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Dowling-Cullen C, Sakellariou D. Decision-making regarding accessing paediatric unscheduled healthcare during the COVID-19 pandemic: a mixed methods rapid review and thematic synthesis. BMJ Open 2024; 14:e085796. [PMID: 39053956 DOI: 10.1136/bmjopen-2024-085796] [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] [Indexed: 07/27/2024] Open
Abstract
OBJECTIVE Reductions in paediatric unscheduled healthcare utilisation were seen during the COVID-19 pandemic, with concerns around their impact on children's health. The reasons for these changes are not well described. This review aims to explore the factors reported by parents that influenced their decision-making around accessing paediatric unscheduled healthcare during the COVID-19 pandemic. DESIGN Mixed methods rapid review and thematic synthesis based on the Enhancing Transparency of Reporting the Synthesis of Qualitative research framework. DATA SOURCES MEDLINE, Embase, Web of Science, PsycEXTRA, PsycINFO, Global Health, Global Index Medicus, Dissertations and Theses Global, Google Scholar and OAISter. Studies published from January 2020 to July 2023 were included. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Qualitative, quantitative and mixed methods studies that assessed the perspectives of parents on decisions to access or delay or avoid accessing paediatric unscheduled healthcare during the COVID-19 pandemic. DATA EXTRACTION AND SYNTHESIS Nvivo 14.23.0 was used to code results the of the primary studies and develop themes, following a thematic synthesis approach. RESULTS Twelve studies were included, all from high-income settings, mainly in Europe. The studies were conducted across varying times and levels of COVID-19-related restrictions. The principal descriptive themes identified were (i) concerns about COVID-19 infection, (ii) balancing and navigating risks, (iii) perception of healthcare service status and conditions and (iv) perception of information and advice. These were developed into analytic themes to further describe the decision-making process. CONCLUSIONS Parents balanced a range of risks, concerns, advice and responsibilities when considering accessing paediatric unscheduled healthcare during the COVID-19 pandemic. External sources of advice and information were important; misconceptions around public health advice may reflect the multitude of information sources and the rapidly changing circumstances of the pandemic. Public health policy and planning should consider parent perspectives when developing measures to ensure equitable access to appropriate paediatric healthcare services.
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Kelly A, Guest K, Chamroeun U, Sinat D, Saroeun Y, Rowland AG. The Impact of COVID-19 on Children, Young People, and Families in Sihanoukville, Cambodia: The Mitigating Work of M'Lop Tapang. Compr Child Adolesc Nurs 2024; 47:115-130. [PMID: 38922696 DOI: 10.1080/24694193.2024.2354329] [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: 04/04/2023] [Accepted: 05/07/2024] [Indexed: 06/28/2024]
Abstract
Globally, children have been adversely affected by the wide variety of impacts of SARS-CoV-2 (Coronavirus | COVID-19). Vulnerable children who depend on the support of education and health and social care systems were left unprotected as these systems were weakened by the pandemic. COVID-19 has exposed the already fragile situations in which many children and young people live and that thousands of children and young people would need ongoing support but remained invisible to statutory authorities. COVID-19 has also been a stark reminder of the vulnerability of individuals and societies and it has exposed deep divisions, inequalities, and injustices between different countries and groups of people. M'Lop Tapang is a local nonprofit organization registered with the Royal Government of Cambodia. This report discusses the efforts of M'Lop Tapang following the declaration of the COVID-19 global pandemic in early 2020, to address the local community needs; to ensure the voices of children remained heard; and to promote children's rights remaining a priority throughout the remainder of the pandemic.What is already known on this topicVulnerable children are dependent on remaining visible to education and health and social care systems to ensure they are safeguarded and protected.Poor safety, financial instability, unemployment, challenges to children's rights and displacement all have the potential to increase vulnerabilities and intensify inequalities.The COVID-19 global pandemic has widened the global lens for the nursing profession and to effect change, children's nurses need to think globally and act locally.What this study addsThis study provides insights into the challenges faced by children and families in Sihanoukville, Cambodia, during the early part of the SARS-CoV-2 (COVID19) pandemic in 2020-2021.The economic impact of COVID-19 on children and families living in Sihanoukville, Cambodia, between 2020 and 2021 is reviewed.The learning from the pragmatic and rapid interventions of M'Lop Tapang, Sihanoukville during the early phase of the SARS-CoV-2 (COVID-19) pandemic, are of use in other countries around the world in future epidemic or pandemic situations.
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Affiliation(s)
- Amanda Kelly
- School of Health Sciences, University of Manchester, Manchester, UK
| | - Keeley Guest
- Faculty of Health, Liverpool John Moores University, Liverpool, UK
| | | | - Dom Sinat
- M'Lop Tapang, Sihanoukville, Cambodia
| | | | - Andrew Graeme Rowland
- M'Lop Tapang, Sihanoukville, Cambodia
- School of health and Society, University of Salford, Salford, UK
- Department of Community Paediatrics, Manchester Local Care Organisation, Manchester University NHS Foundation Trust, Manchester, UK
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Vincent J, Santhakumari RM, Nalinakumari Kesavan Nair A, Sharahudeen A, K P A, Suresh MM, Valamparampil MJ, A V G, Sujatha C, Thekkumkara Surendran A. What our children lost and gained at the time of school closure during the Covid-19 pandemic: a study on psychological distress, behavioural concerns and protective factors of resilience among preschool children in Kerala, India. Int J Equity Health 2024; 23:14. [PMID: 38263155 PMCID: PMC10807164 DOI: 10.1186/s12939-023-02090-3] [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: 03/28/2023] [Accepted: 12/28/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND The pandemic has put at risk the social and emotional development of children on account of the paucity of arenas for social interaction. This study from Kerala, India was conducted to assess the resilience factors, behavioural concerns, psychological distress symptoms among the children aged 3 to 5 years. We also tried to look into the lost opportunities that could have aided the social and emotional development of children like peer interaction, child care hours. METHODS The cross-sectional study was conducted among the children aged 3 to 5 years. A total of 535 children attending the immunisation clinics were enrolled by consecutive sampling. Devereux Early Childhood Assessment P2 (DECA P2) questionnaire was used to assess the levels of resilient factors and behavioural concerns in the study population. RESULTS We observed a high proportion of children in the area of need category of protective factors under DECA P2. The proportion of children falling under area of concern was 64.5%, 49%, 68.4% for attachment/relationship, self-regulation, and initiative respectively. 24.9% study subjects have a behavioural concern score that puts them in the area of need category. The logistic regression model we created identified 'Male Gender,' 'Mothers could spend only less time for child care' and 'electronic devices used as pacifier' as significant predictors for belonging to Area of need Behavioural Concerns T score category. CONCLUSION A large proportion of children aged between 3 to 5 years with reported behavioural concerns and lack of protective factors for socioemotional development. This can be attributed partly to the ongoing pandemic and its associated restrictions. The increased child care hours invested by parents or grandparents could have sized down the full impact that the pandemic would have had on the socio emotional development of the child. Increased time spent using electronic devices coupled with dwindled opportunities for interaction with peers have been notable challenges.
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Affiliation(s)
- Jose Vincent
- Department of Community Medicine, Amala Institute of Medical Sciences, Thrissur, Kerala, India.
| | | | | | - Anisha Sharahudeen
- Government Medical College Thiruvananthapuram, Thiruvananthapuram, Kerala, 695011, India
| | - Asvini K P
- Government Medical College Thiruvananthapuram, Thiruvananthapuram, Kerala, 695011, India
| | | | - Mathew J Valamparampil
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, 695011, India
| | - Gayathri A V
- WHO medical consultant, NTEP, Kerala, Ernakulam, India
| | - Chintha Sujatha
- Government Medical College Thiruvananthapuram, Thiruvananthapuram, Kerala, 695011, India
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Guastaferro K, Sheldrick RC, Nunez-Pepen R, Ortiz M, Much-Hichos M, Trieu D, Broder-Fingert S, Feinberg E. Commentary: How Lay Health Workers in a Federally Qualified Community Health Center Filled a Critical Void in a Public Health Crisis. FAMILY & COMMUNITY HEALTH 2023; 46:259-262. [PMID: 37703514 PMCID: PMC10584361 DOI: 10.1097/fch.0000000000000379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Affiliation(s)
- Kate Guastaferro
- Department of Social and Behavioral Sciences, New York University, New York (Dr Guastaferro); Department of Psychiatry, University of Massachusetts Chan Medical School, Worcester (Dr Sheldrick); Department of Pediatrics, Boston Medical Center, Boston, Massachusetts (Mss Nunez-Pepen and Much-Hichos); Department of Pediatrics, Boston Medical Center, Dorchester, Massachusetts (Mss Ortiz and Trieu); University of Massachusetts Chan Medical School, Worcester (Dr Broder-Fingert); and Brown University, Providence, Rhode Island (Dr Feinberg)
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Theron LC, Cockcroft K, Annalakshmi N, Rodgers JG, Akinduyo TE, Fouché A. Emerging Adult Resilience to the Early Stages of the COVID-Pandemic: A Systematic Scoping Review. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01585-y. [PMID: 37698747 DOI: 10.1007/s10578-023-01585-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/08/2023] [Indexed: 09/13/2023]
Abstract
Human resilience to COVID-19 related stressors remains a pressing concern following the aftereffects of the pandemic and in the face of probable future pandemics. In response, we systematically scoped the available literature (n = 2030 records) to determine the nature and extent of research on emerging adults' adaptive responses to COVID-19 stressors in the early stages of the pandemic. Using a multisystem resilience framework, our narrative review of 48 eligible studies unpacks the personal, relational, institutional and/or physical ecological resources that enabled positive emerging adult outcomes to COVID-18 stressors. We found that there is a geographical bias in studies on this topic, with majority world contexts poorly represented. Resources leading to positive outcomes foregrounded psychological and social support, while institutional and ecological supports were seldom mentioned. Multisystemic combinations of resources were rarely considered. This knowledge has valuable implications for understanding resilience in the context of other large-scale adverse conditions.
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Affiliation(s)
- L C Theron
- Department of Educational Psychology, University of Pretoria, Pretoria, South Africa.
- Faculty of Education, University of Pretoria, Groenkloof Campus, Pretoria, 0002, South Africa.
| | - K Cockcroft
- Department of Psychology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa
| | - N Annalakshmi
- Psychology Department, Bharathiar University, Coimbatore, India
| | - J G Rodgers
- Department of Psychology, School of Health Sciences, North-West University, Vanderbijlpark, South Africa
| | - T E Akinduyo
- Department of Educational Psychology, University of Pretoria, Pretoria, South Africa
| | - A Fouché
- Department of Social Wellbeing, United Arab Emirates University, Al Ain, United Arab Emirates
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D’Souza D, Empringham J, Pechlivanoglou P, Uleryk EM, Cohen E, Shulman R. Incidence of Diabetes in Children and Adolescents During the COVID-19 Pandemic: A Systematic Review and Meta-Analysis. JAMA Netw Open 2023; 6:e2321281. [PMID: 37389869 PMCID: PMC10314307 DOI: 10.1001/jamanetworkopen.2023.21281] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 05/15/2023] [Indexed: 07/01/2023] Open
Abstract
Importance There are reports of increasing incidence of pediatric diabetes since the onset of the COVID-19 pandemic. Given the limitations of individual studies that examine this association, it is important to synthesize estimates of changes in incidence rates. Objective To compare the incidence rates of pediatric diabetes during and before the COVID-19 pandemic. Data Sources In this systematic review and meta-analysis, electronic databases, including Medline, Embase, the Cochrane database, Scopus, and Web of Science, and the gray literature were searched between January 1, 2020, and March 28, 2023, using subject headings and text word terms related to COVID-19, diabetes, and diabetic ketoacidosis (DKA). Study Selection Studies were independently assessed by 2 reviewers and included if they reported differences in incident diabetes cases during vs before the pandemic in youths younger than 19 years, had a minimum observation period of 12 months during and 12 months before the pandemic, and were published in English. Data Extraction and Synthesis From records that underwent full-text review, 2 reviewers independently abstracted data and assessed the risk of bias. The Meta-analysis of Observational Studies in Epidemiology (MOOSE) reporting guideline was followed. Eligible studies were included in the meta-analysis and analyzed with a common and random-effects analysis. Studies not included in the meta-analysis were summarized descriptively. Main Outcomes and Measures The primary outcome was change in the incidence rate of pediatric diabetes during vs before the COVID-19 pandemic. The secondary outcome was change in the incidence rate of DKA among youths with new-onset diabetes during the pandemic. Results Forty-two studies including 102 984 incident diabetes cases were included in the systematic review. The meta-analysis of type 1 diabetes incidence rates included 17 studies of 38 149 youths and showed a higher incidence rate during the first year of the pandemic compared with the prepandemic period (incidence rate ratio [IRR], 1.14; 95% CI, 1.08-1.21). There was an increased incidence of diabetes during months 13 to 24 of the pandemic compared with the prepandemic period (IRR, 1.27; 95% CI, 1.18-1.37). Ten studies (23.8%) reported incident type 2 diabetes cases in both periods. These studies did not report incidence rates, so results were not pooled. Fifteen studies (35.7%) reported DKA incidence and found a higher rate during the pandemic compared with before the pandemic (IRR, 1.26; 95% CI, 1.17-1.36). Conclusions and Relevance This study found that incidence rates of type 1 diabetes and DKA at diabetes onset in children and adolescents were higher after the start of the COVID-19 pandemic than before the pandemic. Increased resources and support may be needed for the growing number of children and adolescents with diabetes. Future studies are needed to assess whether this trend persists and may help elucidate possible underlying mechanisms to explain temporal changes.
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Affiliation(s)
- Daniel D’Souza
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada
| | - Jessica Empringham
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Petros Pechlivanoglou
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | | | - Eyal Cohen
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Edwin S.H. Leong Centre for Healthy Children, University of Toronto, Toronto, Ontario, Canada
| | - Rayzel Shulman
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Division of Endocrinology, Hospital for Sick Children, Toronto, Ontario, Canada
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Guo S, Naccarella L, Riggs E. Promoting Child Health Equity through Health Literacy. CHILDREN (BASEL, SWITZERLAND) 2023; 10:975. [PMID: 37371207 DOI: 10.3390/children10060975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 05/28/2023] [Indexed: 06/29/2023]
Abstract
Every child has the right to a fulfilling and thriving life [...].
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Affiliation(s)
- Shuaijun Guo
- Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, VIC 3052, Australia
- Department of Pediatrics, University of Melbourne, Melbourne, VIC 3052, Australia
| | - Lucio Naccarella
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3053, Australia
| | - Elisha Riggs
- Intergenerational Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, VIC 3052, Australia
- Department of General Practice, University of Melbourne, Melbourne, VIC 3000, Australia
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Newlove‐Delgado T, Russell AE, Mathews F, Cross L, Bryant E, Gudka R, Ukoumunne OC, Ford TJ. Annual Research Review: The impact of Covid-19 on psychopathology in children and young people worldwide: systematic review of studies with pre- and within-pandemic data. J Child Psychol Psychiatry 2023; 64:611-640. [PMID: 36421049 PMCID: PMC10952503 DOI: 10.1111/jcpp.13716] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/02/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND The high volume and pace of research has posed challenges to researchers, policymakers and practitioners wanting to understand the overall impact of the pandemic on children and young people's mental health. We aimed to search for and review the evidence from epidemiological studies to answer the question: how has mental health changed in the general population of children and young people? METHODS Four databases (Medline, CINAHL, EMBASE and PsychINFO) were searched in October 2021, with searches updated in February 2022. We aimed to identify studies of children or adolescents with a mean age of 18 years or younger at baseline, that reported change on a validated mental health measure from prepandemic to during the pandemic. Abstracts and full texts were double-screened against inclusion criteria and quality assessed using a risk of bias tool. Studies were narratively synthesised, and meta-analyses were performed where studies were sufficiently similar. RESULTS 6917 records were identified, and 51 studies included in the review. Only four studies had a rating of high quality. Studies were highly diverse in terms of design, setting, timing in relation to the pandemic, population, length of follow-up and choice of measure. Methodological heterogeneity limited the potential to conduct meta-analyses across studies. Whilst the evidence suggested a slight deterioration on some measures, overall, the findings were mixed, with no clear pattern emerging. CONCLUSIONS Our findings highlight the need for a more harmonised approach to research in this field. Despite the sometimes-inconsistent results of our included studies, the evidence supports existing concerns about the impact of Covid-19 on children's mental health and on services for this group, given that even small changes can have a significant impact on provision at population level. Children and young people must be prioritised in pandemic recovery, and explicitly considered in planning for any future pandemic response.
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Affiliation(s)
| | | | - Frances Mathews
- University of Exeter Medical SchoolUniversity of ExeterExeterUK
| | - Lauren Cross
- Department of PsychiatryUniversity of CambridgeCambridgeUK
| | - Eleanor Bryant
- University of Exeter Medical SchoolUniversity of ExeterExeterUK
| | - Rebecca Gudka
- University of Exeter Medical SchoolUniversity of ExeterExeterUK
| | - Obioha C. Ukoumunne
- University of Exeter Medical SchoolUniversity of ExeterExeterUK
- NIHR Applied Research Collaboration South West Peninsula (PenARC)ExeterUK
| | - Tamsin J. Ford
- Department of PsychiatryUniversity of CambridgeCambridgeUK
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N’dure Baboudóttir F, Jandi Z, Indjai B, Einarsdóttir J, Gunnlaugsson G. "Just Standing Still": A Qualitative Study on Adolescents' Experiences of School Closures Due to Emerging COVID-19 in Bissau, Guinea-Bissau. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5265. [PMID: 37047881 PMCID: PMC10094378 DOI: 10.3390/ijerph20075265] [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: 03/09/2023] [Accepted: 03/22/2023] [Indexed: 06/19/2023]
Abstract
The COVID-19 pandemic affected the lives of children in a myriad of ways across the world. It exposed and aggravated existing inequalities between children within countries and across continents and hampered education. In Guinea-Bissau, school closure was one of the first restrictions implemented to confront the emerging pandemic. The aim was to describe and analyse the experiences of adolescents of school closures in the capital Bissau, their concerns about their future and manifestations of inequality. Data were collected by semi-structured, open-ended interviews with 30 adolescents aged 15-17 years three months into the pandemic during an enforced state of emergency. A thematic analysis identified five themes: appreciation of education, feeling left behind, being stuck in confinement, suggestions for support, and a disrupted future. The results highlight global rather than local inequalities in the demographic, manifested by a lack of targeted educational support for public and private school students; they knew about such efforts elsewhere. The school-attending participants suggested ways to mitigate disruptions in their education, while those out of school aiming to return saw their possibilities fading away. They appreciated education for personal and national benefits, and participants worried about the long-term effects of the pandemic. The study highlighted education loss for all and disrupted future expectations.
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Affiliation(s)
- Fatou N’dure Baboudóttir
- Faculty of Sociology, Anthropology and Folkloristics, University of Iceland, IS-102 Reykjavik, Iceland; (F.N.B.); (J.E.)
| | - Zeca Jandi
- National Institute for Studies and Research (INEP), Avenida dos Combatentes da Liberdade da Pátria, Complexo Escolar 14 de Novembro, Bissau CP 112, Guinea-Bissau; (Z.J.); (B.I.)
| | - Bucar Indjai
- National Institute for Studies and Research (INEP), Avenida dos Combatentes da Liberdade da Pátria, Complexo Escolar 14 de Novembro, Bissau CP 112, Guinea-Bissau; (Z.J.); (B.I.)
| | - Jónína Einarsdóttir
- Faculty of Sociology, Anthropology and Folkloristics, University of Iceland, IS-102 Reykjavik, Iceland; (F.N.B.); (J.E.)
| | - Geir Gunnlaugsson
- Faculty of Sociology, Anthropology and Folkloristics, University of Iceland, IS-102 Reykjavik, Iceland; (F.N.B.); (J.E.)
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Wolf MH, Haugh KL, Taha AA. Down Syndrome Outreach During the COVID-19 Pandemic: An Interprofessional Zoom WhatsApp Collaboration in Syria. J Pediatr Health Care 2023; 37:103-105. [PMID: 36400626 PMCID: PMC9574945 DOI: 10.1016/j.pedhc.2022.10.003] [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: 06/13/2022] [Accepted: 10/10/2022] [Indexed: 11/07/2022]
Affiliation(s)
- Margaret H Wolf
- Margaret H. Wolf, Assistant Professor of Pediatrics, Child Development and Rehabilitation Center, Oregon Health & Science University, Portland, OR.
| | - Kerry L Haugh
- Margaret H. Wolf, Assistant Professor of Pediatrics, Child Development and Rehabilitation Center, Oregon Health & Science University, Portland, OR.
| | - Asma A Taha
- Asma A. Taha, Professor, School of Nursing & Child Development and Rehabilitation Center, Oregon Health & Science University, Portland, OR.
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Chelabi K, Osmanlliu E, Gravel J, Drouin O, Tse SM. The effect of the COVID-19 pandemic on pediatric asthma-related emergency department visits and hospital admissions in Montréal, Quebec: a retrospective cohort study. CMAJ Open 2023; 11:E152-E159. [PMID: 36787991 PMCID: PMC9933991 DOI: 10.9778/cmajo.20220072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Asthma is a chronic respiratory condition that affects 10% of Canadian children and is often exacerbated by viral respiratory infections, prompting concerns about the severity of SARS-CoV-2 disease in children with asthma. We compared sociodemographic and clinical characteristics of children presenting to the emergency department and the incidence of these visits, before and during the pandemic. METHODS We included children aged 0 to 17 years presenting with asthma to 2 tertiary pediatric emergency departments in Montréal, Quebec, between the prepandemic (Jan. 1, 2017, to Mar. 31, 2020) and pandemic (Apr. 1, 2020, to June 30, 2021) periods. We compared the number of emergency department visits and hospital admissions with an interrupted time series analysis and compared the sociodemographic characteristics based on the Canadian Index of Multiple Deprivation (CIMD) and clinical characteristics (including triage level, intensive care admissions, etc.) with Mann-Whitney and χ2 tests. RESULTS We examined 22 746 asthma-related emergency department visits. During the pandemic, a greater proportion of patients presented a triage level 1 or 2 (19.3% v. 14.7%) and were admitted to the intensive care unit (2.5% v. 1.3%). The patients' CIMD quintile distributions did not differ between the 2 periods. We found a 47% decrease (relative risk [RR] 0.53, 95% confidence interval [CI] 0.37 to 0.76) in emergency department visits and a 49% decrease (RR 0.51, 95% CI 0.34 to 0.76) in hospital admissions during the pandemic. INTERPRETATION The decrease in asthma-related emergency department visits was observed through the third wave of the pandemic, but children presented with a higher acuity and with no identified sociodemographic changes. Future studies are required to understand individual behaviours that may have led to the increased acuity at presentation observed in this study.
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Affiliation(s)
- Khadidja Chelabi
- Department of Pediatrics (Chelabi), McGill University; Department of Pediatrics (Osmanlliu), Division of Pediatric Emergency Medicine, Montreal Children's Hospital; Faculty of Medicine (Osmanlliu), McGill University; Department of Pediatric Emergency Medicine (Gravel), Centre hospitalier universitaire Sainte-Justine; Division of Respiratory Medicine (Drouin, Tse), Department of Pediatrics, Centre hospitalier universitaire Sainte-Justine; Department of Social and Preventive Medicine (Drouin), School of Public Health, Université de Montréal; Faculty of Medicine (Tse), Université de Montréal, Montréal, Que
| | - Esli Osmanlliu
- Department of Pediatrics (Chelabi), McGill University; Department of Pediatrics (Osmanlliu), Division of Pediatric Emergency Medicine, Montreal Children's Hospital; Faculty of Medicine (Osmanlliu), McGill University; Department of Pediatric Emergency Medicine (Gravel), Centre hospitalier universitaire Sainte-Justine; Division of Respiratory Medicine (Drouin, Tse), Department of Pediatrics, Centre hospitalier universitaire Sainte-Justine; Department of Social and Preventive Medicine (Drouin), School of Public Health, Université de Montréal; Faculty of Medicine (Tse), Université de Montréal, Montréal, Que
| | - Jocelyn Gravel
- Department of Pediatrics (Chelabi), McGill University; Department of Pediatrics (Osmanlliu), Division of Pediatric Emergency Medicine, Montreal Children's Hospital; Faculty of Medicine (Osmanlliu), McGill University; Department of Pediatric Emergency Medicine (Gravel), Centre hospitalier universitaire Sainte-Justine; Division of Respiratory Medicine (Drouin, Tse), Department of Pediatrics, Centre hospitalier universitaire Sainte-Justine; Department of Social and Preventive Medicine (Drouin), School of Public Health, Université de Montréal; Faculty of Medicine (Tse), Université de Montréal, Montréal, Que
| | - Olivier Drouin
- Department of Pediatrics (Chelabi), McGill University; Department of Pediatrics (Osmanlliu), Division of Pediatric Emergency Medicine, Montreal Children's Hospital; Faculty of Medicine (Osmanlliu), McGill University; Department of Pediatric Emergency Medicine (Gravel), Centre hospitalier universitaire Sainte-Justine; Division of Respiratory Medicine (Drouin, Tse), Department of Pediatrics, Centre hospitalier universitaire Sainte-Justine; Department of Social and Preventive Medicine (Drouin), School of Public Health, Université de Montréal; Faculty of Medicine (Tse), Université de Montréal, Montréal, Que
| | - Sze Man Tse
- Department of Pediatrics (Chelabi), McGill University; Department of Pediatrics (Osmanlliu), Division of Pediatric Emergency Medicine, Montreal Children's Hospital; Faculty of Medicine (Osmanlliu), McGill University; Department of Pediatric Emergency Medicine (Gravel), Centre hospitalier universitaire Sainte-Justine; Division of Respiratory Medicine (Drouin, Tse), Department of Pediatrics, Centre hospitalier universitaire Sainte-Justine; Department of Social and Preventive Medicine (Drouin), School of Public Health, Université de Montréal; Faculty of Medicine (Tse), Université de Montréal, Montréal, Que
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Falkenstein L, Eckel N, Kadel SB, Koenig J, Litaker D, Eichinger M. Service provision and utilisation in German paediatric primary care practices during public health crises: Protocol of the mixed-methods COVID-19 PedCare Study. BMJ Open 2022; 12:e054054. [PMID: 36220317 PMCID: PMC9556743 DOI: 10.1136/bmjopen-2021-054054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 02/25/2022] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Public health crises such as pandemics can cause serious disruptions to the utilisation and provision of healthcare services with negative effects on morbidity and mortality. Despite the important role of paediatric primary care in maintaining high-quality healthcare services during crises, evidence about service utilisation and provision remains limited especially in Germany. This study, therefore, explores the utilisation and provision of paediatric primary care services during the ongoing COVID-19 pandemic and their barriers and facilitators. METHODS AND ANALYSIS The study uses a convergent mixed-methods design and comprises online surveys to parents, adolescents and primary care paediatricians (PCPs) and semistructured interviews with parents and PCPs. We recruit parents and adolescents from paediatric primary care practices and PCPs via email using mailing lists of the German Professional Association of Paediatricians and the German Society of Ambulatory Primary Care Paediatrics. The parent and adolescent surveys assess, inter alia, the utilisation of paediatric primary care services and its correlates, aspects of parental and child health as well as socioeconomic characteristics. The PCP survey investigates the provision of paediatric primary care services and its correlates, aspects of PCP health as well as sociodemographic and practice characteristics. The semistructured interviews with parents and PCPs explore several aspects of the online surveys in more detail. We use descriptive statistics and generalised linear mixed models to assess service utilisation and provision and specific correlates covered in the online surveys and apply qualitative content analysis to explore barriers and facilitators of service utilisation and provision more broadly in the semistructured interviews. We will integrate findings from the quantitative and qualitative analyses at the interpretation stage. ETHICS AND DISSEMINATION The study was approved by the Medical Ethics Review Board of the Medical Faculty Mannheim at Heidelberg University (2020-650N). Study results will be published in journals with external peer-review.
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Affiliation(s)
- Lina Falkenstein
- Medical Faculty Mannheim, Center for Preventive Medicine and Digital Health Baden-Wuerttemberg, Heidelberg University, Heidelberg, Germany
| | - Nathalie Eckel
- Medical Faculty Mannheim, Center for Preventive Medicine and Digital Health Baden-Wuerttemberg, Heidelberg University, Heidelberg, Germany
| | - Simone B Kadel
- Medical Faculty Mannheim, Center for Preventive Medicine and Digital Health Baden-Wuerttemberg, Heidelberg University, Heidelberg, Germany
| | - Jochem Koenig
- Institute of Medical Biostatistics, Epidemiology and Informatics, Division of Pediatric Epidemiology, University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - David Litaker
- Medical Faculty Mannheim, Center for Preventive Medicine and Digital Health Baden-Wuerttemberg, Heidelberg University, Heidelberg, Germany
| | - Michael Eichinger
- Medical Faculty Mannheim, Center for Preventive Medicine and Digital Health Baden-Wuerttemberg, Heidelberg University, Heidelberg, Germany
- Institute of Medical Biostatistics, Epidemiology and Informatics, Division of Pediatric Epidemiology, University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany
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13
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Kyeremateng R, Lynch MA, Pinzón-Segura MC, Osei-Bonsu A, Fortmann J, Wood D. What the children tell us: the COVID-19 pandemic and how the world should respond. BMJ Paediatr Open 2022; 6:10.1136/bmjpo-2022-001481. [PMID: 36645764 PMCID: PMC9582311 DOI: 10.1136/bmjpo-2022-001481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 06/14/2022] [Indexed: 11/25/2022] Open
Abstract
While the COVID-19 pandemic and associated mitigation measures have had a devastating impact on children and youth (CY), they were rarely consulted or their views incorporated into the approaches to address the pandemic.The main objective of this review is to present the voices and opinions of CY relative to the impact of the first year of the pandemic, on their lives and the lives of their families, and to present their recommendations as a call to action to adults and governments.The origin of this review was an iterative consultation process involving an international collective of Child Health professionals specialising in Child Rights. The recruitment of articles began by soliciting articles written or recommended by members of our international Child Health professional organisation. We then developed search strategies which were conducted in two phases, with the assistance of medical librarians. We limited our search to articles that sought the direct perspectives and experiences of CY in regard to the first year of COVID-19, and published between February 2020 and February 2021.Two phases of searches identified 8131 studies for screening. Following removal of irrelevant literature, 28 studies were included for the final analysis.CY articulate the detrimental impact of the COVID-19 pandemic to their health, education, protection and basic needs, clearly and intelligently. They make specific recommendations to address the issues they elucidate. They state a need for accurate information that is targeted for them. They ask for recognition as stakeholders and social actors in the pandemic response planning and implementation processes.We assert that the recognition of CY as stakeholders in response planning for COVID-19 and other emerging crises such as climate change, must become a statutory requirement for local, national and international policy-makers. Evidence of CY participation should specifically be reported to and tracked by the Committee on the Rights of the Child.
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Affiliation(s)
- Rosina Kyeremateng
- Community Paediatrics, Sirona Care and Health Community Interest Company, Bristol, UK
| | | | | | | | - Joshua Fortmann
- East Tennessee State University, Johnson City, Tennessee, USA
| | - David Wood
- Pediatrics, East Tennessee State University James H Quillen College of Medicine, Johnson City, Tennessee, USA
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14
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Kang JW. Impact of coronavirus disease 2019 on children's health. Clin Exp Pediatr 2022; 65:498-499. [PMID: 36111437 PMCID: PMC9561188 DOI: 10.3345/cep.2022.00682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/29/2022] [Indexed: 11/27/2022] Open
Affiliation(s)
- Joon Won Kang
- Department of Pediatrics & Medical Science, Brain Research Institute, College of Medicine, Chungnam National University, Daejeon, Korea.,Department of Pediatrics, Chungnam National University Hospital, Daejeon, Korea.,Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE, USA
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15
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Benninger E, Schmidt-Sane M, Hajski A. Youth Lens: Youth Perspectives on the COVID-19 Pandemic and its Impact on Well-being in an Urban Community. INTERNATIONAL JOURNAL ON CHILD MALTREATMENT : RESEARCH, POLICY AND PRACTICE 2022; 6:1-26. [PMID: 36193247 PMCID: PMC9520102 DOI: 10.1007/s42448-022-00130-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 09/08/2022] [Indexed: 11/01/2022]
Abstract
The COVID-19 pandemic has greatly altered the lives of children and youth throughout the world, with significant implications for their long-term health and well-being. Children were largely excluded from the development and implementation of the various pandemic mitigation strategies and policies, yet their lives were significantly affected. This study sought to shed light on children's perspectives and experiences during the COVID-19 pandemic, the various ways it impacted their health and well-being, along with the resources which allowed them to continue to flourish in the face of extreme hardship. We present a subset of findings regarding the COVID-19 pandemic from the Youth Lens study, with 65 youth (aged 10-18) from urban communities in Cleveland, OH, USA. We utilized a participatory methodology with youth, including the data collection techniques of photo voice, community mapping, group discussion, individual interviews, and journaling. This study highlights important and timely findings related to children's well-being during the COVID-19 pandemic from the youth's perspectives and underscores potential ways to address their challenges and concerns.
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Affiliation(s)
| | | | - Ashley Hajski
- Department of Bioethics, Case Western Reserve University, Cleveland, OH USA
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16
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Jörgensen E, Koller D, Raman S, Olatunya O, Asemota O, Ekpenyong BN, Gunnlaugsson G, Okolo A. The voices of children and young people during COVID-19: A critical review of methods. Acta Paediatr 2022; 111:1670-1681. [PMID: 35608994 PMCID: PMC9348412 DOI: 10.1111/apa.16422] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/06/2022] [Accepted: 05/23/2022] [Indexed: 01/22/2023]
Abstract
AIM Critically review research methods used to elicit children and young people's views and experiences in the first year of COVID-19, using an ethical and child rights lens. METHODS A systematic search of peer-reviewed literature on children and young people's perspectives and experiences of COVID-19. LEGEND (Let Evidence Guide Every New Decision) tools were applied to assess the quality of included studies. The critical review methodology addressed four ethical parameters: (1) Duty of care; (2) Children and young people's consent; (3) Communication of findings; and (4) Reflexivity. RESULTS Two phases of searches identified 8131 studies; 27 studies were included for final analysis, representing 43,877 children and young people's views. Most studies were from high-income countries. Three major themes emerged: (a) Whose voices are heard; (b) How are children and young people heard; and (c) How do researchers engage in reflexivity and ethical practice? Online surveys of children and young people from middle-class backgrounds dominated the research during COVID-19. Three studies actively involved children and young people in the research process; two documented a rights-based framework. There was limited attention paid to some ethical issues, particularly the lack of inclusion of children and young people in research processes. CONCLUSION There are equity gaps in accessing the experiences of children and young people from disadvantaged settings. Most children and young people were not involved in shaping research methods by soliciting their voices.
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Affiliation(s)
- Eva Jörgensen
- Faculty of Sociology, Anthropology and FolkloristicsUniversity of IcelandReykjavikIceland
| | - Donna Koller
- Early Childhood StudiesToronto Metropolitan UniversityTorontoCanada
| | - Shanti Raman
- Department of Community PaediatricsSouth Western Sydney Local Health DistrictLiverpoolNew South WalesAustralia
| | | | - Osamagbe Asemota
- Department of PaediatricsUniversity of Calabar Teaching HospitalCalabarCross River StateNigeria
| | - Bernadine N. Ekpenyong
- Department of Public HealthCollege of Medical Sciences, University of CalabarCalabarNigeria
| | - Geir Gunnlaugsson
- Faculty of Sociology, Anthropology and FolkloristicsUniversity of IcelandReykjavikIceland
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17
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Loyola S, Cano-Pérez E, Torres-Pacheco J, Malambo-Garcia D, Gomez R, Gomez-Camargo D. Epidemiology of COVID-19 in Individuals under 18 Years Old in Cartagena, Colombia: An Ecological Study of the First 14 Months of the Pandemic. Trop Med Infect Dis 2022; 7:107. [PMID: 35736985 PMCID: PMC9228173 DOI: 10.3390/tropicalmed7060107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/07/2022] [Accepted: 06/13/2022] [Indexed: 12/04/2022] Open
Abstract
The epidemiology of the coronavirus disease (COVID-19) has been scarcely described in individuals under 18 years old, particularly during the first months of the pandemic. The study aimed to describe the COVID-19 epidemiology in the Colombian department of Bolívar from March 2020 to April 2021 among individuals under 18 years. Furthermore, we explored whether the use of data generated by a Bolívar reference laboratory captures the departmental epidemiology. Two information sources were used; the national COVID-19 surveillance system and the Bolívar COVID-19 reference laboratory. In using a population-based ecological approach and information from confirmed symptomatic cases, epidemic curves and heat maps were constructed to assess the COVID-19 dynamics and patterns by sex, age, and residence (Cartagena vs. 45 other municipalities). The COVID-19 incidence was comparable between males and females but varied by age group, being higher in children aged 10 years and older. Cartagena had a significantly higher number of cases and experienced early epidemic peaks. Our analyses suggest that information generated by the reference laboratory does not capture the COVID-19 departmental epidemiology, despite conducting population-based surveillance across Bolívar. The study provides a retrospective characterization of the COVID-19 epidemiology in an understudied population and information that may be useful for future evidence-based responses.
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Affiliation(s)
- Steev Loyola
- Molecular Research Unit (UNIMOL), Faculty of Medicine, University of Cartagena, Cartagena de Indias 130014, Colombia; (E.C.-P.); (J.T.-P.); (D.M.-G.)
- PhD Program in Tropical Medicine, Faculty of Medicine, University of Cartagena, Cartagena de Indias 130014, Colombia;
- Faculty of Medicine, Universidad Peruana Cayetano Heredia, Lima 150135, Peru
| | - Eder Cano-Pérez
- Molecular Research Unit (UNIMOL), Faculty of Medicine, University of Cartagena, Cartagena de Indias 130014, Colombia; (E.C.-P.); (J.T.-P.); (D.M.-G.)
| | - Jaison Torres-Pacheco
- Molecular Research Unit (UNIMOL), Faculty of Medicine, University of Cartagena, Cartagena de Indias 130014, Colombia; (E.C.-P.); (J.T.-P.); (D.M.-G.)
| | - Dacia Malambo-Garcia
- Molecular Research Unit (UNIMOL), Faculty of Medicine, University of Cartagena, Cartagena de Indias 130014, Colombia; (E.C.-P.); (J.T.-P.); (D.M.-G.)
- PhD Program in Tropical Medicine, Faculty of Medicine, University of Cartagena, Cartagena de Indias 130014, Colombia;
| | - Ruben Gomez
- PhD Program in Tropical Medicine, Faculty of Medicine, University of Cartagena, Cartagena de Indias 130014, Colombia;
| | - Doris Gomez-Camargo
- Molecular Research Unit (UNIMOL), Faculty of Medicine, University of Cartagena, Cartagena de Indias 130014, Colombia; (E.C.-P.); (J.T.-P.); (D.M.-G.)
- PhD Program in Tropical Medicine, Faculty of Medicine, University of Cartagena, Cartagena de Indias 130014, Colombia;
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18
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Asemota OA, Napier-Raman S, Takeuchi H, Raman S, Asemota EA, Nonye E. Exploring children's knowledge of COVID-19 and stress levels associated with the pandemic in Nigeria: a mixed-method study. BMJ Paediatr Open 2022; 6:10.1136/bmjpo-2022-001444. [PMID: 36053587 PMCID: PMC9226462 DOI: 10.1136/bmjpo-2022-001444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 05/24/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Children have been relatively spared from the direct effects of COVID-19 globally, but there are significant concerns about indirect effects on the most vulnerable children's well-being. Nigeria is the largest African nation, but little is known about children's experience of the COVID-19 pandemic. Our aims were to determine children's knowledge of COVID-19 and their mental health responses to the pandemic. METHODS Children aged 6-17 years living in Calabar, Nigeria, were surveyed using a combination of online data collection assisted by parents and on-site data collection at schools. Parents filled out sociodemographic details, while children answered questions about COVID-19 knowledge and preventive measures. An adapted version of the 'Perceived Stress Scale for Children' was used to assess stress with additional free text space for expression of views and experiences of COVID-19. RESULTS A total of 265 children completed questionnaires, mean age was 12.5 years, 52.1% were girls. All children knew about the virus and over two-thirds (67.8%) had good knowledge of COVID-19 transmission. Children identified television (60.8%), parents (44.2%) and social media (32.8%), as main sources of COVID-19 information. The overall mean stress score among the children was 20.47. Children mentioned the following as stressors: fear of the COVID-19 disease, effect of pandemic restrictions on schooling and social interactions as well as home/family tensions. Parental love and support were overwhelmingly reported as strengths. CONCLUSIONS Nigerian children in this study had good knowledge and understanding of the COVID-19 pandemic and preventive measures to counter the virus. Children had high stress levels and expressed pandemic-related concerns but parental love and support were mitigating factors. Government and child health service providers need to tailor health and support services in response to children's needs and concerns.
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Affiliation(s)
| | - Sharanya Napier-Raman
- School of Medical and Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | | | - Shanti Raman
- Community Paediatrics, Southwest Sydney Local Health District, sydney, New South Wales, Australia
| | | | - Ezeh Nonye
- Department of Paediatrics, New Cross Hospital, Wolverhampton, UK.,Department of Paediatrics, University of Calabar Teaching Hospital, Calabar, Cross River State, Nigeria
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19
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Vanegas SB, Dueñas AD, Kunze M, Xu Y. Adapting
parent‐focused
interventions for diverse caregivers of children with intellectual and developmental disabilities: Lessons learned during global crises. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2022. [DOI: 10.1111/jppi.12422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | - Ana D. Dueñas
- College of Education and Human Services Lehigh University Bethlehem Pennsylvania USA
| | - Megan Kunze
- Department of Special Education and Clinical Sciences and Center for Brain Injury Research and Training University of Oregon Eugene Oregon USA
| | - Yue Xu
- Department of Health Sciences Education University of Illinois College of Medicine at Rockford Rockford Illinois USA
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20
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N'dure Baboudóttir F, Jandi Z, Indjai B, Einarsdóttir J, Gunnlaugsson G. Adolescents amid emerging COVID-19 pandemic in Bissau, Guinea-Bissau: a qualitative study. BMJ Paediatr Open 2022; 6:10.1136/bmjpo-2022-001417. [PMID: 36053634 PMCID: PMC9020297 DOI: 10.1136/bmjpo-2022-001417] [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: 01/17/2022] [Accepted: 03/25/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Worldwide, governments have implemented restrictions on movement and gatherings to contain the COVID-19 pandemic. In the spirit of the Convention on the Rights of the Child, children have a right to express their opinion on matters of concern to them. The study aimed to describe and analyse how adolescents in the capital Bissau understood the unfolding COVID-19 pandemic and their lived experiences during the first 3 months of the pandemic. METHODS Collaborators identified participants in five urban areas in Bissau in June 2020. Semistructured, open-ended interviews were conducted with 30 adolescents aged 15-17 years, attending private and public schools or out-of-school. The interviews were conducted in Kriol, recorded, transcribed, translated and analysed. RESULTS All the participants were heavily affected by the confinement measures during a state of emergency. Almost all believed in the realness of coronavirus while there were some doubts about its arrival in the country. The consequences were staying at home, enforced with increased police violence. At the same time, other violence on the streets or between neighbours had decreased. A few participants said they liked staying at home because they appreciated spending more time with their families. Most participants claimed that they and their family members tried to follow preventive measures. Almost all participants voiced concerns about the worsening financial situation at home, leading to food scarcity. Nearly all the adolescents were tired of the lockdown and worried about the pandemic's implications on their future opportunities. CONCLUSIONS Study participants, here adolescents in Bissau, have a clear notion of their existence and the current situation's potential negative impact on their future. Their voices need to be heard and acted on, which may soften the lockdown's negative impact on adolescents in Guinea-Bissau, as elsewhere.
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Affiliation(s)
- Fatou N'dure Baboudóttir
- Faculty of Sociology, Anthropology and Folkloristics, School of Social Sciences, University of Iceland, Reykjavik, Iceland
| | - Zeca Jandi
- National Institute for Studies and Research (INEP), Republic of Guinea-Bissau, Bissau, Guinea-Bissau
| | - Bucar Indjai
- National Institute for Studies and Research (INEP), Republic of Guinea-Bissau, Bissau, Guinea-Bissau
| | - Jónína Einarsdóttir
- Faculty of Sociology, Anthropology and Folkloristics, School of Social Sciences, University of Iceland, Reykjavik, Iceland
| | - Geir Gunnlaugsson
- Faculty of Sociology, Anthropology and Folkloristics, School of Social Sciences, University of Iceland, Reykjavik, Iceland
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21
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Fram MS, Nguyen HT, Frongillo EA. Food Insecurity among Adolescent Students from 95 Countries Is Associated with Diet, Behavior, and Health, and Associations Differ by Student Age and Sex. Curr Dev Nutr 2022; 6:nzac024. [PMID: 35317415 PMCID: PMC8929982 DOI: 10.1093/cdn/nzac024] [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: 01/11/2022] [Revised: 01/18/2022] [Accepted: 02/10/2022] [Indexed: 12/03/2022] Open
Abstract
Background Adolescents' developmental tasks and challenges vary based on age, sex, and social context. Food insecurity affects adolescents, but existing research has been limited to a few country contexts and has treated adolescence as a singular developmental moment with limited consideration of potential differences in how food insecurity relates to developmental experiences based on adolescent age and sex. Objectives We aimed to describe relations between student-reported food insecurity and students' profiles of nutritional, physical activity, school absenteeism, health/mental health, and victimization experiences, and how these differ by student age and sex. Methods Using cross-sectional data from the Global School-based Student Health Survey, we examined adolescent reports of their food security among 337,738 students 11-18 y old from 95 countries. We identified their profiles of focal experiences, and used mixed-effects linear and logistic regression models to examine differences in these profiles by student food insecurity and how these differ by student age and sex. Results Of students, 25.5% aged 11-14 y compared with 30% aged 15-18 y reported food insecurity in the past 30 d. Food insecurity was associated with less frequent fruit and vegetable intake; more frequent soft drink intake; worse mental health; less physical activity; more missed school; higher odds of smoking, drinking, and using drugs; and more bullying victimization and sexual partners. Food insecurity was associated with reduced age- and sex-specific protection: greater substance use among younger adolescents, more sexual partners among older females, and greater worry among younger males. Food insecurity was also associated with increased age-specific risk: greater soft drink consumption among younger adolescents. Conclusions Across countries, adolescent food insecurity was associated with poorer nutritional, mental health, behavioral, and relationship profiles; these associations differed with student age and sex. Food insecurity interventions should attend to adolescent developmental stage and the gendered contexts through which adolescents navigate daily life.
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Affiliation(s)
| | - Hoa T Nguyen
- Institute for Families in Society, College of Social Work, University of South Carolina, Columbia, SC, USA
| | - Edward A Frongillo
- Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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22
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Geweniger A, Barth M, Haddad AD, Högl H, Insan S, Mund A, Langer T. Impact of the COVID-19 Pandemic on Mental Health Outcomes of Healthy Children, Children With Special Health Care Needs and Their Caregivers-Results of a Cross-Sectional Study. Front Pediatr 2022; 10:759066. [PMID: 35223688 PMCID: PMC8866820 DOI: 10.3389/fped.2022.759066] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 01/18/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Several studies have described widening inequalities as a result of the COVID-19 pandemic, mostly for adult populations. Children and adolescents are particularly impacted by the indirect effects of the pandemic and lockdown measures, such as reduced access to or delays in health care and school closures. National surveys in several countries also show a rising mental health burden in children and adolescents during the COVID-19 pandemic. Children with special health care needs are a particularly vulnerable group in this context as they rely on a wide range of services, which were mostly suspended during the first wave of the pandemic. This study aims: (1) to describe the mental health outcomes of children with and without special healthcare needs and of their caregivers following the first national lockdown in Germany; (2) to investigate variations in mental health outcomes and measures of pandemic burden according to socioeconomic status; (3) to assess the impact of socioeconomic status, disease complexity and psychosocial burden on parent-reported child mental health problems. METHODS We conducted an online survey among 1,619 caregivers of children aged 1-18 years from August 11th until October 5th 2020. Participants were recruited both from families of children with special healthcare needs and of healthy children. Inequalities were analysed by descriptive statistics, simple and hierarchical logistic regression modelling to explore the association between socioeconomic status and psychological outcome measures, disease complexity and general burden related to COVID-19. RESULTS There was a high prevalence of 57.4% of parent-reported mental health problems in children and of a positive screening score for depression in 30.9% of parents. Parent-reported mental health problems were more likely to affect children with low socioeconomic status, with complex chronic disease and those whose parents screened positive for depression. CONCLUSIONS This study highlights inequalities in parent-reported child mental health outcomes by socioeconomic status and disease complexity in a large sample of German families with and without children with special health care needs. Political measures should put children at the centre and aim to mitigate the unequal impact of the COVID-19 pandemic, particularly on the mental health of vulnerable children.
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Affiliation(s)
- Anne Geweniger
- Center for Pediatrics, Department of Neuropediatrics and Muscle Disorders, Medical Center - University of Freiburg, Freiburg, Germany
| | - Michael Barth
- Center for Pediatrics, Department of General Pediatrics, Adolescent Medicine and Neonatology, Medical Center - University of Freiburg, Freiburg, Germany
| | - Anneke D Haddad
- Center for Pediatrics, Department of General Pediatrics, Adolescent Medicine and Neonatology, Medical Center - University of Freiburg, Freiburg, Germany
| | | | - Shrabon Insan
- Center for Pediatrics, Department of Neuropediatrics and Muscle Disorders, Medical Center - University of Freiburg, Freiburg, Germany
| | | | - Thorsten Langer
- Center for Pediatrics, Department of Neuropediatrics and Muscle Disorders, Medical Center - University of Freiburg, Freiburg, Germany
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Health Disparities in Children and Adolescents Living in LMIC During COVID-19 Pandemic. CURRENT TROPICAL MEDICINE REPORTS 2022; 9:194-196. [PMID: 36105113 PMCID: PMC9463048 DOI: 10.1007/s40475-022-00266-5] [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] [Accepted: 07/25/2022] [Indexed: 01/11/2023]
Abstract
Purpose of Review The purpose of this editorial is to introduce the pediatric global health issue focusing on health disparities emerging from the COVID-19 pandemic on children and adolescents living in low- and middle-income countries (LMIC). Recent Findings As the COVID-19 pandemic ensues, children and adolescents living in LMIC have been disproportionately affected by socio-economic and mitigation practices, leading to widening disparities in health and the social determinants of health that influence their well-being. Summary This pediatric global health issue brings to bare the extent, range, and nature of these health disparities, integrated with expert viewpoints, to prompt critical dialogue to address these complex problems.
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24
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Boiro H, Einarsdóttir J, Gunnlaugsson G. Impact of the COVID-19 pandemic on the life of Bissau-Guinean religious (Quranic) schoolboys during a state of emergency: a qualitative study. BMJ Paediatr Open 2021. [PMCID: PMC8685530 DOI: 10.1136/bmjpo-2021-001303] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background COVID-19 is mainly a disease of adults but can affect vulnerable children indirectly through social containment measures. The study aimed to explore the impact of the pandemic on the lives of Quranic schoolboys, almudos, who beg on behalf of their teachers, chernos, in Guinea-Bissau. Methods Data were collected in July 2020 during a state of emergency. Data rest on semistructured interviews with 14 almudos and observations. The almudos, aged 12–16 years, were identified in the capital Bissau and the regional centre Gabú. Results Four interconnected themes were found. The first, hardship, was brought by the COVID-19 pandemic and caused by lockdown and police threats, resulting in a decrease in alms and hunger. The second, circumvention of calamity, included preventive measures the boys undertook and concerns with crowdedness impeding social distancing. Relations with others is the third theme. These had changed with sharply reduced contacts with neighbours and other providers of alms. The parents had more frequent telephone contact with their sons, and encouraged them to continue their studies. At the same time, the chernos and almudos passed more time together, and they dedicated more time than earlier to the studies and prayers. The fourth theme has to do with the boys’ concerns about their long-term aspirations—to complete their studies and become respected chernos, for which begging was seen as an integral part. Conclusion The almudos suffered from decreased alms, resulting in hunger. COVID-19 was only an additional burden to the boys, who are used to facing challenges while begging to complete their religious education. According to the Convention on the Rights of the Child, children have a right to develop their capabilities in line with their future aspirations. Governments and child rights organisations need to address the specific needs of almudos in respectful collaboration with them, their parents, the chernos and their communities.
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Affiliation(s)
- Hamadou Boiro
- Instituto Nacional de Estudos e Pesquisa (INEP), Bissau, Guinea-Bissau
- Faculty of Sociology, Anthropology and Folkloristics, School of Social Sciences, University of Iceland, Reykjavik, Iceland
| | - Jónína Einarsdóttir
- Faculty of Sociology, Anthropology and Folkloristics, School of Social Sciences, University of Iceland, Reykjavik, Iceland
| | - Geir Gunnlaugsson
- Faculty of Sociology, Anthropology and Folkloristics, School of Social Sciences, University of Iceland, Reykjavik, Iceland
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