Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 200
Filtrar
1.
S Afr Med J ; 109(9): 679-685, 2019 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-31635594

RESUMO

BACKGROUND: Limited research investigating treatment outcomes for HIV-positive orphans compared with non-orphans has shown mixed results, with several studies indicating that HIV-positive orphans are at greater risk of delayed access to HIV care and poor antiretroviral therapy (ART) adherence, while other data suggest that ART outcomes of orphans can be similar to those of non-orphans. Understanding the impact of orphan status on short-term ART outcomes could improve targeted intervention strategies, and subsequent long-term treatment and developmental outcomes, for HIV-positive infants, children and adolescents. OBJECTIVES: To evaluate the relationship between orphan status and ART outcomes among HIV-positive infants, children and adolescents initiating ART at two large public sector HIV clinics in Johannesburg, South Africa. METHODS: This was a retrospective cohort study of HIV-positive children aged <18 years initiating standard first-line ART between June 2004 and May 2013. Using propensity scores, orphans and non-orphans were matched for age, sex, World Health Organization stage and ART regimen. The effect of orphanhood on attrition from care (all-cause mortality and loss to follow-up) was evaluated using Cox proportional hazards regression analysis, and its effect on having a detectable viral load (≥400 copies/mL) at 12 months on ART using binomial regression analysis with modified Poisson distribution. RESULTS: A total of 251 (29.4%) orphans (maternal, paternal or both) and 603 (70.6%) non-orphans were included at ART initiation. Following multiple imputation for missing data and propensity score matching, 222 orphans and 222 non-orphans were included. Orphans had a median age of 8.0 years (interquartile range (IQR) 4.9 - 10.7) and non-orphans 7.4 years (IQR 4.2 - 10.2). A total of 12 (5.4%) orphans and 33 (14.9%) non-orphans experienced attrition from care during the first 12 months on ART (adjusted hazard ratio 0.32, 95% confidence interval (CI) 0.17 - 0.63). Among those alive and in care, with a viral load at 12 months on ART, 18.0% of orphans (33/183) and 14.8% of non-orphans (24/162) had a detectable viral load (adjusted risk ratio 1.15, 95% CI 1.04 - 1.28). CONCLUSIONS: Orphans were less likely than non-orphans to experience attrition, but among those in care at 12 months, orphans were more likely to have detectable viral loads. Lower attrition among orphans may be due to their being in institutional or foster care, ensuring that they make their visits; however, their higher rates of non-suppression may result from lack of psychosocial support or stigma resulting in struggles to adhere. Additional research investigating age-specific outcomes will be important to elucidate these effects further.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Crianças Órfãs/estatística & dados numéricos , Infecções por HIV/tratamento farmacológico , Carga Viral/efeitos dos fármacos , Adolescente , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Lactente , Masculino , Estudos Retrospectivos , África do Sul , Resultado do Tratamento
2.
BMC Public Health ; 19(1): 306, 2019 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-30866875

RESUMO

BACKGROUND: Focus on interventions for orphans and vulnerable children (OVC) in South Africa on education, quality of life (QoL) and nutrition-related matters have been reported diminutive. The risk of dropping out of school for an OVC with poor QoL and without varied food intake is very high. The problem with poor; QoL, nutritional care and academic performance (AP) of the OVC is that it sets the foundation for their adults' life. The purpose of this longitudinal study is to develop, implement and to test the efficacy of an evidence-based nutrition education programme (NEP) for OVC that will integrate their families/caregivers, schools and communities. METHODS: A longitudinal study, and a mixed-methods approach steered by action research will be used. This study will be in three phases. Phase 1 will be the needs assessment; Phase 2 will be the development of nutritional education materials, and Phase 3 is the intervention. QoL, dietary intakes, body composition, and anthropometric status, physical activities, and AP of 520 OVC in Soweto will be assessed using standard techniques. Nutrition knowledge, attitude and practices (KAP) of the caregivers will be assessed using previously validated questionnaires. Focus group discussion (FGD) will be conducted to gain an in-depth understanding of what OVC eat and factors affecting their food intakes. Data will be collected at baseline, week 12 and week 24. Generalised Least Squares (GLS) regression model will be used to test the study hypotheses. Atlas-ti and Thematic Framework Analysis (TFA) will be used for qualitative data analysis. DISCUSSION: This study will provide detailed information on the QoL, food intakes concerning academic performance and general well-being of OVC in an Africa setting. The participatory mixed methods nature of the study will provide valuable insights into the drivers and challenges to QoL, AP, and nutritional status of this group. This approach will assist the policymakers' and other stakeholders in decision making regarding the general well-being of the OVC. TRIAL REGISTRATION: ISRCTN12835783 . Date registered 14.01.2019.


Assuntos
Ciências da Nutrição Infantil/educação , Crianças Órfãs , Educação em Saúde/métodos , Educação em Saúde/organização & administração , Populações Vulneráveis , Adolescente , Criança , Crianças Órfãs/estatística & dados numéricos , Prática Clínica Baseada em Evidências , Grupos Focais , Humanos , Estudos Longitudinais , Desenvolvimento de Programas , Projetos de Pesquisa , África do Sul , Inquéritos e Questionários , Populações Vulneráveis/estatística & dados numéricos
3.
PLoS One ; 14(1): e0210489, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30640928

RESUMO

Multiple studies have revealed that adolescent AIDS orphans have more psychosocial problems than healthy adolescents. However, little is known about whether and how the brain structures of adolescent AIDS orphans differ from those of healthy adolescents. Here, we used magnetic resonance imaging to compare adolescent AIDS orphans reared in institutions (N = 20) with a sex- and age-matched group of healthy adolescents reared in families (N = 20) in China using a voxel-based morphometry analysis. First, we found that both total gray- and white-matter volumes did not differ between groups. Second, after correcting for age, sex, and total gray-matter volume, the AIDS orphan group demonstrated smaller hippocampal volumes, larger anterior cingulate cortex (ACC) volumes, and no differences in the amygdala. Third, a whole-brain analysis identified higher gray-matter volume of the ACC in the AIDS orphan group than in the control group. The preliminary findings of this study highlight the need for future research to confirm the sensitivity of the hippocampus and ACC to early adversity.


Assuntos
Síndrome de Imunodeficiência Adquirida/patologia , Encéfalo/patologia , Crianças Órfãs/estatística & dados numéricos , Substância Cinzenta/patologia , Giro do Cíngulo/patologia , Substância Branca/patologia , Síndrome de Imunodeficiência Adquirida/epidemiologia , Síndrome de Imunodeficiência Adquirida/etnologia , Adolescente , Tonsila do Cerebelo/diagnóstico por imagem , Tonsila do Cerebelo/patologia , Grupo com Ancestrais do Continente Asiático , Encéfalo/diagnóstico por imagem , China/epidemiologia , Feminino , Substância Cinzenta/diagnóstico por imagem , Giro do Cíngulo/diagnóstico por imagem , Hipocampo/diagnóstico por imagem , Hipocampo/patologia , Humanos , Masculino , Tamanho do Órgão , Orfanatos , Prevalência , Substância Branca/diagnóstico por imagem
4.
Sci Total Environ ; 658: 1161-1174, 2019 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-30677980

RESUMO

BACKGROUND: Adequate hygiene behaviors and environmental health conditions are fundamental to children's health, development, and well-being. They are especially important in institutional care settings for orphaned and abandoned children, a particularly vulnerable population whose basic needs are often not met. OBJECTIVES: We systematically reviewed the evidence about hygiene behaviors and environmental health conditions in institutional care settings for children and associated health outcomes; interventions to improve these behaviors, conditions, and outcomes; and obstacles to improvement. METHODS: PubMed, Web of Science, Scopus, and EBSCOhost were searched for studies in the peer-reviewed and grey literature. Studies were included if they reported primary data on one or more environmental health condition or hygiene behavior in an institutional care setting for orphaned and abandoned children. RESULTS: Forty-five publications reporting on over 500 institutions in 29 countries were included. The most documented concern was poor personal hygiene behaviors followed by inadequate water and sanitation infrastructure and overcrowding. Protozoan, helminthic, viral infections, and diarrheal illness among institutionalized children were the most commonly documented associated health outcomes. DISCUSSION: More studies documented the status of hygiene and environmental health in children's institutions than interventions to improve behaviors and conditions. Insufficient finances and expertise or involvement of caregivers are reported barriers to implementing improvements in children's institutions. The development of guidelines for essential environmental health standards in orphanages, monitoring of facility conditions, accountability for facility deficiencies, and implementation research to identify improvement opportunities would contribute to and promote the health and development of orphaned and abandoned children worldwide.


Assuntos
Criança Abandonada/estatística & dados numéricos , Crianças Órfãs/estatística & dados numéricos , Saúde Ambiental/normas , Higiene/normas , Orfanatos/estatística & dados numéricos , Adolescente , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Populações Vulneráveis
5.
SAHARA J ; 15(1): 7-19, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-29409392

RESUMO

The burden of human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS) on the elderly population in three divisions within the Northwest Region of Cameroon was examined. Data for this paper were extracted from a larger study which had been conducted concerning the burden of HIV infection and AIDS on the older adults in the Northwest Region of Cameroon. Using in-depth interviews (IDIs) and focus group discussions (FGDs), data were collected from 36 participants who were purposively selected from the three divisions which had been chosen randomly. 6 FGD sessions were held with 30 women aged 60 years and above and who were affected by HIV infection and AIDS, while IDIs sessions were held with 6 male community leaders. The results revealed that HIV infection and AIDS has added another dimension to the role of older persons. HIV infection and AIDS affects older people in diverse ways, as they have to look after themselves, their sick children and are often also left to look after their grandchildren orphaned by HIV infection and AIDS. These emerging issues in their lives make them vulnerable to health, social, economic and psychological challenges, and place a burden on them as caregivers instead of being cared for in their old age. Apart from increased direct expenditures, taking care of victims of HIV infection and AIDS requires older people to stay away from social, religious and community activities. The results showed that the loss of a child to HIV infection and AIDS affects the economic/financial well-being, participation in social/religious interactions as well as the community activities of older people participants. The implications of these findings for caregiving and social policy are discussed.


Assuntos
Síndrome de Imunodeficiência Adquirida/epidemiologia , Cuidadores/psicologia , Crianças Órfãs/estatística & dados numéricos , Infecções por HIV/epidemiologia , Síndrome de Imunodeficiência Adquirida/psicologia , Adaptação Psicológica , Luto , Camarões/epidemiologia , Criança , Família , Feminino , Grupos Focais , Infecções por HIV/psicologia , Humanos , Relação entre Gerações , Relações Interpessoais , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Formulação de Políticas , Pesquisa Qualitativa , Apoio Social
6.
J Biosoc Sci ; 50(3): 380-396, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29017619

RESUMO

This study examined the relationship between orphanhood status, living arrangements and sexual debut. The study is important in the context of southern Africa, where a substantial number of children live apart from their parents because the parent is dead or living elsewhere, and where female adolescents face disproportionate sexual and reproductive health risks. Data for female adolescents were taken from Demographic and Health Surveys conducted in seven southern African countries. Unadjusted and adjusted hazard ratios of sexual debut were estimated using Cox Proportional Hazard models. The results from multivariate analyses showed that non-co-residence with biological parents was significantly associated with higher risk of sexual debut in five of the seven countries. Using pooled data, the results showed that father absence was associated with higher risk of sexual debut - whether the father was deceased or living elsewhere. Interventions to delay sexual debut among female adolescents should seek to promote father-adolescent co-residence and improve access to education.


Assuntos
Crianças Órfãs/estatística & dados numéricos , Coito , Características de Residência/estatística & dados numéricos , Adolescente , África Austral , Características da Família , Feminino , Humanos , Análise Multivariada , Privação Paterna , Modelos de Riscos Proporcionais , Fatores de Risco
7.
AIDS Care ; 30(2): 160-167, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29019254

RESUMO

Social desirability bias and underreporting of HIV risk behaviors are significant challenges to the accurate evaluation of HIV prevention programs for orphans and vulnerable children (OVC) in sub-Saharan Africa. Valid and reliable HIV risk behavior instruments are critical to address these challenges. We assessed the psychometric properties of two risk behavior measures, the World Aids Foundation Survey (WAF) and the Peer HIV Risk Behavior Screener (PHRBS), administered to 210 OVC in Zambia using Audio Computer Assisted Self-Interviewing. All WAF subscales exhibited good internal reliability (α > .80); only the Sexual Behavior Practices subscale strongly distinguished (P < .01) adolescents who engaged in HIV risk behaviors ("cases") from those who did not ("non-cases"). An 8-item version of the PHRBS, refined using exploratory factor analysis, demonstrated good internal reliability (α = 87), differentiated "cases" from "non-cases" (P < .01), and correlated strongly with the Sexual Behavior Practices subcale (r = .34, P < .01). Results suggest that report of peers' sexual behaviors can serve as a proxy for OVCs' own behavior in contexts where social desirability bias affects reporting.


Assuntos
Crianças Órfãs/estatística & dados numéricos , Diagnóstico por Computador/normas , Infecções por HIV/epidemiologia , Entrevistas como Assunto/métodos , Psicometria/métodos , Populações Vulneráveis/estatística & dados numéricos , Adolescente , África ao Sul do Saara , Criança , Crianças Órfãs/psicologia , Feminino , Infecções por HIV/psicologia , Humanos , Masculino , Reprodutibilidade dos Testes , Assunção de Riscos , Comportamento Sexual/estatística & dados numéricos , Inquéritos e Questionários , Zâmbia/epidemiologia
8.
AIDS Care ; 30(sup4): 34-41, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30626199

RESUMO

Children affected by HIV/AIDS are at high risk for poor mental health outcomes. Social and psychological connectedness to school has been identified as an important resilience factor for youth affected by adversity (Centers for Disease Control and Prevention. (2009). School connectedness: Strategies for increasing protective factors among youth. Atlanta, GA: U.S. Department of Health and Human Services). Defined as "the belief by students that adults in the school care about their learning as well as about them as individuals" (Centers for Disease Control and Prevention. (2009). School connectedness: Strategies for increasing protective factors among youth. Atlanta, GA: U.S. Department of Health and Human Services), school connectedness has been shown to be associated with higher academic performance, increased mental health, and quality of life. However, few studies have examined school connectedness in sub-Saharan Africa, and none have examined school connectedness in relation to mental health in children orphaned by HIV/AIDS. Further, existing studies have relied on self-report measures. Against this background, the aim of the current study was to examine orphan status, school connectedness, and their interaction in relation to child mental health by using a multimethod design. 750 children between the ages of 7-11, recruited through South African community-based organizations (224 AIDS/HIV orphans, 276 non-AIDS/HIV orphans, 250 non-orphans; 51.2% girls), completed measures of school connectedness; children, caregivers, and teachers reported on child well-being using the Strengths and Difficulties Questionnaire. AIDS/HIV and non-AIDS/HIV orphans reported lower school connectedness than non-orphans. However, results demonstrated significant relations between school connectedness and overall mental health regardless of group, suggesting that school connectedness buffers against negative mental health outcomes regardless of orphan status. This study identifies a strategic point of intervention to build resilience against the cascading effects of HIV/AIDS and poverty in children in sub-Saharan Africa.


Assuntos
Cuidadores/psicologia , Crianças Órfãs/psicologia , Infecções por HIV/psicologia , Pobreza , Resiliência Psicológica , Adolescente , Adulto , Cuidadores/estatística & dados numéricos , Criança , Bem-Estar da Criança , Crianças Órfãs/estatística & dados numéricos , Feminino , Infecções por HIV/diagnóstico , Infecções por HIV/tratamento farmacológico , Humanos , Masculino , Saúde Mental , Pobreza/psicologia , Pobreza/estatística & dados numéricos , Qualidade de Vida , Instituições Acadêmicas , África do Sul
11.
SAHARA J ; 14(1): 93-109, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-28969498

RESUMO

BACKGROUND: HIV/AIDS has led to increased mortality and morbidity, negatively impacting adult labour especially in HIV/AIDS burdened Sub-Saharan Africa. There has been some exploration of the effects of HIV/AIDS on paid child labour, but little empirical work on children's non-paid child work. This paper provides quantitative evidence of how child and household-level factors affect children's involvement in both domestic and family farm work for households with a person living with HIV/AIDS (PLWHA) compared to non-PLWHA households using the 2010/2011 Centre for Health Economics Uganda HIV questionnaire Survey. METHOD: Descriptive analysis and multivariate logistic modelling is used to explore child and household-level factors that affect children's work participation. RESULTS: This research reveals greater demands on the labour of children in PLWHA households in terms of family farm work especially for boys. Results highlight the expected gendered social responsibilities within the household space, with girls and boys engaged more in domestic and family farm work, respectively. Girls shared a greater proportion of household financial burden by working more hours in paid work outside the household than boys. Lastly, the study revealed that a household head's occupation increases children's participation in farm work but had a partial compensatory effect on their involvement in domestic work. Wealth and socio-economic standing is no guarantee to reducing child work. CONCLUSION: Children from PLWHA households are more vulnerable to child work in family farm work especially boys; and girls are burdened beyond the household space through paid work. Differing perspectives and solutions need to consider the contextual nature of child work.


Assuntos
Cuidadores/estatística & dados numéricos , Filho de Pais Incapacitados/estatística & dados numéricos , Crianças Órfãs/estatística & dados numéricos , Infecções por HIV/economia , Adulto , Agricultura , Cuidadores/economia , Criança , Estudos Transversais , Emprego , Estudos de Avaliação como Assunto , Características da Família , Feminino , Infecções por HIV/epidemiologia , Serviço de Limpeza , Humanos , Renda , Masculino , Ocupações , Características de Residência , Uganda/epidemiologia , Populações Vulneráveis
12.
J Contemp Dent Pract ; 18(10): 893-898, 2017 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-28989126

RESUMO

AIM: The aim of the study was to identify risk factors and treatment needs of orphan children of Selangor, Kuala Lumpur, Malaysia. Ob ectives: (1) To identify the association between the frequency of snacking and caries among orphan schoolchildren, (2) To assess Streptococcus mutans and Lactobacilli (microbiological assessment) in saliva of orphan children, and (3) To formulate treatment needs for orphan children. MATERIALS AND METHODS: A cross-sectional study was done among 253 children of 5-, 12-, and 15-year-olds living in various orphanage houses of Selangor, Kuala Lumpur, Malaysia. Demographic data, and dietary and oral hygiene practices were collected through a structured questionnaire. Clinical examinations of children were conducted to assess oral health status and recorded in the World Health Organization oral health assessment form (1997). Stimulated saliva was collected for S. mutans and Lactobacilli levels. The statistical software, namely, Statistical Package for the Social Sciences version 19.0 was used for the analysis of the data. RESULTS: The final data analysis included 253 children of which 116 (45.8%) were boys and 137 (54.2%) were girls. Overall, 140 (55.33%) children were caries-free and 113 (44.66%) children presented with caries (decayed/missing/filled surface >0). High levels of salivary microbiological counts (S. mutans and Lactobacilli), i.e., ≥105, stress the importance of necessary preventive oral health services. Treatment needs among orphan children showed that most of the children, i.e., 58 (22.9%), need preventive or caries-arresting care followed by 49 (19.4%) who require two-surface filling as an immediate measure. CONCLUSION: From the results of our study, orphan children have low utilization of preventive and therapeutic oral health services. Urgent attention is required to plan a comprehensive dental health-care program to improve their oral health status. CLINICAL SIGNIFICANCE: Parents are the primary caretakers of children, but woefully some of them have to lead their lives without parents, the latter either being dead or incapable of bringing up their children. Such a group of children is known as orphans. As oral health is an integral part of general health, it is essential for health-care policy makers to address oral health needs of this underprivileged group of society. This article highlights the risk factors and treatment needs among orphan schoolchildren.


Assuntos
Necessidades e Demandas de Serviços de Saúde , Saúde Bucal/estatística & dados numéricos , Orfanatos , Adolescente , Criança , Crianças Órfãs/estatística & dados numéricos , Pré-Escolar , Estudos Transversais , Assistência Odontológica para Crianças , Cárie Dentária/epidemiologia , Feminino , Humanos , Lactobacillus , Malásia , Masculino , Higiene Bucal/estatística & dados numéricos , Orfanatos/estatística & dados numéricos , Fatores de Risco , Saliva/microbiologia , Fumar/epidemiologia , Streptococcus mutans , Inquéritos e Questionários
14.
Health Care Women Int ; 38(12): 1327-1343, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-28850326

RESUMO

The study of depressive symptoms among caregivers raising HIV/AIDS-orphans is emerging as an important area of research. However, it has not been explored at length in generational and cultural contexts. In this study, the authors explore the role of financial strain, raising a HIV-infected and/or impacted child, and caregiver knowledge on the depressive symptoms of 89-older caregivers raising HIV/AIDS-orphans in Namibia, Africa. In this study, we found elevated levels of depressive symptoms among this population. Using hierarchical regression, a significant positive association between financial strain and depressive symptoms was found. A significant negative association between caring for an HIV-infected orphan and depression was shown. Our work suggests the need for economic assistance programs and psychosocial interventions for older caregivers.


Assuntos
Cuidadores/psicologia , Crianças Órfãs/estatística & dados numéricos , Depressão/psicologia , Infecções por HIV/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Estresse Psicológico/psicologia , Idoso , Idoso de 80 Anos ou mais , Criança , Crianças Órfãs/psicologia , Depressão/diagnóstico , Depressão/epidemiologia , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/psicologia , Feminino , Infecções por HIV/mortalidade , Humanos , Entrevistas como Assunto , Masculino , Namíbia/epidemiologia , Pobreza , Fatores Socioeconômicos
16.
BMC Oral Health ; 17(1): 108, 2017 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-28693477

RESUMO

BACKGROUND: The purpose of this study was to determine the prevalence and clinical effects of untreated dental caries in Pakistani children residing in orphanages using the DMFT and PUFA index; association of decay and untreated dental caries with demographics including type of orphanage; behavioural and dental visiting pattern; and association of dental pain experience and type of orphanage with dental visiting. METHODS: A cross-sectional survey was conducted on a total of 753 orphan children belonging to 4-17 years of age group residing in twin cities of Rawalpindi and Islamabad, Pakistan. Clinical examination of children was performed using the DMFT and PUFA index for the assessment of dental caries and untreated decay, followed by questionnaire enquiring about eating and oral hygiene habits, dental visiting pattern and dental pain and swelling experience. Association between dental decay, child's dental visiting and pain as a consequence of untreated decay was carried out using chi square test and logistic regression analysis. RESULTS: The overall caries prevalence was 34.8% and overall prevalence of PUFA/pufa was 15.9%. The mean score of DMFT and dmft was 1.18 (SD 0.39) and 1.04 (SD 0.23), and mean PUFA was 1.18 (SD 0.57) and mean pufa score 1.14 (SD 0.35). Untreated caries ratio was found to be 49.1% indicating half the decay had progressed to involve the pulp. No significant association of gender was found with DMFT, dmft, PUFA and pufa (p > 0.05), however, when analysed individually, the 'D' component of DMFT was significantly associated with male gender (p = 0.05). Furthermore, no significant association of DMFT/dmft or PUFA/pufa in either dentition was found with behavioural characteristics such as dietary and oral hygiene habits. Also, 66.2% children who experienced pain had not been to the dentist in the past year (p = 0.013) and 52.6% children who mentioned experiencing pain at night had not been to the dentist in the past year (p = 0.009). Children with decay were more likely to have visited the dentist (OR 3.3, 95% CI 1.42-7.6, p = 0.006). However, children who reported to have experienced pain were less likely to have visited the dentist in the past year (OR 0.53, 95% CI 0.32-0.88, p = 0.014). CONCLUSIONS: Moderate levels of decay were found in the sample with 'd' component majorly responsible for the cumulative DMFT index. However, alarmingly almost half of the decay component (49.1%) had progressed to involve the pulp. Experiencing pain in teeth prompted dental visits. Initiation of preventive services for children residing in orphanages in Pakistan would help greatly towards reducing the burden of untreated decay.


Assuntos
Crianças Órfãs/estatística & dados numéricos , Cárie Dentária/complicações , Adolescente , Criança , Pré-Escolar , Estudos Transversais , Índice CPO , Cárie Dentária/epidemiologia , Feminino , Humanos , Masculino , Orfanatos/estatística & dados numéricos , Paquistão/epidemiologia , Prevalência , Índice de Gravidade de Doença
17.
Scand J Public Health ; 45(6): 605-611, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28669316

RESUMO

AIMS: The dramatic increase in the number of refugees in Europe presents a major public health challenge. The limited existing evidence indicates that the mental health needs of refugees are significant; unaccompanied refugee minors (URMs) constitute a particularly vulnerable group. In this study, we aimed to investigate whether a short questionnaire (Children's Revised Impact of Event Scale; CRIES-8) could be used as a screening tool for PTSD symptoms in URMs, 8-18 years old, during their routine health check-up. METHODS: Data were collected at the healthcare centre for asylum-seekers in Uppsala, Sweden. In total, 208 URMs completed the CRIES-8 during their health assessment. RESULTS: The CRIES-8 was feasible to use, showed good internal consistency and its factor structure was confirmed. Children with less than four years of education often had difficulties completing the questionnaire by themselves and needed help reading the questions. Almost all the respondents were male (98%), aged 9-18 years. The majority (81%) came from Afghanistan. About 76% scored above the cut-off and therefore were considered to be at risk of PTSD. The proportion of children who screened positive did not differ based on age, country of origin or current living arrangements. CONCLUSIONS: The CRIES-8 is a useful tool in clinical settings, however, children should be provided with reading support and instructions about how to complete the questionnaire. The high number of children who screened positive for PTSD symptoms indicates the need for a more thorough mental health assessment, and early prevention/intervention programmes to address URMs' mental health issues.


Assuntos
Crianças Órfãs/psicologia , Programas de Rastreamento/métodos , Menores de Idade/psicologia , Refugiados/psicologia , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Inquéritos e Questionários , Adolescente , Criança , Crianças Órfãs/estatística & dados numéricos , Europa (Continente) , Estudos de Viabilidade , Feminino , Humanos , Masculino , Menores de Idade/estatística & dados numéricos , Refugiados/estatística & dados numéricos , Reprodutibilidade dos Testes
18.
Econ Hum Biol ; 27(Pt A): 126-136, 2017 11.
Artigo em Inglês | MEDLINE | ID: mdl-28605623

RESUMO

This paper estimates the long-term heterogeneous legacies of exposures to war in utero and during early childhood on height in adulthood. Using a novel dataset on the regional WWII destruction in Germany, combined with the German Socio-Economic Panel (SOEP), we find that individuals who experienced warfare in utero and during childhood are an average of 2cm shorter as adults, suggesting that the negative scarring effect of WWII dominated the positive effect coming from a selection. Among war survivors, children from less privileged families who resided in highly destroyed regions, particularly girls, suffered the greatest health consequences of warfare. Our analyses also show that wartime children who lost their parents during the war years are an average of 1.3cm shorter as adults. However, the father's conscription during WWII had no long-term effect on adult height.


Assuntos
Estatura , Crianças Órfãs/estatística & dados numéricos , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Exposição à Guerra/efeitos adversos , II Guerra Mundial , Adulto , Feminino , Alemanha/epidemiologia , Nível de Saúde , Humanos , Masculino , Gravidez , Distribuição por Sexo , Fatores Socioeconômicos
19.
Prax Kinderpsychol Kinderpsychiatr ; 66(4): 242-258, 2017 Apr.
Artigo em Alemão | MEDLINE | ID: mdl-28393649

RESUMO

Resilient or Risk Group? Psychological Burden at Unaccompanied Refugee Minors (URM) in Germany Unaccompanied minors (umA in German) are considered as a risk group for psychological disorders. In international studies a high prevalence for trauma, anxiety, and depression were reported. A sample of N = 52 unaccompanied minors living in Germany was questioned on symptom severity as well as stress experience with the Refugee Health Screening-15. More than each second unaccompanied minor shows clinically relevant symptom severity and stress experience. In age-specific analyses the highest stress levels were found among the youngest unaccompanied minors. Therefore, specifically adapted settings for care should be applied for this high-risk group.


Assuntos
Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/psicologia , Crianças Órfãs/psicologia , Crianças Órfãs/estatística & dados numéricos , Transtorno Depressivo/psicologia , Menores de Idade/psicologia , Menores de Idade/estatística & dados numéricos , Refugiados/psicologia , Refugiados/estatística & dados numéricos , Resiliência Psicológica , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Adolescente , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/terapia , Criança , Estudos Transversais , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/terapia , Feminino , Alemanha , Humanos , Masculino , Programas de Rastreamento , Gravidez , Medição de Risco , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/terapia
20.
Health Policy Plan ; 32(7): 943-955, 2017 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-28431108

RESUMO

Child mortality is one of the most pressing global health and policy issues in the developing world. The leading drivers of death-pneumonia, diarrhea and malaria-are preventable and treatable. However, these illnesses are exacerbated by a lack of accessible nutrition, water, basic and preventive health services, and sanitary living conditions-all factors which are more likely to disproportionately impact the poor. We examine whether Kenya's largest social protection impacts children's incidence of upper respiratory illness. The Kenya Cash Transfer for Orphans and Vulnerable Children was designed to support orphans affected by HIV/AIDS and has covered over 240,000 households as of 2014. Using longitudinal, cluster-randomized program data from 2007 to 2009, we run a generalized linear latent and mixed method estimation model on a sample of children 0-7 years and under-5 years of age. We find that the program is associated with a decrease in illness in children 0-7 years of age (P < 0.05), but found no effects on a stratified sample of under-5 children. Furthermore, no impacts on health care seeking in the event of illness were detected. This study is one of few examining children's health using data from a large scale unconditional cash transfer program. With the widespread adoption of over 123 cash transfer programs across sub-Saharan Africa, these findings suggest social cash transfer programs are capable of promoting the multidimensional well-being for the world's most vulnerable populations.


Assuntos
Saúde da Criança/economia , Crianças Órfãs/estatística & dados numéricos , Malária/epidemiologia , Assistência Pública/estatística & dados numéricos , Infecções Respiratórias/epidemiologia , Criança , Saúde da Criança/estatística & dados numéricos , Pré-Escolar , Feminino , Infecções por HIV , Humanos , Lactente , Recém-Nascido , Quênia , Estudos Longitudinais , Malária/economia , Masculino , Infecções Respiratórias/economia , Populações Vulneráveis/estatística & dados numéricos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA