetrators of unwanted sexual touching (UST) were friends/classmates (27.0%) and among males, intimate partners (IP) (35.9%). The first incident of UST among females occurred while traveling on foot (33.0%) and among males, in the respondent's home (29.1%). Among females (13-17), the key perpetrators of unwanted attempted sex (UAS) were relatives (28.9%) and among males, friends/classmates (31.0%). Among females, UAS occurred mainly while traveling on foot (42.2%) and among males, in school (40.8%). Among females and males (18-24 years), the main perpetrators of UST were IP (32.1% and 43.9%) and the first incident occurred mainly in school (24.9% and 26.0%), respectively. The main perpetrators of UAS among females and males (18-24 years) were IP (33.3% and 40.6%, respectively). Among females, UAS occurred while traveling on foot (32.7%), and among males, in the respondent's home (38.8%); UAS occurred mostly in the evening (females 60.7%; males 41.4%) or afternoon (females 27.8%; males 37.9%). Among females (18-24 years), the main perpetrators of pressured/forced sex were IP and the first incidents occurred in the perpetrator's home. Prevention interventions need to consider perpetrators and context of CSA to increase their effectiveness. In Kenya, effective CSA prevention interventions that target intimate relationships among young people, the home and school settings are needed.


Asunto(s)
Abuso Sexual Infantil/estadística & datos numéricos , Adolescente , Niño , Coerción , Estudios Transversales , Exposición a la Violencia/estadística & datos numéricos , Familia , Femenino , Amigos , Humanos , Relaciones Interpersonales , Kenia/epidemiología , Masculino , Violación/estadística & datos numéricos , Conducta Sexual/estadística & datos numéricos , Parejas Sexuales , Tacto , Adulto Joven
11.
Muscle Nerve ; 39(4): 423-31, 2009 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-19229875

RESUMEN

Juvenile myasthenia gravis shares a similar pathophysiologic origin with adult myasthenia gravis, but there are important differences, mostly relating to epidemiology, presentation, and therapeutic decision making. Gender ratios and the proportion of seropositive patients differ in the pre- and postpubertal age groups. The diagnostic evaluation is similar to that in adults, although special techniques are sometimes necessary to perform single-fiber electromyography in younger patients. Therapeutic decisions in affected children and adolescents are complicated by the greater long-term consequences of using steroids, and thus other interventions, such as intravenous immunoglobulin (IVIg) and plasmapheresis, may play a greater therapeutic role in this population than in adults. Steroid-sparing agents may contribute to the management of refractory cases, but they should be used with caution due to the risk of malignancy.


Asunto(s)
Inmunoglobulinas Intravenosas/uso terapéutico , Factores Inmunológicos/uso terapéutico , Miastenia Gravis , Timectomía , Niño , Femenino , Humanos , Masculino , Miastenia Gravis/tratamiento farmacológico , Miastenia Gravis/epidemiología , Miastenia Gravis/cirugía , Factores de Riesgo , Distribución por Sexo
12.
Support Care Cancer ; 12(7): 526-30, 2004 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-15150704

RESUMEN

GOALS: Oral mucositis (OM), the painful inflammation of oropharyngeal tissues, is an economically costly chemotherapy toxicity. Several agents to prevent chemotherapy-induced OM are in development, with most studies conducted among transplantation subjects with a brief well-defined risk period. The potential value of these preventative agents among hematology-oncology populations receiving cyclic standard-dose therapy is unknown. PATIENTS AND METHODS: Patients receiving standard-dose chemotherapy at an outpatient oncology center over a 2-week time-frame were invited to participate in an anonymous unprompted survey. The survey instrument consisted of six demographic questions and six questions regarding toxicities of chemotherapy. RESULTS: Of 514 patients providing completed surveys from among approximately 1625 patients (32% response rate), 167 (32%) reported experiencing OM. Factors associated with developing OM included number of chemotherapy cycles ( P=0.001), hematologic malignancy ( P=0.02), female gender ( P=0.03), age ( P=0.05), and treatment with anthracyclines ( P=0.001), vinca alkaloids ( P=0.001), cyclophosphamide ( P=0.001), fludarabine ( P=0.01), cis/carboplatin ( P=0.05) and radiotherapy ( P=0.005). Among patients experiencing OM, 69% considered OM to be an important toxicity with 7% rating their OM very severe, 18% severe, 36% moderate and 29% mild. Recurrent OM was reported by 87 patients (53%) and was judged similar in severity by 67%, milder by 27% and more severe by 6%. OM was considered the sixth most distressing complication behind (in descending order) fatigue, hair loss, nausea, numbness and diarrhea, and more important than anxiety and heartburn. CONCLUSIONS: OM represents a common toxicity of standard-dose chemotherapy occurring in approximately one-third of patients. High-risk populations can be identified, permitting targeting of primary prophylaxis strategies whereby all patients possessing high-risk factors are treated to prevent OM. However, since OM was self-reported by only one-third of patients receiving standard-dose chemotherapy, but over half of those experiencing OM developed recurrent episodes, secondary prophylaxis strategies targeting recurrent OM episodes may be more appropriate.


Asunto(s)
Antineoplásicos/efectos adversos , Mucosa Bucal/efectos de los fármacos , Estomatitis/inducido químicamente , Estomatitis/psicología , Estrés Psicológico/etiología , Adulto , Anciano , Anciano de 80 o más Años , Relación Dosis-Respuesta a Droga , Femenino , Humanos , Masculino , Persona de Mediana Edad , Mucosa Bucal/patología , Neoplasias/complicaciones , Neoplasias/tratamiento farmacológico , Estudios Retrospectivos , Factores de Riesgo , Índice de Severidad de la Enfermedad , Encuestas y Cuestionarios , Factores de Tiempo
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