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Musoke D, Nalinya S, Lubega GB, Deane K, Ekirapa-Kiracho E, McCoy D. The impact of the COVID-19 lockdown on social and economic welfare in Uganda. Arch Public Health 2024; 82:117. [PMID: 39103969 DOI: 10.1186/s13690-024-01337-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 06/29/2024] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND As a measure to slow down the transmission of Coronavirus disease (COVID-19), governments around the world placed their countries under various stringent lockdown measures. Uganda is one of the countries that had a strict lockdown in Africa. This qualitative study explored the social and economic impacts of the COVID-19 lockdown in both an urban (Kampala) and rural (Wakiso) setting in Central Uganda. METHODS The study used focus group discussions (FGDs), household interviews, and key informant interviews (KIIs). 14 FGDs were conducted among several stakeholders including community health workers, health professionals, and members of the community. 40 household interviews were conducted among low, middle, and high-income households, while 31 KIIs were held among policy makers, non-governmental organisations, and the private sector. Data were analysed thematically in NVivo 2020 (QSR International). RESULTS Findings from the study are presented under six themes: family disruption; abuse of children's rights; disruption in education; food insecurity; impact on livelihoods; and violation of human rights. The study found that the COVID-19 lockdown led to family breakups, loss of family housing, as well as increased both caring responsibilities and gender-based violence especially towards females. Children's welfare suffered through increased child labour, sexual exploitation, and early marriages. The extended closure of schools led to delayed educational milestones, poor adaptation to home-based learning, and increased school drop-out rates. Increased food insecurity led to changes in feeding patterns and reduced food varieties. Livelihoods were negatively affected hence people depleted their savings and capital. Unlawful detention and beating by law enforcement officers increased during the lockdown. CONCLUSION Future pandemic planning needs to consider the consequences of lockdown on the social and economic wellbeing of communities hence put in place appropriate mitigation measures during and after the outbreak.
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Affiliation(s)
- David Musoke
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda.
| | - Sarah Nalinya
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Grace Biyinzika Lubega
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | | | - Elizabeth Ekirapa-Kiracho
- Department of Health Policy, Planning and Management, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - David McCoy
- International Institute for Global Health, United Nations University, Kuala Lumpur, Malaysia
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Musoke D, Lubega GB, Twesigye B, Nakachwa B, Brown MO, Gibson L. Enhancing the capacity of community health workers in prevention and control of epidemics and pandemics in Wakiso district, Uganda: evaluation of a pilot project. BMC PRIMARY CARE 2024; 25:260. [PMID: 39020314 PMCID: PMC11253445 DOI: 10.1186/s12875-024-02522-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Accepted: 07/12/2024] [Indexed: 07/19/2024]
Abstract
BACKGROUND Community Health Workers (CHWs) play a crucial role in outbreak response, including health education, contact tracing, and referral of cases if adequately trained. A pilot project recently trained 766 CHWs in Wakiso district Uganda on epidemic and pandemic preparedness and response including COVID-19. This evaluation was carried out to generate evidence on the outcomes of the project that can inform preparations for future outbreaks in the country. METHODS This was a qualitative evaluation carried out one year after the project. It used three data collection methods: 30 in-depth interviews among trained CHWs; 15 focus group discussions among community members served by CHWs; and 11 key informant interviews among community health stakeholders. The data was analysed using a thematic approach in NVivo (version 12). RESULTS Findings from the study are presented under four themes. (1) Improved knowledge and skills on managing epidemics and pandemics. CHWs distinguished between the two terminologies and correctly identified the signs and symptoms of associated diseases. CHWs reported improved communication, treatment of illnesses, and report writing skills which were of great importance including for managing COVID-19 patients. (2) Enhanced attitudes towards managing epidemics and pandemics as CHWs showed dedication to their work and more confidence when performing tasks specifically health education on prevention measures for COVID-19. (3) Improved health practices such as hand washing, vaccination uptake, and wearing of masks in the community and amongst CHWs. (4) Enhanced performance in managing epidemics and pandemics which resulted in increased work efficiency of CHWs. CHWs were able to carry out community mobilization through door-to-door household visits and talks on community radios as part of the COVID-19 response. CHWs were also able to prioritize health services for the elderly, and support the management of patients with chronic diseases such as HIV, TB and diabetes by delivering their drugs. CONCLUSIONS These findings demonstrate that CHWs can support epidemic and pandemic response when their capacity is enhanced. There is need to invest in routine training of CHWs to contribute to outbreak preparedness and response.
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Affiliation(s)
- David Musoke
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, P. O. Box 7072, Kampala, Uganda.
| | - Grace Biyinzika Lubega
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, P. O. Box 7072, Kampala, Uganda
| | - Belinda Twesigye
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, P. O. Box 7072, Kampala, Uganda
| | - Betty Nakachwa
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, P. O. Box 7072, Kampala, Uganda
| | - Michael Obeng Brown
- Institute of Health and Allied Professions, School of Social Sciences, Nottingham Trent University, Nottingham, NG1 4FQ, UK
| | - Linda Gibson
- Institute of Health and Allied Professions, School of Social Sciences, Nottingham Trent University, Nottingham, NG1 4FQ, UK
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Pan T, Gallo ME, Donald KA, Webb K, Bath KG. Elevated risk for psychiatric outcomes in pediatric patients with Multisystem Inflammatory Syndrome (MIS-C): A review of neuroinflammatory and psychosocial stressors. Brain Behav Immun Health 2024; 38:100760. [PMID: 38586284 PMCID: PMC10992702 DOI: 10.1016/j.bbih.2024.100760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 02/19/2024] [Accepted: 03/17/2024] [Indexed: 04/09/2024] Open
Abstract
Multisystem Inflammatory Syndrome in Children (MIS-C) is a secondary immune manifestation of COVID-19 involving multiple organ systems in the body, resulting in fever, skin rash, abdominal pain, nausea, shock, and cardiac dysfunction that often lead to hospitalization. Although many of these symptoms resolve following anti-inflammatory treatment, the long-term neurological and psychiatric sequelae of MIS-C are unknown. In this review, we will summarize two domains of the MIS-C disease course, 1) Neuroinflammation in the MIS-C brain and 2) Psychosocial disruptions resulting from stress and hospitalization. In both domains, we present existing clinical findings and hypothesize potential connections to psychiatric outcomes. This is the first review to conceptualize a holistic framework of psychiatric risk in MIS-C patients that includes neuroinflammatory and psychosocial risk factors. As cases of severe COVID-19 and MIS-C subside, it is important for clinicians to monitor outcomes in this vulnerable patient population.
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Affiliation(s)
- Tracy Pan
- Stanford University School of Medicine, Stanford, CA, USA
- Department of Cognitive, Linguistic, and Psychological Sciences, Brown University, Providence, RI 029112, USA
- The Neuroscience Institute, University of Cape Town, South Africa
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Meghan E. Gallo
- Department of Cognitive, Linguistic, and Psychological Sciences, Brown University, Providence, RI 029112, USA
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY, 10032, USA
- Department of Psychiatry, Columbia University Irving Medical College, New York, NY, 10032, USA
- Division of Molecular Therapeutics, New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Kirsten A. Donald
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
- The Neuroscience Institute, University of Cape Town, South Africa
| | - Kate Webb
- Division of Paediatric Rheumatology, School of Child and Adolescent Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, 7700, South Africa
- Crick African Network, Francis Crick Institute, London, UK
| | - Kevin G. Bath
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY, 10032, USA
- Department of Psychiatry, Columbia University Irving Medical College, New York, NY, 10032, USA
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Zani B, Luckett B, Thurman TR. COVID-19 pandemic stressors, familial discord, and anxiety among adolescents living with HIV in South Africa: pathways to non-adherence. AIDS Care 2024; 36:137-144. [PMID: 38301123 DOI: 10.1080/09540121.2024.2308025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 01/10/2024] [Indexed: 02/03/2024]
Abstract
Adolescents living with HIV (ALHIV) have poorer adherence to antiretroviral treatment (ART). This study investigates the interconnectivity of stressors induced by the COVID-19 pandemic, anxiety and family dynamics on adolescents' adherence to ART. A telephone survey was conducted among 196 South African ALHIV previously enrolled in support groups. Generalized structural equations modeling was used to understand how pandemic-related stressors affected ART adherence. Respondents reported experiencing life stressors since the implementation of COVID-19 restrictions, including doing worse at school (32%), loss of household income (44%) and less food available (38%). Forty-two percent reported greater verbal aggression from adults at home and 60% experienced anxiety. The structural equations model demonstrated a direct path from experiencing life stressors to increased verbal aggression from caregivers, which led to anxiety and ultimately, poorer ART adherence. Each stressor experienced increased the odds of experiencing verbal aggression by 51% (OR=1.51, 95%CI=1.14-2.00) which, in turn, increased the odds of having anxiety four-fold (OR=4.1, 95%C =2.16-7.76). Anxiety was associated with a 74% reduction in the odds of being fully ART adherent (OR=0.26, 95%CI=0.08-0.81). COVID-19-induced stressors exacerbated the mental and physical vulnerability of ALHIV. Findings elucidate how both discord at home and anxiety can result in poorer ART adherence.
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Affiliation(s)
- Babalwa Zani
- Tulane International, Cape Town, South Africa
- Highly Vulnerable Children Research Center, Cape Town, South Africa
| | - Brian Luckett
- Tulane International, Cape Town, South Africa
- Highly Vulnerable Children Research Center, Cape Town, South Africa
- School of Public Health and Tropical Medicine, Department of International Health and Sustainable Development, Tulane University, New Orleans, LA, USA
| | - Tonya R Thurman
- Tulane International, Cape Town, South Africa
- Highly Vulnerable Children Research Center, Cape Town, South Africa
- School of Public Health and Tropical Medicine, Department of International Health and Sustainable Development, Tulane University, New Orleans, LA, USA
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Kim ES, Adriko M, Oseku KC, Lokure D, Webb EL, Sabapathy K. Factors associated with hookworm and Schistosoma mansoni infections among school-aged children in Mayuge district, Uganda. BMC Public Health 2024; 24:1620. [PMID: 38886749 PMCID: PMC11184691 DOI: 10.1186/s12889-024-19092-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 06/10/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Hookworm infection and schistosomiasis are two of sub-Saharan Africa's most common neglected tropical diseases. An annual mass drug administration (MDA) program against schistosomiasis and soil-transmitted helminths (STHs), including hookworm, has been implemented in Mayuge district, Uganda, since 2003 to date. However, hookworm and schistosomiasis remain prevalent in Mayuge district. Understanding the factors that predispose children to these infections in the context of MDA could inform interventions to reduce prevalence in Uganda and similar settings. METHOD This cross-sectional study took place in 33 randomly selected primary schools in the Mayuge district from January to February 2022. Children in primary classes 4 or 5, in the selected schools provided single stool samples and completed questionnaires. Stool specimens were examined using the Kato-Katz method to determine the prevalence of hookworm and schistosomiasis. We performed univariable and multivariable logistic regression to assess the associations of each infection with potential risk factors. RESULT A total of 1,617 students (mean age 12.1 years, 50.1% male) were enrolled. The prevalence of hookworm infection and schistosomiasis was 21.8% (95% confidence interval (CI): 19.8-23.9%) and 18.7% (95% CI: 16.8-20.7%), respectively. In multivariable analysis, longer water fetching time (over 30 min versus less than 30 min) and working daily in the soil were associated with increased odds of hookworm infection (adjusted odds ratio (AOR): 1.49, 95% CI: 1.13-1.96 and 1.37, 95% CI: 1.03-1.82, respectively). Higher odds of schistosomiasis were linked to proximity to water bodies within a one-hour walking distance (AOR: 1.84, 95% CI: 1.35-2.50), and not always washing hands before eating (AOR: 2.00, 95% CI: 1.50-2.67). Swimming, bathing, or washing in water bodies twice a week, compared to never, also increased schistosomiasis odds (AOR: 2.91, 95% CI: 1.66-5.13). CONCLUSION Consistent with the mechanisms of acquisition, hookworm infection increased with exposure to soil, and schistosomiasis increased with exposure to unclean water. Our findings highlight the importance of Water, Sanitation, and Hygiene programs and strategies aimed at reducing exposure within the framework of Neglected Tropical Disease elimination programs.
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Affiliation(s)
- Eun Seok Kim
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
- World Vision Korea, Seoul, Korea.
| | - Moses Adriko
- Vector-Borne and NTDs Control Division, Ministry of Health, Kampala, Uganda
| | | | - David Lokure
- Information and Technology Sector, Kotido District Local Government, Kotido, Uganda
| | - Emily L Webb
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Kalpana Sabapathy
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
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Wolf K, Schmitz J. Scoping review: longitudinal effects of the COVID-19 pandemic on child and adolescent mental health. Eur Child Adolesc Psychiatry 2024; 33:1257-1312. [PMID: 37081139 PMCID: PMC10119016 DOI: 10.1007/s00787-023-02206-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 04/03/2023] [Indexed: 04/22/2023]
Abstract
The COVID-19 pandemic and associated containment measures have massively changed the daily lives of billions of children and adolescents worldwide. To investigate the global longitudinal effects on various mental health outcomes over a period of 1.5 years, we conducted a scoping review in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). We included the peer-reviewed articles from PubMed, Web of Science, and APA PsycInfo that were published between December 2019 and December 2021, followed a longitudinal or repeated cross-sectional design, and quantitatively assessed with clinical questionnaires the effect of the COVID-19 pandemic or a related stressor on mental health indicators in community samples of children and adolescents.The results of our qualitative analysis of 69 studies indicate a general trend of less psychological well-being and more mental health problems, such as heightened stress, and depressive and anxiety symptoms during the pandemic. Data suggest that both protection measure intensity and infection dynamics were positively associated with severity of the psychopathology. The most reported influencing factors were age, gender, socio-economic status, previous state of mental and physical health, self-regulation abilities, parental mental health, parenting quality, family functioning, social support, isolation and loneliness, health-related worries, and consistent routines and structure. Our results demonstrate that children and adolescents worldwide have experienced more mental health problems due to the COVID-19 pandemic. They call for improved access to child and adolescent mental health care and prioritisation of child and adolescent welfare in political decision making.
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Affiliation(s)
- Kristin Wolf
- Department of Clinical Child and Adolescent Psychology, Wilhelm-Wundt-Institute for Psychology, University of Leipzig, Leipzig, Germany.
| | - Julian Schmitz
- Department of Clinical Child and Adolescent Psychology, Wilhelm-Wundt-Institute for Psychology, University of Leipzig, Leipzig, Germany
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Habib RR, El Khayat M, Ghanawi J, Katrib RS, Hneiny L, Halwani DA. Child labor and associated risk factors in the wake of the COVID-19 pandemic: a scoping review. Front Public Health 2024; 11:1240988. [PMID: 38361576 PMCID: PMC10867312 DOI: 10.3389/fpubh.2023.1240988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 12/04/2023] [Indexed: 02/17/2024] Open
Abstract
Child labor can significantly impact the health, welfare, and development of children engaged in labor. The spread of child labor around the globe is predicted to accelerate as a consequence of the COVID-19 pandemic. To this end, a scoping review was conducted to (a) synthesize emerging themes and results from recent research on child labor during the COVID-19 pandemic, (b) identify factors that increase the risk of children falling into child labor and (c) provide recommendations that can inform the development of policies and programs to ensure that previous efforts to combat child labor are not lost. Six electronic databases (Medline, EMBASE, Scopus, CINAHL, Global health, and Web of Science) were searched on January 21, 2022. The database searches, along with the grey literature search, identified 5,244 studies, of which 45 articles were included in the final review. Several of those articles (8 of 45 articles) reviewed concluded that the pandemic could increase child labor worldwide including the worst forms of child labor. The reviewed studies identified primary risk factors for child labor during the COVID-19 pandemic including economic challenges, temporary school closure and a greater demand for child labor, mortality among parents, and limited social protection. This scoping review identified the need for more field research on child labor following the COVID-19 pandemic to detect emerging patterns of child labor and to develop effective intervention measures. There is also a need for further empirical research on the consequences of the COVID-19 pandemic on gender differences in occupational exposure and health outcomes among working children and marginalized groups such as migrants, refugees, and minority groups. Based on the conclusions drawn from this review, it is evident that addressing child labor in the wake of the pandemic necessitates a multi-sectoral response by the government, businesses, civil society, and funding/donor agencies. This response should address various areas such as education, social and child protection, and legislation to support vulnerable children and their families in order to combat child labor subsequent to the pandemic.
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Affiliation(s)
- Rima R. Habib
- Faculty of Health Sciences, Department of Environmental Health, American University of Beirut, Beirut, Lebanon
| | - Moussa El Khayat
- Faculty of Health Sciences, Department of Environmental Health, American University of Beirut, Beirut, Lebanon
| | - Joly Ghanawi
- Faculty of Health Sciences, Department of Environmental Health, American University of Beirut, Beirut, Lebanon
| | - Reem S. Katrib
- Faculty of Health Sciences, Department of Environmental Health, American University of Beirut, Beirut, Lebanon
| | - Layal Hneiny
- Wegner Health Sciences Library, University of South Dakota, Sioux Falls, SD, United States
| | - Dana A. Halwani
- Faculty of Health Sciences, Department of Environmental Health, American University of Beirut, Beirut, Lebanon
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Mashiloane N, Nell W, Truter E. A qualitative exploration of the drivers for the transfer of foster children in Gauteng, South Africa. CHILD ABUSE & NEGLECT 2023; 146:106472. [PMID: 37778284 DOI: 10.1016/j.chiabu.2023.106472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/17/2023] [Accepted: 09/14/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND Many children in South Africa are orphaned or subjected to maltreatment, leaving them in need of care and protection. Foster care is one form of alternative care for such children. Retention of foster parents, or foster care placement stability, is one of the many challenges related to foster care, globally and in South Africa. This instability can have an adverse impact on children, and although some research speaks to the problem, the experiences of South African role players regarding this problem have not been documented, to date. To improve foster care retention in South Africa, local, contextualized studies exploring the drivers of foster care placement instability are required. AIM The aim of this qualitative study was thus to explore designated social workers' (DSWs) and foster parents' experiences about the reasons prompting foster care transfers. PARTICIPANTS AND SETTING A purposively selected sample of ten foster parents and ten DSWs in the Gauteng province of South Africa took part in the study. METHODS A descriptive qualitative study was adopted as basis for this study, which entailed thematic analysis of 20 semi-structured interviews. RESULTS It was found that children's behavioural problems, a shortage of resources, a lack of parenting skills, problematic relationships between foster parents and foster children, and previous traumatic events, led to most foster care transfers. A key finding from this study, which appears not to be evident in previous studies, centres on the critical role played by money, or rather its absence, in contributing to foster care placement instability. CONCLUSIONS When considered in conjunction with findings emerging from previous studies, our findings underscore the importance of obtaining a contextualized understanding of local, cultural factors at play in foster care delivery. To improve foster care retention in South Africa, which is fraught with challenges not yet reported elsewhere, it is recommended that screening procedures for foster parents be revised, and that allocation of resources to DSWs be prioritized.
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Affiliation(s)
- Nomlinda Mashiloane
- South African Council of Social Service Profession (SACSSP) and the South African Association of Social Workers in Private Practice (SAASWIPP), South Africa
| | - Werner Nell
- Faculty of Humanities, Optentia Research Entity, North-West University, Vanderbijlpark, South Africa.
| | - Elmien Truter
- Faculty of Health Sciences, COMPRES Research Entity, North-West University, Vanderbijlpark, South Africa.
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Davidson J, Karadzhov D, Collins H, Brown A. Complexities of protecting children from violence during the COVID-19 pandemic: Providers' and policymakers' best practices, innovations and challenges in 12 countries. CHILD ABUSE & NEGLECT 2023; 146:106480. [PMID: 37801758 DOI: 10.1016/j.chiabu.2023.106480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 09/15/2023] [Accepted: 09/20/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND Globally, the COVID-19 pandemic has put children at an increased risk of neglect, violence and other human rights violations. Despite growing evidence of its impact on child protective services, there has been a dearth of research from low- and middle-income countries. OBJECTIVE This cross-sectional qualitative study explored service providers' and policymakers' views and experiences of children's protection, in real-time, in the last quarter of 2020. METHODS A smartphone app-based survey containing both open- and closed-ended questions was used. The data were analyzed using descriptive statistics and qualitative content analysis. PARTICIPANTS AND SETTING Eighty-four respondents participated, including service providers, service managers and policymakers, mostly representing non-governmental organizations (NGOs), civil society organizations (CSOs) and governments across 12 countries (predominantly Kenya, South Africa and the Philippines). RESULTS Most respondents reported their sectors had experienced challenges in protecting children from violence - particularly delays in reporting abuse and pursuing justice, and reaching those living in poor and/or rural areas. Good practices and innovations in children's protection during the pandemic were reported in several domains: advocacy and signposting; justice; health care; education and awareness-raising; children's visibility; and virtual service delivery. Community resources and involvement were also highlighted as vital. The ineffectiveness of child protection laws, policies and organizational responses, however, hindered the implementation of effective practices. CONCLUSIONS The COVID-19 pandemic has accentuated the complexities and interconnectivity of systems, processes and actors and their joint impact on children's protection and rights. Collectively, the findings reinforce the criticality of collaborative, urgent and child-centered responses.
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Affiliation(s)
- Jennifer Davidson
- Institute for Inspiring Children's Futures, University of Strathclyde, Glasgow, Scotland, United Kingdom.
| | - Dimitar Karadzhov
- Institute for Inspiring Children's Futures, University of Strathclyde, Glasgow, Scotland, United Kingdom
| | - Hilllary Collins
- Research Associate, University of Glasgow, Glasgow, Scotland, United Kingdom
| | - Aaron Brown
- Children & Young People's Centre for Justice, University of Strathclyde, Glasgow, Scotland, United Kingdom
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Liu C, Zhang M, Ma C, Fu M, Guo J, Zhen C, Zhang B. Childhood abuse as a mediator of the relationship between early family socio-economic status and geriatric depression: A population-based study in China. Heliyon 2023; 9:e22021. [PMID: 38034775 PMCID: PMC10682629 DOI: 10.1016/j.heliyon.2023.e22021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 11/01/2023] [Accepted: 11/02/2023] [Indexed: 12/02/2023] Open
Abstract
Previous studies have suggested that childhood socioeconomic status (SES) is linked to geriatric depressive symptoms in many developed countries. However, the potential pathways of the relationship between childhood SES and geriatric depressive symptoms need to be further explored. This study aimed to assess the mediating effect of being abused during childhood on the association between childhood SES and geriatric depressive symptoms, using evidence from a longitudinal study in China. The study cohort included 8137 individuals. Childhood abuse was defined as experiences related to parental violence, sibling abuse, school violence, community violence, and parental quarrel. Results indicated poor childhood SES was associated significantly with geriatric depressive symptoms. The indirect effect of poor childhood SES to high geriatric depressive risk through community violence, sibling abuse, school violence, and parental quarrel were 0.02, 0.01, 0.02, and 0.01, respectively. Our findings shed new light on the literature regarding the impact of childhood SES on elderly depressive symptoms. Furthermore, childhood SES demonstrated a significant correlation with geriatric depressive symptoms through bullying behaviors. The findings highlight the need to promote both childhood social welfare and psychological well-being within the elderly population.
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Affiliation(s)
- Chengcheng Liu
- The School of Social Development and Public Policy, Beijing Normal University, Beijing, 100875, PR China
| | - Mingyu Zhang
- School of Public Health, Peking University, Beijing, 100191, PR China
| | - Chongyue Ma
- School of Accounting, Henan University of Economics and Law, PR China
| | - Mingqi Fu
- School of Public Management, Central South University, Wuhan, 430079, PR China
| | - Jing Guo
- School of Public Health, Peking University, Beijing, 100191, PR China
- Health Policy and Technology Assessment Center, Peking University Health Science Center, Beijing, PR China
| | - Cheng Zhen
- Center For the History of Medicine, School of Health Humanities, Peking University Health Science Center, Beijing, PR China
| | - Bo Zhang
- Department of Neurology and ICCTR Biostatistics and Research Design Center, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
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Chippaux JP. COVID-19 impacts on healthcare access in sub-Saharan Africa: an overview. J Venom Anim Toxins Incl Trop Dis 2023; 29:e20230002. [PMID: 37405230 PMCID: PMC10317188 DOI: 10.1590/1678-9199-jvatitd-2023-0002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 05/30/2023] [Indexed: 07/06/2023] Open
Abstract
This overview aimed to describe the situation of healthcare access in sub-Saharan Africa, excluding South Africa, during the COVID-19 pandemic. A PubMed® search from March 31, 2020, to August 15, 2022, selected 116 articles. Healthcare access and consequences of COVID-19 were assessed based on comparisons with months before its onset or an identical season in previous years. A general reduction of healthcare delivery, associated with the decline of care quality, and closure of many specialty services were reported. The impact was heterogeneous in space and time, with an increase in urban areas at the beginning of the pandemic (March-June 2020). The return to normalcy was gradual from the 3rd quarter of 2020 until the end of 2021. The impact of COVID-19 on the health system and its use was attributed to (a) conjunctural factors resulting from government actions to mitigate the spread of the epidemic (containment, transportation restrictions, closures of businesses, and places of entertainment or worship); (b) structural factors related to the disruption of public and private facilities and institutions, in particular, the health system; and (c) individual factors linked to the increase in costs, impoverishment of the population, and fear of contamination or stigmatization, which discouraged patients from going to health centers. They have caused considerable socio-economic damage. Several studies emphasized some adaptability of the healthcare offer and resilience of the healthcare system, despite its unpreparedness, which explained a return to normal activities as early as 2022 while the COVID-19 epidemic persisted. There appears to be a strong disproportion between the moderate incidence and severity of COVID-19 in sub-Saharan Africa, and the dramatic impact on healthcare access. Several articles make recommendations for lowering the socioeconomic consequences of future epidemics to ensure better management of health issues.
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Affiliation(s)
- Jean-Philippe Chippaux
- Paris Cité University, Research Institute for Development, Mother and child in tropical environment: pathogens, health system and epidemiological transition, Paris, France
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Sakaue K, Wokadala J, Ogawa K. Effect of parental engagement on children's home-based continued learning during COVID-19-induced school closures: Evidence from Uganda. INTERNATIONAL JOURNAL OF EDUCATIONAL DEVELOPMENT 2023; 100:102812. [PMID: 37288272 PMCID: PMC10176102 DOI: 10.1016/j.ijedudev.2023.102812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 05/09/2023] [Accepted: 05/10/2023] [Indexed: 06/09/2023]
Abstract
This study examines the effect of parental engagement on children's continued learning amid COVID-19-induced school closures in Uganda, where the government's distance learning program had limited coverage. The results show that children from households with more parental engagement are more likely to engage in learning activities at home when primary schools are closed. A significant effect of parental engagement is found in rural areas as well. Furthermore, we found that, in rural areas, the level of parental engagement is significantly more correlated with home-based learning among children from government schools than those from private schools.
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Affiliation(s)
- Katsuki Sakaue
- Graduate School of International Cooperation Studies, Kobe University, 2-1 Rokkodai-cho, Nada-ku, Kobe 657-8501, Japan
| | - James Wokadala
- College of Business and Management Sciences, Makerere University, Plot 51, Pool Road, Kampala P.O. Box 7062, Uganda
| | - Keiichi Ogawa
- Graduate School of International Cooperation Studies, Kobe University, 2-1 Rokkodai-cho, Nada-ku, Kobe 657-8501, Japan
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Moon C, Lim S, Kim Y. Domestic violence towards children in Kenya and Zambia during the COVID-19 pandemic. Public Health 2023; 221:17-22. [PMID: 37354599 PMCID: PMC10183627 DOI: 10.1016/j.puhe.2023.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 05/09/2023] [Accepted: 05/10/2023] [Indexed: 06/26/2023]
Abstract
OBJECTIVES Although research has demonstrated that the COVID-19 pandemic has increased the likelihood of children experiencing domestic abuse, few empirical studies have focused on the most vulnerable communities in developing countries. This study aimed to evaluate the impact of the COVID-19 pandemic on domestic violence towards children in Kenya and Zambia. STUDY DESIGN In collaboration with an international non-governmental organisation (NGO), an original door-to-door survey of 842 children and their parents (or adult guardians) was conducted in Kenya and Zambia. The survey sites were carefully selected to target economically underprivileged communities with the presence of NGOs as well as those without. METHODS Using multivariate regression analysis of child and parent survey responses, we attempted to identify how parents' experiences of COVID-19 affected children's exposure to domestic violence. Our analysis of domestic violence included both emotional (psychological) and physical violence. RESULTS Children from households whose guardians perceived a strongly negative effect of COVID-19 were more likely to experience domestic violence. The correlation was statistically significant for both emotional and physical violence. In Kenya, children in communities with NGO presence were less likely to experience domestic violence. CONCLUSIONS The COVID-19 pandemic has exposed children to an increased risk of experiencing domestic violence. Children from underprivileged communities in developing countries are particularly vulnerable to such risk, as they tend to lack social support from communities and governments. International organisations must pay more attention to these children during the pandemic.
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Affiliation(s)
- Chungshik Moon
- Department of Political Science and International Relations, Chung-Ang University, Seoul, Republic of Korea
| | - Sijeong Lim
- Division of International Studies, Korea University, Seoul, Republic of Korea
| | - Youngwan Kim
- Department of Political Science, Sogang University, Seoul, Republic of Korea.
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Chippaux JP. [Impact of COVID-19 on public health in sub-Saharan Africa]. BULLETIN DE L'ACADEMIE NATIONALE DE MEDECINE 2023; 207:150-164. [PMID: 36628105 PMCID: PMC9816877 DOI: 10.1016/j.banm.2022.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 10/27/2022] [Indexed: 01/09/2023]
Abstract
Objective This work aimed to assess the impact of COVID-19 on healthcare supply in sub-Saharan Africa except South Africa. Method A search through PubMed® between April 2020 and August 2022 selected 135 articles. The impact of COVID-19 was assessed on comparisons with the months prior to the onset of COVID-19 or an identical season in previous years. Results The decline of health services, associated with a reduction in their quality, and the closure of specialized health units have been reported. Many control programs and public health interventions have been interrupted, with the risk of an increase of the corresponding diseases. Social disorganization has generated mental health issues among the population, including health personnel. The impact was heterogeneous in space and time. The main causes were attributed to containment measures (transport restrictions, trade closures) and the lack of human and material resources. The increase in costs, in addition to the impoverishment of the population, and the fear of being contaminated or stigmatized have discouraged patients from going to health centres. The studies mention the gradual return to normal after the first epidemic wave and the resilience of the healthcare system. Conclusion Several articles make recommendations aimed at reducing the impact of future epidemics: support for community workers, training of health workers and reorganization of services to improve the reception and care of patients, technological innovations (use of telephones, drones, etc.) and better information monitoring.
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El Salih I, Njuguna FM, Widjajanto PH, Kaspers G, Bailey A, Mostert S. Impact of COVID-19 measures on the health and healthcare of children in East-Africa: Scoping review. Int J Health Plann Manage 2023; 38:579-598. [PMID: 36691260 DOI: 10.1002/hpm.3612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 11/29/2022] [Accepted: 12/22/2022] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic is of grave concern. As scientific data is being collected about the nature of COVID-19, government leaders and policy makers are challenged. They might feel pressured to take strong measures to stop virus spread. However, decisions could cause more harm than do good. This study maps all existing literature regarding the impact of COVID-19 containment measures on the health and healthcare of children in East-Africa. METHODS This scoping review follows Population Concept Context guidelines of Arksey and O'Malley and PRISMA 2020 checklist. PubMed, Web of Science, and Embase were searched. All peer-reviewed literature published in English between January 2020 and October 2022 was considered. Initial screening of titles and abstracts was undertaken independently by two reviewers, with a third available in case of doubt. This was followed by full-text screening involving two independent reviewers. RESULTS In total, 70 studies were included. Eight containment measures affecting children's health and healthcare were distinguished: lockdowns, school closures, physical distancing, travel restrictions, business closures, stay-at-home orders, curfews, quarantine measures with contact tracing. The consensus in the studies is that containment measures could minimise COVID-19 spread but have adverse indirect effects on children in East-Africa. Seven indirect effects were distinguished: economic damage, limited education access, food insecurity, child abuse, limited healthcare access, disrupted health-programs, and mental health challenges. CONCLUSION Government leaders and policy makers should take adverse indirect effects of COVID-19 measures into account, particularly in resource-limited regions such as East-Africa, apply a holistic approach, and strengthen socioeconomic and health-systems to protect the most vulnerable.
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Affiliation(s)
- Ibrahim El Salih
- International Development Studies, Department of Human Geography and Spatial Planning, Utrecht University, Utrecht, The Netherlands
| | - Festus Muigai Njuguna
- Department of Child Health and Pediatrics, Moi Teaching and Referral Hospital, Moi University, Eldoret, Kenya
| | - Pudjo Hagung Widjajanto
- Department of Pediatric Oncology, Dr Sardjito General Hospital, Gadjah Mada University, Yogyakarta, Indonesia
| | - Gertjan Kaspers
- Emma's Children Hospital, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Ajay Bailey
- International Development Studies, Department of Human Geography and Spatial Planning, Utrecht University, Utrecht, The Netherlands
| | - Saskia Mostert
- Emma's Children Hospital, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
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Musoke D, Nalinya S, Lubega GB, Deane K, Ekirapa-Kiracho E, McCoy D. The effects of COVID-19 lockdown measures on health and healthcare services in Uganda. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001494. [PMID: 36963035 PMCID: PMC10021763 DOI: 10.1371/journal.pgph.0001494] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 12/20/2022] [Indexed: 01/24/2023]
Abstract
Many countries across the world instituted lockdowns as a measure to prevent the spread of COVID-19. However, these lockdowns had consequences on health systems. This study explored effects of the COVID-19 lockdown measures on health and healthcare services in Uganda. The qualitative study employed focus group discussions (FGDs), household interviews, and key informant interviews (KIIs) in both an urban (Kampala district) and rural (Wakiso district) setting in central Uganda. Fourteen FGDs were conducted among community members, local leaders, community health workers, and health practitioners. Interviews were conducted among 40 households, while 31 KIIs were held among various stakeholders including policy makers, non-governmental organisations, and the private sector. Data was analysed by thematic analysis with the support of NVivo 2020 (QSR International). Findings from the study are presented under four themes: maternal and reproductive health; child health; chronic disease services; and mental health. Maternal and reproductive health services were negatively affected by the lockdown measures which resulted in reduced utilisation of antenatal, postnatal and family planning services. These effects were mainly due to travel restrictions including curfew, and fear of contracting COVID-19. The effects on child health included reduced utilisation of services which was a result of difficulties faced in accessing health facilities because of the travel restrictions. Patients with chronic conditions could not access health facilities for their routine visits particularly due to suspension of public transport. Depression, stress and anxiety were common due to social isolation from relatives and friends, loss of jobs, and fear of law enforcement personnel. There was also increased anxiety among health workers due to fear of contracting COVID-19. The COVID-19 lockdown measures negatively affected health, and reduced access to maternal, reproductive and child health services. Future interventions in pandemic response should ensure that their effects on health and access to health services are minimised.
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Affiliation(s)
- David Musoke
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Sarah Nalinya
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Grace Biyinzika Lubega
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Kevin Deane
- The Open University, Milton Keynes, United Kingdom
| | - Elizabeth Ekirapa-Kiracho
- Department of Health Policy, Planning and Management, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - David McCoy
- International Institute for Global Health, United Nations University, Kuala Lumpur, Malaysia
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King R, Namugumya R, Namuddu C, Mbazzi FB, Kasujja FX, Nankabirwa J, Seeley J. "Right now we are scared of each other, we fear everyone, the whole world has COVID": The impact of COVID-19 on young female sex workers in Kampala, Uganda, during national lockdowns in 2020-2021. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001268. [PMID: 36962902 PMCID: PMC10021140 DOI: 10.1371/journal.pgph.0001268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 11/18/2022] [Indexed: 01/06/2023]
Abstract
In 2020-2021 the COVID-19 pandemic led to multiple and diverse global public health response strategies globally and in Uganda to slow the spread of the virus by promoting wearing face coverings in public, frequent hand washing, physical distancing, restricting travel, and imposing home lockdowns. We conducted 146 interviews over four rounds of phone-follow up calls over 15 months with 125 young female sex workers coinciding in time with four different government-imposed lockdown periods in Kampala, Uganda, to assess the impact of these measures on young sex workers, their families and their communities as well as to gauge their resilience. Our findings revealed how COVID-19 fears and public health restrictions over time pushed an already marginalized population to the brink and how that pressure drove some participants into a new way of life.
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Affiliation(s)
- Rachel King
- Institute for Global Health Sciences, Department of Epidemiology and Biostatistics, University of California, San Francisco, (UCSF), San Francisco, California, United States of America
| | - Ritah Namugumya
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine (MRC/UVRI & LSHTM) Uganda Research Unit, Entebbe, Uganda
| | - Catherine Namuddu
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine (MRC/UVRI & LSHTM) Uganda Research Unit, Entebbe, Uganda
| | - Femke Bannink Mbazzi
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine (MRC/UVRI & LSHTM) Uganda Research Unit, Entebbe, Uganda
| | - Francis Xavier Kasujja
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine (MRC/UVRI & LSHTM) Uganda Research Unit, Entebbe, Uganda
| | - Judith Nankabirwa
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine (MRC/UVRI & LSHTM) Uganda Research Unit, Entebbe, Uganda
| | - Janet Seeley
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine (MRC/UVRI & LSHTM) Uganda Research Unit, Entebbe, Uganda
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, United Kingdom
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Owusu-Addo E, Owusu-Addo SB, Bennor DM, Mensah-Odum N, Deliege A, Bansal A, Yoshikawa M, Odame J. Prevalence and determinants of sexual abuse among adolescent girls during the COVID-19 lockdown and school closures in Ghana: A mixed method study. CHILD ABUSE & NEGLECT 2023; 135:105997. [PMID: 36528934 PMCID: PMC9750886 DOI: 10.1016/j.chiabu.2022.105997] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 12/03/2022] [Accepted: 12/09/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND In the wake of the COVID-19 pandemic, concerns have been raised that the pandemic may derail global efforts against child sexual abuse (CSA). OBJECTIVES This study examines the prevalence and associated factors of sexual abuse among adolescent girls in the context of the COVID-19 pandemic in Ghana. PARTICIPANTS AND SETTING The sample comprised 853 adolescent girls aged 13-19 (16.03 ± 2.04 years) in Ghana. METHODS The study employed a concurrent mixed-method design. RESULTS Overall, the prevalence of CSA during the COVID-19 lockdown and school closures was 32.5 %. Protective factors for CSA were feeling safe in neighbourhood (AOR = 0.526, 95 % CI = [0.325, 0.850]) and parents often listen to opinions (AOR = 0.446, 95 % CI = [0.241, 0.826]). Risk factors for CSA were physical activity (AOR = 1.649, OR = 1.783, 95 % CIAOR = [1.093, 2.487, 95 % CIOR = [1.241, 2.561]), parents sometimes listen to opinions (AOR = 1.199, OR = 1.924, 95 % CIAOR = [0.504, 2.853], 95 % CIOR = [1.034, 3.582]), living with another relative (AOR = 2.352, OR = 2.484, 95 % CIAOR = [0.270, 20.523], 95 % CIOR = [0.317, 19.475]), Akan ethnicity (AOR = 1.576, OR = 1.437, 95 % CIAOR = [0.307, 8.091], 95 % CIOR = [0.316, 6.534]), having no disability (AOR = 1.099, OR = 1.138, 95 % CIAOR = [0.679, 1.581], 95 % CIOR = [0.786, 1.649]) and having a close relationship with parents (AOR = 1.334, OR = 1.752, 95 % CIAOR = [0.746, 2.385], 95 % CIOR = [1.096, 2.802]). CONCLUSION Knowledge of the risk and protective factors identified in this study can guide and inform the development of CSA prevention programmes during disruptive occurrences like school closures and lockdown.
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Affiliation(s)
- E Owusu-Addo
- Bureau of Integrated Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - S B Owusu-Addo
- Health Promotion Directorate, Ghana Health Service, Ashanti Region, Ghana
| | - D M Bennor
- Bureau of Integrated Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - N Mensah-Odum
- Bureau of Integrated Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - A Deliege
- UNICEF Ghana Country Office, Accra, Ghana
| | - A Bansal
- UNICEF Ghana Country Office, Accra, Ghana
| | | | - J Odame
- UNICEF Ghana Country Office, Accra, Ghana
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Huang N, Yang F, Liu X, Bai Y, Guo J, Riem MME. The prevalences, changes, and related factors of child maltreatment during the COVID-19 pandemic: A systematic review. CHILD ABUSE & NEGLECT 2023; 135:105992. [PMID: 36549089 PMCID: PMC9755012 DOI: 10.1016/j.chiabu.2022.105992] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 10/09/2022] [Accepted: 12/07/2022] [Indexed: 05/04/2023]
Abstract
BACKGROUND The impact of the COVID-19 pandemic has been extensive and drastic during the twenty-first century. The increasing phenomenon of child maltreatment during the pandemic is a significant public health concern. OBJECTIVE This study is the first systematic review to analyze and summarize the prevalence rates, risk factors, and protective factors related to child maltreatment during the COVID-19 pandemic. METHODS Four electronic databases (PubMed, Web of Science, Scopus, Embase) were systematically searched. Some potential studies were also identified from the reference lists of previously included articles. The quality of the included studies was assessed by the National Institutes of Health (NIH) Quality Assessment Tool and Critical Appraisal Skills Program (CASP) Quality Assessment Tool. RESULTS A total of 35 articles were included in the analysis, with 16 having prevalence information and 22 having factor information. Sixteen studies were conducted in the US, the other 17 studies were from 12 countries, and only two studies contained mixed countries. The prevalences of child maltreatment during the pandemic varied widely in different types and measurements. The pandemic rates of physical abuse, psychological abuse, neglect, and sexual abuse were 0.1 %-71.2 %, and 4.9 %-61.8 %, 7.3 %-40 % and 1.4 %-19.5 %, respectively. There was a decline in allegations of child maltreatment and an increase in severe cases of child maltreatment during the COVID-19 pandemic. Lockdown measures and their side effects were the main risk factors contributing to child maltreatment. CONCLUSIONS This review calls for targeted measures to prevent child maltreatment during the COVID-19 pandemic and current and future lockdowns and more future replication studies conducted in countries other than the US.
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Affiliation(s)
- Ning Huang
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing 100191, China
| | - Fan Yang
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing 100191, China
| | - Xiaohan Liu
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing 100191, China
| | - Yashuang Bai
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing 100191, China
| | - Jing Guo
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing 100191, China.
| | - Madelon M E Riem
- Behavioral Science Institute, Radboud University, the Netherlands; Clinical Child & Family Studies, Faculty of Behavioral and Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands
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Nono D, Gumisiriza N, Tumwine C, Amaral LJ, Elvis Ainamani H, Musisi S, Colebunders R. Impact of COVID-19 on the well-being of children with epilepsy including nodding syndrome in Uganda: A qualitative study. Epilepsy Behav 2023; 138:108992. [PMID: 36423386 PMCID: PMC9647031 DOI: 10.1016/j.yebeh.2022.108992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 11/04/2022] [Accepted: 11/04/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To investigate the impact of the COVID-19 pandemic and related restrictions on the access and use of health services by children with epilepsy including nodding syndrome in Uganda. METHODS Four focus group discussions (FGD) with parents/caregivers of children with epilepsy and five in-depth interviews with key informants were conducted between April and May 2021 at Butabika National Mental Referral Hospital and Kitgum General Hospital. RESULTS COVID-19-related restrictions, including the halting of non-essential services and activities, and suspension of public transport, created several challenges not only for children with epilepsy and their parents/caregivers but also for their healthcare providers. Study participants described extreme transport restrictions that reduced their access to healthcare care services, increased food insecurity and shortage or inability to afford essential medicines as consequences of COVID-19-related restrictions. However, parents/caregivers and healthcare workers adopted several coping strategies for these challenges. Parents/caregivers mentioned taking on casual work to earn an income to buy food, medicines, and other necessities. Healthcare workers intensified outreach services to affected communities. A positive impact of lockdown measures described by some FGD participants was that most family members stayed at home and were able to care for children with epilepsy in turn. CONCLUSIONS Our study highlights the significant negative impact of the COVID-19 pandemic and related restrictions on access to health services and the general well-being of children with epilepsy. Decentralized epilepsy treatment services and nutritional support could reduce the suffering of children with epilepsy and their families during the ongoing COVID-19 pandemic and similar future emergencies.
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Affiliation(s)
- Denis Nono
- AfriChild Centre for the Study of the African Child, Makerere University, Kampala, Uganda
| | - Nolbert Gumisiriza
- Department of Mental Health, Kabale University School of Medicine, Kabale, Uganda
| | - Christopher Tumwine
- Department of Mental Health, Kabale University School of Medicine, Kabale, Uganda
| | | | | | - Seggane Musisi
- Department of Psychiatry, Makerere University, Kampala, Uganda
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Reeson M, Polzin W, Pazderka H, Agyapong V, Greenshaw AJ, Hnatko G, Wei Y, Szymanski L, Silverstone PH. Child sexual abuse survivors: Differential complex multimodal treatment outcomes for pre-COVID and COVID era cohorts. CHILD ABUSE & NEGLECT 2022; 134:105926. [PMID: 36332320 PMCID: PMC9624116 DOI: 10.1016/j.chiabu.2022.105926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 09/28/2022] [Accepted: 10/07/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Child sexual abuse (CSA) is a form of early-life trauma that affects youth worldwide. In the midst of the current COVID-19 pandemic, it is imperative to investigate the potential impact of added stress on already vulnerable populations. OBJECTIVE The aim of this study was to evaluate the effectiveness of a multimodal treatment program on mental health outcomes for youth CSA survivors aged 8-17. Secondary to this, we explored the potential impact of the COVID-19 on treatment outcomes. PARTICIPANTS AND SETTING Participants of this study were children and youth aged 8-17 who were engaged in a complex multimodal treatment program specifically designed for youth CSA survivors. METHODS Participants were asked to complete self-report surveys at baseline and at the end of two subsequent treatment rounds. Surveys consisted of measures pertaining to: (1) PTSD, (2) depression, (3) anxiety, (4) quality of life, and (5) self-esteem. RESULTS Median scores improved for all groups at all timepoints for all five domains. For the pre-Covid participants, the largest improvements in the child program were reported in depression (36.6 %, p = 0.05); in the adolescent program anxiety showed the largest improvement (-35.7 %, p = 0.006). Improvements were generally maintained or increased at the end of round two. In almost every domain, the improvements of the pre-COVID group were greater than those of the COVID-I group. CONCLUSIONS A complex multimodal treatment program specifically designed for youth CSA survivors has the capacity to improve a number of relevant determinants of mental health and well-being. The COVID-19 pandemic may have retraumatized participants, resulting in treatment resistance.
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Affiliation(s)
- Matthew Reeson
- Department of Psychiatry, University of Alberta, 1E1 Walter Mackenzie Health Sciences Center (WMC), 8440 112 St NW, Edmonton, Canada
| | - Wanda Polzin
- Little Warriors Be Brave Ranch, Edmonton, Alberta, Canada(1)
| | - Hannah Pazderka
- Department of Psychiatry, University of Alberta, 1E1 Walter Mackenzie Health Sciences Center (WMC), 8440 112 St NW, Edmonton, Canada
| | - Vincent Agyapong
- Department of Psychiatry, University of Alberta, 1E1 Walter Mackenzie Health Sciences Center (WMC), 8440 112 St NW, Edmonton, Canada
| | - Andrew J Greenshaw
- Department of Psychiatry, University of Alberta, 1E1 Walter Mackenzie Health Sciences Center (WMC), 8440 112 St NW, Edmonton, Canada
| | - Gary Hnatko
- CASA Child Treatment Center, 10645 63 Ave NW, Edmonton, Canada
| | - Yifeng Wei
- Department of Psychiatry, University of Alberta, 1E1 Walter Mackenzie Health Sciences Center (WMC), 8440 112 St NW, Edmonton, Canada
| | | | - Peter H Silverstone
- Department of Psychiatry, University of Alberta, 1E1 Walter Mackenzie Health Sciences Center (WMC), 8440 112 St NW, Edmonton, Canada.
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Katz C, Varela N, Korbin JE, Najjar AA, Cohen N, Bérubé A, Bishop E, Collin-Vézina D, Desmond A, Fallon B, Fouche A, Haffejee S, Kaawa-Mafigiri D, Katz I, Kefalidou G, Maguire-Jack K, Massarweh N, Munir A, Munoz P, Priolo-Filho S, Tarabulsy GM, Levine DT, Tiwari A, Truter E, Walker-Williams H, Wekerle C. Child protective services during COVID-19 and doubly marginalized children: International perspectives. CHILD ABUSE & NEGLECT 2022; 131:105634. [PMID: 35525629 PMCID: PMC9013646 DOI: 10.1016/j.chiabu.2022.105634] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 03/29/2022] [Accepted: 04/11/2022] [Indexed: 05/04/2023]
Abstract
BACKGROUND Alongside deficits in children's wellbeing, the COVID-19 pandemic has created an elevated risk for child maltreatment and challenges for child protective services worldwide. Therefore, some children might be doubly marginalized, as prior inequalities become exacerbated and new risk factors arise. OBJECTIVE To provide initial insight into international researchers' identification of children who might have been overlooked or excluded from services during the pandemic. PARTICIPANTS AND SETTING This study was part of an international collaboration involving researchers from Brazil, Canada, Colombia, Israel, South Africa, Uganda, the UK and the USA. Researchers from each country provided a written narrative in response to the three research questions in focus, which integrated the available data from their countries. METHOD Three main questions were explored: 1) Who are the children that were doubly marginalized? 2) What possible mechanisms may be at the root? and 3) In what ways were children doubly marginalized? The international scholars provided information regarding the three questions. A thematic analysis was employed using the intersectional theoretical framework to highlight the impact of children's various identities. RESULTS The analysis yielded three domains: (1) five categories of doubly marginalized children at increased risk of maltreatment, (2) mechanisms of neglect consisting of unplanned, discriminatory and inadequate actions, and (3) children were doubly marginalized through exclusion in policy and practice and the challenges faced by belonging to vulnerable groups. CONCLUSION The COVID-19 pandemic can be used as a case study to illustrate the protection of children from maltreatment during worldwide crises. Findings generated the understanding that child protective systems worldwide must adhere to an intersectionality framework to protect all children and promote quality child protection services.
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Affiliation(s)
- Carmit Katz
- Bob Shapell School of Social Work, Tel Aviv University, Ramat Aviv 69978, Israel.
| | - Natalia Varela
- Faculty of social and human sciences, Externado University, Calle 12 No. 1-17 Este, Bogotá, Colombia.
| | - Jill E Korbin
- Department of Anthropology, Case Western Reserve University, USA.
| | - Afnan Attarsh Najjar
- Bob Shapell School of Social Work, Tel Aviv University, Ramat Aviv 69978, Israel
| | - Noa Cohen
- Bob Shapell School of Social Work, Tel Aviv University, Ramat Aviv 69978, Israel
| | - Annie Bérubé
- Department of Psycho-education and Psychology, Université du Québec en Outaouais, Canada.
| | - Ellen Bishop
- School of Geography, Geology and the Environment, University of Leicester, United Kingdom of Great Britain and Northern Ireland.
| | - Delphine Collin-Vézina
- Centre for Research on Children and Families, McGill University, Suite 106, Wilson Hall, 3506 University Street, Montreal, Quebec H3A 2A7, Canada.
| | - Alan Desmond
- Leicester Law School and University of Leicester Migration, Mobility and Citizenship Network (MMCN), United Kingdom of Great Britain and Northern Ireland.
| | - Barbara Fallon
- Factor-Inwentash Faculty of Social Work, the University of Toronto, Canada.
| | - Ansie Fouche
- Department of Social Wellbeing, United Arab Emirates University, United Arab Emirates; Department of Child Protection Social Work, North-West University, South Africa.
| | - Sadiyya Haffejee
- University of Johannesburg, Cnr Kingsway & University Roads, Auckland Park, Johannesburg 2092, South Africa.
| | - David Kaawa-Mafigiri
- Department of Social Work and Social Administration, Makerere University, Uganda.
| | - Ilan Katz
- Social Policy Research Centre (SPRC), University of New South Wales, Sydney, NSW 2052, Australia.
| | - Genovefa Kefalidou
- School of Computing and Mathematical Sciences, University of Leicester, United Kingdom of Great Britain and Northern Ireland.
| | - Katie Maguire-Jack
- University of Michigan, School of Social Work, 1080 S. University Ave., Ann Arbor, MI 48109, USA.
| | - Nadia Massarweh
- Al-Qasemi Educational College of Education, Baqa-El-Gharbia, 3010000, P. O. Box 124, Israel
| | - Akhtar Munir
- Department of Social Work and Sociology, Kohat University of Science and Technology, Kohat, Pakistan
| | - Pablo Munoz
- Nacional Universidad de Colombia, Building 205 - Of. 117, Bogota, DC, Colombia.
| | - Sidnei Priolo-Filho
- Graduate Program of Psychology, the Universidade Tuiuti do Paraná, Rua Sydnei Antonio Rangel Santos 238, Curitiba, Paraná, Brazil
| | - George M Tarabulsy
- Faculty of Social Sciences, Pavillon Charles-De Koninck 1030, Avenue des Sciences-Humaines Suite 3456, Laval University, Quebec, Quebec G1V 0A6, Canada.
| | - Diane Thembekile Levine
- Leicester Institute for Advanced Studies, University of Leicester/School of Media, Communications and Sociology, United Kingdom of Great Britain and Northern Ireland; Centre for Social Development in Africa, University of Johannesburg.
| | - Ashwini Tiwari
- Institute of Public and Preventive Health, Augusta University, 1120 15th St, Augusta, GA 30912, USA.
| | - Elmien Truter
- Social Work Department, Faculty of Health Sciences, North-West University, COMPRES research entity, Vanderbijlpark Campus, South Africa.
| | | | - Christine Wekerle
- Offord Centre for Child Studies, McMaster University, 1280 Main St. W. - MIP 201A, Hamilton, ON L8S 4K1, Canada
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Karbasi Z, Safdari R, Eslami P. The silent crisis of child abuse in the COVID-19 pandemic: A scoping review. Health Sci Rep 2022; 5:e790. [PMID: 35989944 PMCID: PMC9386128 DOI: 10.1002/hsr2.790] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 07/23/2022] [Accepted: 08/01/2022] [Indexed: 11/15/2022] Open
Abstract
Background and Aims The global outbreak of COVID-19 has become an international concern. The lives of children are severely affected by COVID-19 pandemic. There is evidence of a pandemic impact on violence against children. This scoping review study aimed to investigate the effects of the COVID-19 pandemic on child abuse. Methods We searched PubMed, Scopus, and Web of Science databases to retrieve related studies. Regarding the recent incident of COVID-19, the articles were reviewed from 2019 to June 1, 2021. The terms Child abuse and COVID-19 were used in the precise search technique of each database. The search techniques were created to work with any scientific database that used the keywords given. Results In the initial search of scientific databases, 568 articles were retrieved. After applying the inclusion and exclusion criteria during the screening process, 16 papers were included in the scoping review. Twelve articles have mentioned the increase of physical, psychological, and neglect types of abuse. However, sexual violence has not been reported in any of the articles. Four articles reported a reduction in the incidence of child abuse. Conclusion During the COVID-19 pandemic, a crisis occurred in the form of an upsurge in violence toward children, since limits made to diminish the virus, in general, increased the danger to children. Numerous factors such as stress, poverty, financial situation, history of violence, school closures, and lack of contact with support organizations contribute to this phenomenon. Social action and support needed is the right of every child in need in this critical situation.
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Affiliation(s)
- Zahra Karbasi
- Department of Health Information Sciences, Faculty of Management and Medical Information SciencesKerman University of Medical SciencesKermanIran
| | - Reza Safdari
- Department of Health Information Management, School of Allied Medical SciencesTehran University of Medical SciencesTehranIran
| | - Parisa Eslami
- Department of Health Information Management, School of Allied Medical SciencesTehran University of Medical SciencesTehranIran
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Park WJ, Walsh KA. COVID-19 and the unseen pandemic of child abuse. BMJ Paediatr Open 2022; 6:e001553. [PMID: 36645748 PMCID: PMC9471211 DOI: 10.1136/bmjpo-2022-001553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/05/2022] [Indexed: 02/02/2023] Open
Affiliation(s)
- Wesley J Park
- Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
- Department of Continuing Education, University of Oxford, Oxford, UK
| | - Kristen A Walsh
- Department of Family Medicine, Morristown Medical Center, Morristown, New Jersey, USA
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Salisbury T, Qurashi N, Mansoor Q. Change in Incidence and Severity of Abusive Head Trauma in the Paediatric Age Group Pre- and During COVID-19 Lockdown in the North East of England. BRITISH AND IRISH ORTHOPTIC JOURNAL 2022; 18:101-110. [PMID: 36117555 PMCID: PMC9414736 DOI: 10.22599/bioj.265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 06/17/2022] [Indexed: 11/30/2022] Open
Abstract
Background: Abusive head trauma (AHT) is currently the accepted terminology that encompasses previously used terms such as non-accidental injury (NAI) or non-accidental head injury (NAHI) and shaken baby syndrome (SBS). It is AHT and its ocular manifestations that ophthalmologists are vital in identifying and reporting. Objectives: To investigate whether there is a change in the incidence or severity of AHT pre- and during COVID-19 lockdown. Participants and Settings: AHT cases reported between March–June 2019 and March–June 2020. Data will be collected from ***** **** ********* NHS Foundation Trust. Methods: A retrospective comparative study. Main Outcome Measures: Results: Of the pre-lockdown safeguarding referrals, 5/61 (8.19%) had confirmed AHT, and 4/40 (10%) of the during lockdown group were confirmed AHT. The absence of teachers was evident, as in the pre-lockdown group 40% (2) of referrals originated from schools compared to none during the lockdown period. Ophthalmic involvement was not present in any of the pre-lockdown cases and only 50% (2) of the during lockdown cases, with the appropriate proforma only used in one of these cases. Unfortunately, no further statistical testing was meaningful in light of the small sample size. Conclusions: The loss of the early warning detection mechanism provided by schools and health visitors may have contributed to both the change in presentation and severity of cases during the lockdown. There is also a need for ophthalmology and paediatrics to collaborate to ensure AHT cases are thoroughly investigated and documented.
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Garagiola ER, Lam Q, Wachsmuth LS, Tan TY, Ghali S, Asafo S, Swarna M. Adolescent Resilience during the COVID-19 Pandemic: A Review of the Impact of the Pandemic on Developmental Milestones. Behav Sci (Basel) 2022; 12:220. [PMID: 35877290 PMCID: PMC9311591 DOI: 10.3390/bs12070220] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 06/21/2022] [Accepted: 06/24/2022] [Indexed: 02/01/2023] Open
Abstract
This review explores the literature regarding the ways in which the COVID-19 pandemic has affected the navigation of developmental milestones among adolescents, specifically those in late adolescence, across several domains of their lives. The exploration is contextualized globally, focusing on five key areas: mental health, physical health, education, peer relationships, and family relationships. Implications for practice and interventions are explored in each key area to provide recommendations for those working with adolescents, as well as future research. The changes brought about by the pandemic and the readjustment to what some have referred to as the "new normalcy" will undoubtedly have lasting effects on all areas of life for this cohort of adolescents, who have shown remarkable resilience navigating this new and unfamiliar world. These changes are synthesized, with the aim to highlight differences and similarities of the shared experiences of the pandemic globally. After exploring the current realities, this chapter goes on to outline the ways in which the experience of such a significant developmental period of one's life during the COVID-19 pandemic will have an impact on adolescents for years to come. Although it is still impossible to comprehend the long-term effects, in examining proximal effects, we can postulate distal implications and potential future effects, as well as possible ways to mitigate these implications as we transition back to more of what was experienced pre-pandemic life, from a post-pandemic experience.
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Affiliation(s)
- Erica R. Garagiola
- Department of Psychology, Rutgers University, New Brunswick, NJ 08901, USA; (S.G.); (M.S.)
| | - Queenie Lam
- Department of Psychology, Long Island University Brooklyn, Brooklyn, NY 11201, USA;
| | - Louise S. Wachsmuth
- Counseling and Clinical Psychology, Teacher’s College, Columbia University, New York, NY 10027, USA;
| | - Tse Yen Tan
- Yale Center for Emotional Intelligence, New Haven, CT 06511, USA;
| | - Samara Ghali
- Department of Psychology, Rutgers University, New Brunswick, NJ 08901, USA; (S.G.); (M.S.)
| | - Seth Asafo
- Department of Psychiatry, University of Ghana, Korle Bu, Accra P.O. Box GP 4236, Ghana;
| | - Manjari Swarna
- Department of Psychology, Rutgers University, New Brunswick, NJ 08901, USA; (S.G.); (M.S.)
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Groenewald C, Isaacs N, Isaacs D. Adolescent Sexual and Reproductive Health During the COVID-19 Pandemic: A Mini Review. FRONTIERS IN REPRODUCTIVE HEALTH 2022; 4:794477. [PMID: 36303613 PMCID: PMC9580774 DOI: 10.3389/frph.2022.794477] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 02/21/2022] [Indexed: 11/13/2022] Open
Abstract
This mini review explores the impact of the COVID-19 pandemic on adolescent sexual and reproductive health. We conducted a rapid review of the literature across three databases, with a particular focus on the African continent. Few studies have specifically focused on adolescents in Africa and this paper contributes to this paucity of research. Findings revealed the unintended consequences of the pandemic. Studies across several countries showed that the respective lockdown measures restricted adolescents' access to sexual and reproductive health services. The literature also showed increases in adolescent pregnancies during the lockdown, along with increases in reports of sexual violence against adolescents. We conclude this paper by offering recommendations to address these unintended consequences and potentially improve adolescent sexual and reproductive health in African communities.
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Affiliation(s)
- Candice Groenewald
- Centre for Community-Based Research, Human Sciences Research Council, Durban, South Africa
- Psychology Department, Rhodes University, Grahamstown, South Africa
| | - Nazeema Isaacs
- Human and Social Capabilities, Human Sciences Research Council, Cape Town, South Africa
| | - Dane Isaacs
- Human and Social Capabilities, Human Sciences Research Council, Cape Town, South Africa
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28
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Gumisiriza N, Kamoen O, Boven A, Dusabimana A, Nono D, Musisi S, Colebunders R. Impact of the COVID-19 pandemic on persons with epilepsy in Uganda: A descriptive cross-sectional study. Epilepsy Behav 2022; 128:108536. [PMID: 35104731 PMCID: PMC8720867 DOI: 10.1016/j.yebeh.2021.108536] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 12/27/2021] [Accepted: 12/27/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To evaluate the impact of the coronavirus disease 2019 (COVID-19) pandemic on the disease course, lives, and psychosocial wellbeing of persons with epilepsy (PWE) in Uganda. METHODS From April 2021 till May 2021, we carried out a descriptive cross-sectional study at four hospitals located in four regions of Uganda. PWE presenting at the study sites were offered a structured questionnaire in the local language. We used the PHQ-9 questionnaire to screen for depression and the GAD-7 to screen for anxiety. Univariate and multivariable logistic regression was used to investigate factors associated with anxiety and depression. RESULTS A total of 370 responses were collected. The median age of the respondents was 20.5 years (IQR 15-29), and 51.9% were males. During the lockdown period, the seizure frequency increased in 87 (23.5%) PWE. Various forms of physical and psychological violence were inflicted upon 106 (28.6%) PWE. Fifty-eight (15.7%) screened positive for anxiety and 65 (17.6%) positive for depression. Both increased seizure frequency and experienced violence were associated with experiencing depression and anxiety. CONCLUSION The COVID-19 pandemic and lockdown impacted seizure frequency and the psychosocial wellbeing of PWE in Uganda. Increased seizure frequency was associated with higher rates of anxiety and depression. This underlines the importance of continued follow-up of PWE and a low threshold to screen for depression, anxiety, and domestic violence.
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Affiliation(s)
- Nolbert Gumisiriza
- Department of Mental Health, Kabale University School of Medicine, Kabale, Uganda
| | - Olivia Kamoen
- Department of Neurology, Heilig Hart Ziekenhuis, Lier, Belgium
| | - Annelies Boven
- Global Health Institute, University of Antwerp, Antwerp, Belgium
| | | | - Denis Nono
- AfriChild Centre for the Study of the African Child, Makerere University, Kampala, Uganda
| | - Seggane Musisi
- Department of Psychiatry, Makerere University College of Health Sciences, Kampala, Uganda
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Abstract
On March 11, 2020, the World Health Organization declared the coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2, a global pandemic. This pandemic disrupted health care for patients and providers. Uncertainty about COVID-19 played a significant role in the negative mental health impact in older adults. The effect of increasing age on morbidity and mortality in those who came down with COVID-19 has been substantial. The pandemic took a tremendous toll on the mental and physical health of older adults in general with even more severe consequences in more disadvantaged populations within the group.
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Affiliation(s)
- Azziza Bankole
- Virginia Tech Carilion School of Medicine, Carilion Center for Healthy Aging, 2001 Crystal Spring Avenue, Roanoke, VA 24014, USA.
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30
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Alenezi S, Alnamnakani MA, Temsah MH, Murshid R, Alfahad F, Alqurashi H, Alonazy H, Alothman M, Aleissa M. Epidemiology of Child Maltreatment during the COVID-19 Pandemic in Saudi Arabia. CHILDREN (BASEL, SWITZERLAND) 2022; 9:312. [PMID: 35327683 PMCID: PMC8947060 DOI: 10.3390/children9030312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/16/2022] [Accepted: 02/18/2022] [Indexed: 11/21/2022]
Abstract
Child maltreatment, especially during health crises, is a major public health issue transcending cultural, social, and racial contexts. We assessed the sociodemographic and related risk factors associated with the types and rates of child maltreatment. We also assessed the economic, social, and environmental characteristics of child maltreatment victims and their perpetrators, as they were reported to the Saudi National Family Safety Program (NFSP), with consideration of the COVID-19 pandemic’s impact. A secondary data analysis of a retrospective review was conducted to compare types and rates before and during the COVID-19 outbreak, utilizing descriptive and multivariate analyses on anonymized data from the NFSP. According to a predetermined list of relevant risk factors for child maltreatment outlined by the NFSP, these anonymized data were obtained and analyzed with no exclusion criteria (n = 1304). The findings showed that a child’s age correlated significantly and positively with their odds of being physically maltreated; as a child’s age increased by one year, on average, their corresponding predicted odds of being physically maltreatment tended to rise by a factor equal to 7.6% (p < 0.001). Neglected children, compared to those who had not been previously neglected, were predicted to be almost twice (2.23 times more) as likely to be victims of physical maltreatment on average (p < 0.001). Children were notably more likely to experience sexual abuse during the COVID-19 pandemic than those exposed to abuse during the period before (1.69 times). The COVID-19 pandemic was associated with significantly lower odds of physical child maltreatment (47.7% less). This study found no statistically significant effect of the COVID-19 pandemic on children’s odds of being emotionally maltreated (p = 0.169). These findings support the existence of specific risk factors for child maltreatment for both child victims and perpetrators. They also attest to the significant differences between different types of maltreatment. A systematic, proactive system is needed to screen and document child maltreatment with a higher degree of integration with community reporting systems.
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Affiliation(s)
- Shuliweeh Alenezi
- Department of Psychiatry, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia;
- Department of Psychiatry, King Saud University Medical City, King Saud University, Riyadh 12372, Saudi Arabia
- SABIC Psychological Health Research and Applications Chair (SPHRAC), Department of Psychiatry, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia
| | - Mahdi A. Alnamnakani
- Pediatric Department, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia; (M.A.A.); (M.-H.T.); (R.M.); (H.A.)
| | - Mohamad-Hani Temsah
- Pediatric Department, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia; (M.A.A.); (M.-H.T.); (R.M.); (H.A.)
| | - Rozan Murshid
- Pediatric Department, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia; (M.A.A.); (M.-H.T.); (R.M.); (H.A.)
| | - Fahad Alfahad
- Department of Psychiatry, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Haitham Alqurashi
- Department of Psychiatry, Children’s Hospital, Ministry of Health, Taif 26514, Saudi Arabia;
| | - Hana Alonazy
- Pediatric Department, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia; (M.A.A.); (M.-H.T.); (R.M.); (H.A.)
| | - Mohamad Alothman
- Pediatric Emergency Department, King Saud University Medical City, King Saud University, Riyadh 12372, Saudi Arabia;
- National Family Safety Program, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh 11426, Saudi Arabia;
| | - Majid Aleissa
- National Family Safety Program, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh 11426, Saudi Arabia;
- Pediatric Department, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia
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Abuse in Patients with Spinal Cord Injury During the COVID-19 Pandemic. ARCHIVES OF NEUROSCIENCE 2022. [DOI: 10.5812/ans.121167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: One of the chronic diseases with various challenges for patients and caregivers is spinal cord injury (SCI). The spread and prevalence of coronavirus disease 2019 (COVID-19) have been an influential risk factor for abuse. Objectives: The aim of this study was to assess the rate of abuse in patients with SCI during the COVID-19 pandemic. Methods: This cross-sectional descriptive study population was all SCI cases in Ilam, Iran. Researcher-made forms and questionnaires with confirmed validity and reliability, including the demographic characteristics, form and perceived abuse researcher-made questionnaire for people with SCI, were used. The perceived abuse questionnaire for patients with SCI was a researcher-made questionnaire designed based on library studies, interviews with patients, and determination of abuse instances. This instrument consists of 20 questions answered as yes (score 1) or no (score 0). After data collection, statistical analyzes were performed using the SPSS software version 16. Results: According to our results, the mean ± SD of the perceived abuse score by caregivers and patients was 8.48 ± 2.31 and 42.45% during the COVID-19 pandemic, respectively. Moreover, the mean ± SD of the age of patients was 62.86 ± 19.15 years, and the patient abuse increased with elevation in age (P = 0, F = 27.42). The possible abuse score was 0 - 20 divided into three categories of low (20, 20.4%), moderate (76, 76.5%), and high (2, 2%). The perceived abuse score was significantly higher among women and patients with a history of more than 10 years of SCI. Abuse prevalence did not have a significant relationship with income and marital status. Regarding age and abuse, our results showed a rise in perceived abuse scores with an increase in age. Conclusions: The present study showed that it is necessary to take measures to prevent abuse in patients with SCI. Moreover, the prevalence of abuse related to COVID-19 in patients with SCI was high. Therefore, preventive actions need to be proposed in this field.
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Ethical responsibilities of European children's teams facing the resurgent COVID-19 pandemic. Eur J Pediatr 2022; 181:207-213. [PMID: 34241684 PMCID: PMC8266989 DOI: 10.1007/s00431-021-04185-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/15/2021] [Accepted: 06/24/2021] [Indexed: 10/25/2022]
Abstract
The COrona VIrus Disease 2019 (COVID-19) pandemic is posing an unprecedented challenge to healthcare systems around the globe. Europe has been struggling for 1 year now, and despite some encouraging progress (above all, the beginning of vaccination), the second wave is ongoing. Even though children are less affected than adults, the COVID-19 pandemic-and in particular the measures to counter it-is having a considerable impact on the paediatric healthcare setting. It is, therefore, the duty of paediatric teams in Europe to prepare for the challenges ahead. We wish to contribute to this necessary preparedness in two ways: firstly, by assessing the direct and indirect impact of the pandemic on children and on the paediatric setting; secondly, and more importantly, by identifying the various responsibilities of paediatric healthcare professionals, in light of established ethical principles. Only abiding by these responsibilities will it be possible to ensure that ill children and their families are properly supported even in these difficult times and to grant that decisions about children's healthcare remain morally justified and lawful. What is Known: • The COVID-19 outbreak is posing an unprecedented challenge to healthcare systems around the globe • Despite the children are less affected than adults, the COVID-19 pandemic is having a huge impact also on paediatric setting What is New: • The COVID-19 pandemic lays out specific responsibilities of paediatric professionals towards our pa-tients, society and ourselves • The paediatric teams in Europe should assess the direct and indirect impact of the pandemic on the chil-dren and on the paediatric settings, ensuring consistency between centres and across regions in Europe.
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Malamsha MP, Sauli E, Luhanga ET. Development and Validation of a Mobile Game for Culturally Sensitive Child Sexual Abuse Prevention Education in Tanzania: Mixed Methods Study. JMIR Serious Games 2021; 9:e30350. [PMID: 34747703 PMCID: PMC8663517 DOI: 10.2196/30350] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 09/05/2021] [Accepted: 10/25/2021] [Indexed: 11/15/2022] Open
Abstract
Background Globally, 3 out of 20 children experience sexual abuse before the age of 18 years. Educating children about sexual abuse and prevention is an evidence-based strategy that is recommended for ending child sexual abuse. Digital games are increasingly being used to influence healthy behaviors in children and could be an efficient and friendly approach to educating children about sexual abuse prevention. However, little is known on the best way to develop a culturally sensitive game that targets children in Africa—where sexual education is still taboo—that would be engaging, effective, and acceptable to parents and caretakers. Objective This study aimed to develop a socioculturally appropriate, mobile-based game for educating young children (<5 years) and parents and caretakers in Tanzania on sexual abuse prevention. Methods HappyToto children’s game was co-designed with 111 parents and caretakers (females: n=58, 52.3%; male: n=53, 47.7%) of children below 18 years of age and 24 child experts in Tanzania through surveys and focus group discussions conducted from March 2020 to April 2020. From these, we derived an overview of topics, sociocultural practices, social environment, and game interface designs that should be considered when designing child sexual abuse prevention (CSAP) education interventions. We also conducted paper prototyping and storyboarding sessions for the game’s interface, storylines, and options. To validate the application’s prototype, 32 parents (females: n=18, 56%; males: n=14, 44%) of children aged 3-5 years and 5 children (females: n=2, 40%; males: n=3, 60%) of the same age group played the game for half an hour on average. The parents undertook a pre-post intervention assessment on confidence and ability to engage in CSAP education conversations, as well as exit surveys on the usability and sociocultural acceptability of the game, while children were quizzed on the topics covered and their enjoyment of the game. Results Parents and caregivers showed interest in the developed game during the conducted surveys, and each parent on average navigated through all the parts of the game. The confidence level of parents in talking about CSAP increased from an average of 3.56 (neutral) before using the game to 4.9 (confident) after using the game. The ability scores, calculated based on a range of topics included in CSAP education talks with children, also increased from 5.67 (out of 10) to 8.8 (out of 10) after the game was played. Both confidence level and ability scores were statistically significant (P<.001). All 5 children were interested in the game and enjoyed the game-provided activities. Conclusions The HappyToto game can thus be an effective technology-based intervention for improving the knowledge and skills of parents and children in CSAP education.
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Affiliation(s)
- Maria Proches Malamsha
- School of Computation and Communication Science and Engineering, Nelson Mandela African Institution of Science and Technology, Arusha, United Republic of Tanzania
| | - Elingarami Sauli
- School of Life Science and Bioengineering, Nelson Mandela African Institution of Science and Technology, Arusha, United Republic of Tanzania
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Gonzalez-Domenech P, Romero-Béjar JL, Gutierrez-Rojas L, Jimenez-Fernandez S, Diaz-Atienza F. Behavioural Difficulties in Children and Adolescents with Mental Disorders under Extreme Situations. J Clin Med 2021; 10:jcm10214876. [PMID: 34768396 PMCID: PMC8584948 DOI: 10.3390/jcm10214876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/19/2021] [Accepted: 10/20/2021] [Indexed: 11/22/2022] Open
Abstract
In 2020, the Governments of many countries maintained different levels of confinement of the population due to the pandemic that produced the COVID-19. There are few studies published on the psychological impact in the child and adolescent population diagnosed with mental disorders, especially during the home confinement stage. Explanatory models based on socio-demographic and clinical variables provide an approximation to level changes in different dimensions of behavioural difficulties. A categorical-response logistic ordinal regression model, based on a cross-sectional study with 139 children and adolescents diagnosed with mental disorders is performed for each dimension under analysis. Most of the socio-demographic and clinical explanatory variables considered (24 of 26) were significant at population level for at least one of the four dimensions of behavioural difficulties (15 response variables) under analysis. Odds-ratios were interpreted to identify risk or protective factors increasing or decreasing severity in the response variable. This analysis provides useful information, making it possible to more readily anticipate critical situations due to extreme events, such as a confinement, in this population.
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Affiliation(s)
- Pablo Gonzalez-Domenech
- Faculty of Medicine, University of Granada, Avenida Ilustración, 60, 18016 Granada, Spain; (P.G.-D.); (L.G.-R.); (S.J.-F.); (F.D.-A.)
| | - José Luis Romero-Béjar
- Department of Statistics and Operational Research, University of Granada, Avda Fuentenueva, 18071 Granada, Spain
- Correspondence:
| | - Luis Gutierrez-Rojas
- Faculty of Medicine, University of Granada, Avenida Ilustración, 60, 18016 Granada, Spain; (P.G.-D.); (L.G.-R.); (S.J.-F.); (F.D.-A.)
| | - Sara Jimenez-Fernandez
- Faculty of Medicine, University of Granada, Avenida Ilustración, 60, 18016 Granada, Spain; (P.G.-D.); (L.G.-R.); (S.J.-F.); (F.D.-A.)
| | - Francisco Diaz-Atienza
- Faculty of Medicine, University of Granada, Avenida Ilustración, 60, 18016 Granada, Spain; (P.G.-D.); (L.G.-R.); (S.J.-F.); (F.D.-A.)
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Atim MG, Kajogoo VD, Amare D, Said B, Geleta M, Muchie Y, Tesfahunei HA, Assefa DG, Manyazewal T. COVID-19 and Health Sector Development Plans in Africa: The Impact on Maternal and Child Health Outcomes in Uganda. Risk Manag Healthc Policy 2021; 14:4353-4360. [PMID: 34703344 PMCID: PMC8541793 DOI: 10.2147/rmhp.s328004] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 10/08/2021] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION Health Sector Development Plans (HSDPs) aim to accelerate movement towards achieving sustainable development goals for health, reducing inequalities, and ending poverty. Reproductive, maternal, newborn and child health (RMNCH) services are vulnerable to economic imbalances, including health insecurity, unmet need for healthcare, and low health expenditure. The same vulnerability influences the potential of a country to combat global outbreaks such as the COVID-19. We aimed to provide some important insights into the impacts of COVID-19 on RMNCH indicators and outcomes of the HSDP in Uganda. METHODS We conducted a descriptive study of secondary data obtained from the Ugandan government-led portals, supplemented by analyses of relevant articles published up to 06 May 2021 and deposited in PubMed. RESULTS Through synthesizing actionable and relevant evidence, we realized that RMNCH in Uganda is highly affected by the COVID-19 pandemic and the lockdown measures. The impact was across immunization, antenatal, sexual and reproductive health, emergency and obstetric, and postnatal care services. There was a decline sharply by 9.6% for under-five vitamin A coverage, 9% for DPT3HibHeb3 coverage, 6.8% for measles vaccination coverage, 6% for isoniazid preventive therapy coverage, and 3% for facility-based deliveries. Maternal and under-five deaths increased by 7.6% and 4%, respectively. Outreaches were rarely conducted in the lockdown period. CONCLUSION The COVID-19 pandemic has created a multitude of questions regarding the optimal policies to mitigate the disease while minimizing the unintended detrimental consequences of RMNCH. The lockdown restrictions threatened to reverse the progress made on the national HSDP for RMNCH. In Uganda, where young women are vulnerable to early marriage, unintended pregnancies, and unsafe abortion, access to RMNCH services should continue regardless of the COVID-19 status in the country. We urge that Uganda and other African countries should build resilient and sustainable health systems that can withstand emerging diseases like the COVID-19.
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Affiliation(s)
- Mary Gorret Atim
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Public Health, Busitema University Faculty of Health Sciences, Mbale, Uganda
| | - Violet Dismas Kajogoo
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Mafie District Hospital, Mafia Island, Pwani Region, Tanzania
| | - Demeke Amare
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Ethiopian Food and Drug Administration Authority (EFDA), Addis Ababa, Ethiopia
| | - Bibie Said
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Kibong’oto National Tuberculosis Hospital, Kilimanjaro, Tanzania
| | - Melka Geleta
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Federal Ministry of Health, Addis Ababa, Ethiopia
| | - Yilkal Muchie
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- All Africa Leprosy and Rehabilitation Training (ALERT) Centre, Addis Ababa, Ethiopia
| | - Hanna Amanuel Tesfahunei
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Hager Biomedical Research Institute, Asmara, Eritrea
| | - Dawit Getachew Assefa
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Nursing, College of Medical and Health Sciences, Dilla University, Dilla, Ethiopia
| | - Tsegahun Manyazewal
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Are Working Children in Developing Countries Hidden Victims of Pandemics? SOCIAL SCIENCES-BASEL 2021. [DOI: 10.3390/socsci10090321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The consequences of the recent pandemic have been disproportionately disruptive to several social groups, including children. As developing economies have been firefighting the recent pandemic, the welfare of minors could be affected and children’s economic exploitation and abuse could increase. Therefore, the present research aims to shed light on and to investigate the association between child labour in developing countries and pandemics, including the coronavirus, through conducting a systematic literature review on previous empirical studies. The present research concludes that previous studies on non-COVID-19 pandemics have mainly focused on the African economies, while studies on the recent pandemic have focused on Asian countries. In addition, differences were observed in relation to the methodological approaches and the characteristics of minor employees and the protection services in certain countries have proven to be insufficient. Suggestions for future research and policy implications are presented.
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Pattenden J, Campling L, Castañón Ballivián E, Gras C, Lerche J, O'Laughlin B, Oya C, Pérez‐Niño H, Sinha S. Introduction: Covid-19 and the conditions and struggles of agrarian classes of labour. JOURNAL OF AGRARIAN CHANGE 2021; 21:582-590. [PMID: 38607818 PMCID: PMC8447154 DOI: 10.1111/joac.12440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 05/31/2021] [Indexed: 05/17/2023]
Abstract
Covid-19 generated a crisis in capitalism, but not of capitalism. Capitalism reproduces itself in crisis and in ways that have significant but uneven impacts on the conditions and struggles of agrarian classes of labour. This article explores preliminary studies of how Covid-19 has affected agrarian social formations in Africa, Asia and Latin America and the farmers, petty commodity producers, labourers and agribusinesses who populate them. It considers some of the implications for wage-labour, agriculture, accumulation and social reproduction including care work. And it briefly considers Covid-19's political impacts-in terms of the role of the state and possibilities for challenging capitalism, its violence and its ecological crisis.
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Affiliation(s)
| | - Liam Campling
- School of Business and ManagementQueen Mary University of LondonLondonUK
| | | | - Carla Gras
- National Council of Scientific and Technological Research (CONICET)Buenos AiresArgentina
- Instituto de Altos Estudios SocialesUniversity of San MartínBuenos AiresArgentina
| | - Jens Lerche
- School of Business and ManagementQueen Mary University of LondonLondonUK
| | | | - Carlos Oya
- School of Business and ManagementQueen Mary University of LondonLondonUK
| | | | - Shreya Sinha
- Department of GeographyUniversity of CambridgeCambridgeUK
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Sserwanja Q, Adam MB, Kawuki J, Olal E. COVID-19 in conflict border regions: a case of South Kordofan, Sudan. Confl Health 2021; 15:34. [PMID: 33947451 PMCID: PMC8094973 DOI: 10.1186/s13031-021-00370-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 04/21/2021] [Indexed: 11/21/2022] Open
Abstract
The novel coronavirus disease (COVID-19) was first reported in Sudan on 13 March 2020. Since then, Sudan has experienced one of the highest rates of COVID-19 spread and fatalities in Africa. One year later, as per 22 March 2021, Sudan had registered 29,661 confirmed cases and 2,028 deaths with a case fatality rate (CFR) of 6.8 %. By 12 December 2020, of the 18 states in Sudan, South Kordofan had the fifth highest CFR of 17.4 %, only surpassed by the other conflict affected North (57.5 %), Central (50.0 %) and East (31.8 %) Darfur States. By late March 2021, just three months from December 2020, the number of cases in South Kordofan increased by 100 %, but with a significant decline in the CFR from 17.4 to 8.5 %. South Kordofan is home to over 200,000 poor and displaced people from years of destructive civil unrests. To date, several localities such as the Nubba mountains region remain under rebel control and are not accessible. South Kordofan State Ministry of Health in collaboration with the federal government and non-governmental organizations set up four isolation centres with 40 total bed capacity, but with only two mechanical ventilators and no testing centre. There is still need for further multi-sectoral coalition and equitable allocation of resources to strengthen the health systems of rural and conflict affected regions. This article aims at providing insight into the current state of COVID-19 in South Kordofan amidst the second wave to address the dearth of COVID-19 information in rural and conflict affected regions.
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Affiliation(s)
- Quraish Sserwanja
- Programmes Department, GOAL Global, Khartoum, Sudan. .,Global Health Uganda, Mawanda Road, Plot 667, P.0 Box 33842, Kampala, Uganda.
| | | | - Joseph Kawuki
- Centre for Health Behaviors Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong- SAR, China
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Magala Ssekandi A, Sserwanja Q, Olal E, Kawuki J, Bashir Adam M. Corticosteroids Use in Pregnant Women with COVID-19: Recommendations from Available Evidence. J Multidiscip Healthc 2021; 14:659-663. [PMID: 33758509 PMCID: PMC7981138 DOI: 10.2147/jmdh.s301255] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 03/03/2021] [Indexed: 01/08/2023] Open
Abstract
Pregnant women experience immune system changes to accommodate and tolerate the growing foetus, these changes also increase their susceptibility to viral infections such as SARS-COV-2. COVID-19 in pregnancy increases the likelihood of hospital admission and intensive care compared to non-pregnant women. Early administration of low-dose corticosteroids to patients with acute respiratory distress syndrome can reduce all-cause mortality among such patients. However, during pregnancy, prolonged use of corticosteroids that readily cross the placenta like dexamethasone can negatively impact both the mother and foetus. Evidence is thus needed on the choice, timing, and duration for corticosteroids use among pregnant women with COVID-19. This article aims to provide evidence on corticosteroid use in pregnant women with COVID-19. The RECOVERY trial deduced that low-dose dexamethasone (6 milligrams) reduced mortality by up to one-third among COVID-19 patients on mechanical ventilation and one-fifth among those who received supplemental oxygen. Pregnant women in this trial received either oral prednisolone or intravenous hydrocortisone. Based on the RECOVERY trial findings, the Royal College of Obstetricians and Gynaecologists (RCOG) recommends that pregnant women with moderate-to-severe COVID-19 receive oral prednisolone or intravenous hydrocortisone. However, currently, the World Health Organisation (WHO) does not explicitly specify which corticosteroid to use among pregnant women with moderate-to-severe COVID-19. We also note that there are no published articles on corticosteroid use among pregnant women with severe COVID-19 in Africa.
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Affiliation(s)
| | | | | | - Joseph Kawuki
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
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