The burden attributable to primary headache disorders in children and adolescents in Ethiopia: estimates from a national schools-based study.

BACKGROUND: We previously reported high prevalences of headache disorders among children (6-11 years) and adolescents (12-17 years) in Ethiopia. Here we provide data on headache-attributed burden collected contemporaneously from the same study participants. Part of the global schools-based programme within the Global Campaign against Headache, the study is the first to present such data from sub-Saharan Africa. METHODS: A cross-sectional survey following the generic protocol for the global study was conducted in six schools (urban and rural), in Addis Ababa city and three regions of Ethiopia. The child or adolescent versions of the Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation (HARDSHIP) structured questionnaires were self-completed under supervision by pupils in class. Headache diagnostic questions were based on ICHD-3 beta but for the inclusion of undifferentiated headache (UdH). RESULTS: Of 2,349 eligible participants, 2,344 completed the questionnaires (1,011 children [43.1%], 1,333 adolescents [56.9%]; 1,157 males [49.4%], 1,187 females [50.6%]; participating proportion 99.8%). Gender- and age-adjusted 1-year prevalence of headache, reported previously, was 72.8% (migraine: 38.6%; tension-type headache [TTH]: 19.9%; UdH: 12.3%; headache on ≥ 15 days/month (H15+): 1.2%). Mean headache frequency was 2.6 days/4 weeks but, with mean duration of 2.7 h, mean proportion of time with headache was only 1.0% (migraine: 1.4%; TTH: 0.7%; H15+: 9.1%). Mean intensity was 1.8 on a scale of 1-3. Symptomatic medication was consumed on about one third of headache days across headache types. Lost school time reportedly averaged 0.7 days over the preceding 4 weeks, representing 3.5% of school time, but was 2.4 days/4 weeks (12.0%) in the important small minority with H15+. However, actual absences with headache the day before indicated averages overall of 9.7% of school time lost, and 13.3% among those with migraine. Emotional impact and quality-of-life scores reflected other measures of burden, with clear adverse impact gradients (H15 + > migraine > TTH > UdH). CONCLUSIONS: The high prevalence of headache among children and adolescents in Ethiopia, who represent half its population, is associated with substantial burden. Lost school time is probably the most important consequence. Estimates suggest a quite deleterious effect, likely to be reflected in both individual prospects and the prosperity of society.

Prevalence of musculoskeletal system problems in children working in Turkey's automotive industry.

OBJECTIVE: This epidemiology study was conducted to determine the musculoskeletal system problems of children working in the automotive industry and related factors affecting them in the province of Sanliurfa, the Turkish province where the child population is the highest at 44.9%. DESIGN AND METHODS: A cross-sectional descriptive type study of 256 children aged 7-17 years working in Sanliurfa Evren Auto Industry Site and Birecik Firat Auto Industry Site was carried out between April and September 2021. RESULTS: The majority (55.9%) of the children spent most of their time afoot while working and had musculoskeletal symptoms, with a duration of more than one year. The body areas with the most symptoms were the waist, feet, and hands, respectively. These symptoms had not occurred before a child started working and were affected by the posture they worked in, and their daily working and sleep hours. CONCLUSION: Public health nurses are in a position to ensure that tetanus vaccination of working children, employment examinations, routine health checks, and necessary personal protective equipment are available. They can also work to ensure that children work for legal periods, get paid their wages, have health insurance, receive apprenticeship training, and only start working when they reach the age of being an apprentice or apprentice candidate.

[Assessment of COVID-19 Risky Contact of Healthcare Workers in an University Hospital]. / Bir Üniversite Hastanesindeki Saglik Çalisanlarinin COVID-19 Riskli Temas Durumlarinin Degerlendirilmesi.

Healthcare workers are the group with the highest risk of COVID-19 transmission. The illness of healthcare workers poses a risk to patients admitted to the hospital, colleagues and households besides their own health. In this study, it was aimed to determine the risk assessment and the factors associated with risk status of an university hospital healthcare workers after risky COVID-19 contact. The data of the descriptive study were obtained from 773 follow-up records of 555 healthcare workers who applied with COVID-19 risky contact between 06.04-10.05.2020. Employees who were positive for RT-PCR evaluated as "patients" and others as "risky contact". Risk assessment was classified as no risk, low, medium and high risk contact according to the "Algorithm of Assessment of Health Workers with COVID-19 Contact" of the Ministry of Health. The relationship between the risk levels of the participants and their demographic and workplace characteristics and their usage of personal protection were evaluated. Mean, standard deviation, percentage, chi-square and ANOVA tests were used in the analysis of the data. The average age of the healthcare workers was determined as 34.4 ± 7.6 years. It was determined that 56.2% of those who had contact were female, 62.9% were married and 17.5% had an additional disease. It was determined that 45.6% of the risky contacts were nurses, 18.4% were supportive personnel and 16.9% were doctors. While 46.5% of the contacts were found as medium, 28.0% low, 17.1% high risk and 8.4% risk free. 38.2% of risky contacts occurred while working in internal/surgical clinics. While 66.0% of the employees had risky contact during patient care and treatment, 25% had risky contact with colleagues in social settings. High-risk contact was higher in social relations between employees. The source of the contact was a colleague in 73.2% of the employees. The average age of high-risk employees was smaller than those of low-risk. While 54.5% of the employees wore surgical masks during contact, 67.8% of the patients did not have a mask. Of 555 employees followed, 37 (6.7%) were diagnosed as COVID-19; 48.6% of the patients were nurses and 18.9% were doctors. It was determined that 48.6% of the healthcare workers were working in the COVID-19 service, outpatient clinic or intensive care unit at the time of diagnosis. The source of the infection was thought to be a colleague in 51.6% of the patients. COVID-19 was more common in nurses and doctors. It was determined that risky contact also occurred in services other than the units where COVID-19 patients were treated and risky contact often took place while providing healthcare to the patients and during social relations between the employees. Unprotected contact of the employees with each other in the workplace was identified as an important risk source. Inadequate use of personal protective equipment by healthcare workers led to an increase in medium and high risk contacts. The use of masks by patients and their relatives during the health service delivery and the proper use of personal protective equipment by healthcare professionals will reduce the risk. With the physical improvement of the rest areas of the employees and the arrangement of the breaks, the risky contact between colleagues in the social areas will be reduced.

The prevalence of headache disorders in children and adolescents in Ethiopia: a schools-based study.

BACKGROUND: The Global Burden of Disease (GBD) study establishes headache as the second-highest cause of disability worldwide. Because most headache data in GBD are from adults, leading to underestimation of headache-attributed burden, a global schools-based programme within the Global Campaign against Headache is contributing data from children (7-11 years) and adolescents (12-17 years). This national study in Ethiopia is the first in this programme reported from sub-Saharan Africa. METHODS: A cross-sectional survey following the generic protocol for the global study was conducted in six schools (urban and rural), in Addis Ababa city and three regions of Ethiopia. Structured questionnaires were self-completed under supervision by pupils within their classes. Headache diagnostic questions were based on ICHD-3 beta criteria but for the inclusion of undifferentiated headache (UdH). RESULTS: Of 2349 potential participants, 2344 completed the questionnaire (1011 children [43.1%], 1333 adolescents [56.9%]; 1157 males [49.4%], 1187 females [50.6%]), a participation proportion of 99.8%. Gender- and age-adjusted 1-year prevalence of headache was 72.8% (migraine: 38.6%; tension-type headache: 19.9%; UdH: 12.3%; all headache on ≥15 days/month: 1.2%; probable medication-overuse headache: 0.2%). Headache was more prevalent in females (76.2%) than males (71.0%), a finding reflected only in migraine among the headache types. Headache was more prevalent among adolescents (77.6%) than children (68.4%), reflected in all types except migraine, although prevalence of UdH fell sharply after age 14 years to 3.9%. For headache overall, findings matched those in Turkey and Austria, obtained with the same questionnaire, but the high prevalence of migraine, not increasing with age, was surprising. The study highlighted diagnostic difficulties in young people, especially when poorly educated, with migraine diagnoses driven by improbably high proportions reporting nausea (44.8%) and vomiting (28.0%) as usual symptoms accompanying their headaches. CONCLUSIONS: Headache is very common in children and adolescents in Ethiopia. This has major public-health implications, since half the country's population are aged under 18 years.