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Ndongo FA, Kana R, Nono MT, Noah JPYA, Ndzie P, Tejiokem MC, Biheng EH, Ndie J, Nkoa TA, Ketchaji A, Ngako JN, Penda CI, Bissek ACZK, Ndombo POK, Hawa HM, Msellati P, Lallemant M, Faye A. Association between mental disorders with detectable viral load and poor adherence to antiretroviral therapy among adolescents infected with Human Immunodeficiency Virus on follow-up at Chantal Biya Foundation, Cameroon. JOURNAL OF EPIDEMIOLOGY AND POPULATION HEALTH 2024; 72:202193. [PMID: 38523399 DOI: 10.1016/j.jeph.2024.202193] [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: 01/13/2023] [Revised: 10/11/2023] [Accepted: 10/30/2023] [Indexed: 03/26/2024]
Abstract
INTRODUCTION Perinatally HIV-Infected Adolescents (HIVIA) are more likely to have mental health problems than their uninfected peers. In resource-limited settings, mental health disorders are rarely taken into account in the care offered to HIVIA and have an impact on their routine follow-up. The objective of this study was to assess the baseline socio-demographic factors and mental health conditions associated with detectable viral load or poor ART adherence in HIVIA on ART followed at the Mother and Child Centre of the Chantal Biya Foundation in Yaoundé (CME-FCB), Cameroon. METHODS A cross-sectional study was conducted in HIVIA aged 10 to 19 years, followed at CME-FCB during the period from December 2021 to March 2022. Sociodemographic, clinical, and mental characteristics were collected using a structured questionnaire administered face-to-face by trained healthcare providers. The primary outcome was viral load ≥ 40 copies/mL in HIVIA on ART for at least six months. The secondary outcome was poor ART adherence, defined as ≥ 1 missed dose of antiretroviral therapy within the last past three days. The main exposure variables were mental health disorders, including the level of anxiety, depression and low self-esteem. RESULTS In total, 302 adolescents were interviewed, 159 (52.7 %) were girls and median age was 15.2 years (IQR: 12.0-17.5). Having missed at least 1 dose of ART drugs during the last 3 days before screening concerned 53 (35.0 %) cases. Of the 247 adolescents with an available viral load (VL) in the last 12 months prior to screening, 33 (26.7 %) had a VL ≥ 40 copies/mL. Among participating adolescents, 29.1 % presented with high or very high anxiety, 26.5 % with severe depression, 36.4 % with history of suicidal ideation, and 20.5 % low self-esteem. Low self-esteem was strongly associated with a higher risk of poor ART adherence (adjusted odds ratio(aOR) (95 % confidence interval (95 %CI)): 2.2 (1.1-4.3); p = 0.022). Living with the father (aOR (95 %CI): 0.6 (0.3-1.1); p = 0.085) or in a household with a televisor (aOR (95 %CI): 0.5 (0.2-1.1); p = 0.069) were slightly associated with a lower risk of poor adherence to ART. Having both parents alive (aOR (95 %CI): 0.4 (0.2-0.9); p = 0.031) or receiving ART with efavirenz or dolutegravir (aOR (95 %CI): 0.5 (0.2-0.9); p = 0.047) was strongly associated with a lower likelihood of having a detectable VL. Moreover, detectable viral load was slightly less frequent in adolescents whose household was equipped with a television (p = 0.084) or who were completely disclosed for HIV status (p = 0.070). CONCLUSION This study found that co-morbid low self-esteem had higher odds of poor ART adherence in HIVIA. Moreover, both poor ART adherence, and detectable viral load were associated with impaired life conditions in HIVIA.
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Affiliation(s)
- Francis Ateba Ndongo
- University of Garoua, Cameroon; Centre Mère-enfant, Fondation Chantal Biya, Yaounde, Cameroon; Ministry of Public Health, Yaounde, Cameroun.
| | - Rogacien Kana
- Media Convergence Consulting Office, Yaounde, Cameroon
| | - Marius Tchassep Nono
- Action for Youths and Family, Douala, Cameroon; University of Douala, Douala, Cameroon
| | | | | | | | | | - Justin Ndie
- Ministry of Public Health, Yaounde, Cameroun
| | | | | | | | | | | | | | | | - Philippe Msellati
- Research Institute for Sustainable Development (IRD), Abidjan, Côte d'Ivoire
| | - Marc Lallemant
- Programs for HIV Prevention and Treatment (PHPT) Foundation - Research Institute for Sustainable Development (IRD), Paris, France
| | - Albert Faye
- Hôpital Universitaire Robert Debré, Paris, France
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Shah GH, Etheredge GD, Maluantesa L, Waterfield KC, Ikhile O, Engetele E, Mulenga A, Tabala A, Bossiky B. Socioeconomic status and other factors associated with HIV status among OVC in Democratic Republic of Congo (DRC). Front Public Health 2022; 10:912787. [PMID: 36262234 PMCID: PMC9574395 DOI: 10.3389/fpubh.2022.912787] [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: 04/04/2022] [Accepted: 09/05/2022] [Indexed: 01/22/2023] Open
Abstract
Background Orphans and vulnerable children (OVC) are a high-risk group for HIV infection, particularly in Sub-Saharan Africa. Purpose This study aims to portray the socioeconomic profile of OVC and examine the association of household and parent/guardian characteristics with the HIV status of OVC. Methods For this quantitative retrospective study, we obtained data from ICAP/DRC for a total of 1,624 OVC from households enrolled for social, financial, and clinical services between January 2017 and April 2020 in two provinces of the Democratic Republic of Congo, Haut-Katanga and Kinshasa. We computed descriptive statistics for OVC and their parents' or guardians' characteristics. We used the chi-square test to determine bivariate associations of the predictor variables with the dichotomous dependent variable, HIV positivity status. To analyze the association between these independent variables and the dichotomous dependent variable HIV status after controlling for other covariates, we performed firth's logistic regression. Results Of the OVC included in this study, 18% were orphans, and 10.9% were HIV+. The chi-square analysis showed that among parents/guardians that were HIV+, a significantly lower proportion of OVC (11.7%) were HIV+ rather than HIV- (26.3%). In contrast, for parents/guardians with HIV- status, 9.0% of OVC were HIV-negative, and 11.7% of OVC were OVC+. The firth's logistic regression also showed the adjusted odds of HIV+ status were significantly lower for OVC with parents/guardians having HIV+ status themselves (AOR, 0.335; 95% CI, 0.171-0.656) compared with HIV-negative parents/guardians. The adjusted odds of HIV+ status were significantly lower for OVC with a monthly household income of < $30 (AOR, 0.421; 95% CI, 0.202-0.877) compared with OVC with a monthly household income > $30. Conclusions Our results suggest that, with the exception of a few household and parent/guardian characteristics, the risk of HIV+ status is prevalent across all groups of OVC within this study, which is consistent with the existing body of evidence showing that OVC are in general vulnerable to HIV infection. With a notable proportion of children who are single or double orphans in DRC, HIV+ OVC constitute a high-risk group that merits customized HIV services. The findings of this study provide data-driven scientific evidence to guide such customization of HIV services.
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Affiliation(s)
- Gulzar H. Shah
- Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, United States,*Correspondence: Gulzar H. Shah
| | | | | | - Kristie C. Waterfield
- Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, United States
| | - Osaremhen Ikhile
- Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, United States
| | | | | | - Alice Tabala
- ICAP, Columbia University, New York, NY, United States
| | - Bernard Bossiky
- National Multisectoral HIV/AIDS program (PNMLS), HIV Program, Presidency of DRC, Kinshasa, Congo
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Lee MS, Jhone JH, Kim JB, Kweon YS, Hong HJ. Characteristics of Korean Children and Adolescents Who Die by Suicide Based on Teachers' Reports. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116812. [PMID: 35682396 PMCID: PMC9180601 DOI: 10.3390/ijerph19116812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/25/2022] [Accepted: 05/31/2022] [Indexed: 02/01/2023]
Abstract
We analyzed the clinical characteristics and suicide-related factors of students who died by suicide in Korea in 2016–2020, based on teachers’ reports. Using data on total suicide deaths (N = 654, mean age = 16.0, 52.6% boys) collected by the Ministry of Education of Korea, we investigated the demographic and clinical characteristics and suicide-related factors of suicide deaths in students aged 9–18 years. Considering gender, more boys (52.6%, N = 344) died by suicide than girls (47.4%, N = 310). About 425 (65.0%) of the suicides were among high school students. The most common suicide method was jumping from a high place (70.6%, N = 454), followed by hanging (25.7%, N = 165). Additionally, 9.4% (N = 48) of the students who died by suicide had a history of attempted suicide, 13.4% (N = 73) had attempted self-harm, and 12.8% (N = 48) were acquainted with someone who had died by suicide. Teachers observed 20.6% (N = 120) of the suicide warning signs at school. Girls tended to have higher rates of attempted suicide, emotional problems, and psychiatric disorders than boys. This study was conducted with the largest sample of Korean suicide students observed at school. Effective suicide-related mental health training for teachers could contribute to suicide prevention in students.
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Affiliation(s)
- Mi-Sun Lee
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea;
| | - Jin Ho Jhone
- Department of Social Welfare, Soongsil University, Seoul 06978, Korea;
| | - Joon Beom Kim
- Interdisciplinary Graduate Program in Social Welfare Policy, Yonsei University, Seoul 03722, Korea;
| | - Yong-Sil Kweon
- Department of Psychiatry, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea;
| | - Hyun Ju Hong
- Department of Psychiatry, Hallym University Sacred Heart Hospital, Anyang 14068, Korea
- Suicide and School Mental Health Institute, Hallym University, Anyang 14068, Korea
- Correspondence: ; Tel.: +82-31-380-3750
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Asanbe C, Visser M, Moleko AG, Makwakwa C. Coping strategies and mental health of adolescents impacted by parental HIV and AIDS in rural South Africa. J Child Adolesc Ment Health 2021; 33:3-16. [PMID: 35670528 DOI: 10.2989/17280583.2022.2058951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objective: The study explored whether orphanhood status as well as coping strategies predicted mental health outcomes in orphans and vulnerable adolescents who participated in an NGO-supported programme in rural South Africa.Method: Participants comprised 175 adolescents (aged 11-18 years) from a low-resource community, and included non-orphans (n = 57), orphans due to AIDS (n = 62) and orphans due to other causes (n = 56). All participants rated themselves on the age-appropriate Youth Self-Report scales and 95 completed the Children's Coping Strategies Checklist (CCSC). Little's test of data missing completely at random revealed that the CCSC missing data did not display a specific pattern.Results: Active coping negatively predicted internalising, externalising and general psychological problems, while avoidant coping predicted general psychological problems. Orphanhood group status, sex and age did not predict coping strategies used. A higher proportion of orphans by AIDS had elevated scores of internalising problems and all participants on somatic complaints.Conclusions: Active coping strategies minimise the risk for emotional and behavioural problems among the participants. Our findings suggest that agencies and non-governmental organisations that provide services to vulnerable adolescents can facilitate active coping skills to enhance their psychological well-being.
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Affiliation(s)
- Comfort Asanbe
- Department of Psychology, College of Staten Island, City University of New York, New York, USA
- Department of Psychology, University of Pretoria, Pretoria, South Africa
| | - Maretha Visser
- Department of Psychology, University of Pretoria, Pretoria, South Africa
| | - Anne-Gloria Moleko
- Department of Psychology, University of Pretoria, Pretoria, South Africa
| | - Catherine Makwakwa
- Lefika Orphaned and Vulnerable Children Programme, Pretoria, South Africa
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Pillay K, Tomita A, Paruk S. Patterns of emotional and behavioural challenges in children living with HIV: results from a hyperendemic South African setting. VULNERABLE CHILDREN AND YOUTH STUDIES 2021; 16:232-244. [PMID: 34484413 PMCID: PMC8415290 DOI: 10.1080/17450128.2020.1869361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 12/22/2020] [Indexed: 06/13/2023]
Abstract
This study examined the patterns of emotional and behavioural problems in children from an HIV hyperendemic sub-Saharan Africa setting. A cross-sectional questionnaire survey was administered to 198 parents/caregivers of children living with HIV aged 2-12 years, attending a paediatric HIV out-patient service at a public sector hospital in KwaZulu-Natal Province, South Africa. The parent version of the Strengths and Difficulties Questionnaire (SDQ) which consists of five sub-scales (i.e. emotional difficulties, conduct problems, hyperactivity/inattention symptoms, peer problems and prosocial behaviours) were used to capture data on emotional and behavioural problems in children. The results indicated that over half of sampled children (n = 115, 58.1%) had abnormal levels of problems in at least one sub-scale, with adjusted regression indicating that academic difficulties and delayed milestones were significantly associated (i.e. greater total SDQ score as a continuous measure). Lower parental/caregiver educational attainment (i.e. not having tertiary education) was the only parent/caregiver characteristic associated with greater emotional and behavioural problems. Given the high prevalence of emotional and behavioural problems and its link to academic difficulties and delayed milestones, the need for screening and developmental support for children living with HIV may be warranted.
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Affiliation(s)
- Kusturi Pillay
- Discipline of Psychiatry, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Andrew Tomita
- KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
- Centre for Rural Health, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Saeeda Paruk
- Discipline of Psychiatry, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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Abstract
OBJECTIVE Somatization and functional somatic symptoms reflect conditions in which physical symptoms are not sufficiently explained by medical conditions. Literature suggests that these somatic symptoms may be related to illness exposure in the family. Children with a parent or sibling with a chronic illness may be particularly vulnerable to developing somatic symptoms. This study provides a systematic review of the literature on somatic symptoms in children with a chronically ill family member. METHODS A systematic review (PROSPERO registry ID: CRD42018092344) was conducted using six databases (PubMed, EMBASE, PsychINFO, Scopus, CINAHL, and Cochrane) from articles published before April 5, 2018. All authors evaluated articles by title and abstract, and then by full-text review. Relevant data were extracted by the first author and reviewed by remaining authors. RESULTS Twenty-seven unique studies met the criteria. Seventeen examined somatic symptoms in children with a chronically ill parent, and seven evaluated somatic symptoms in children with a chronically ill sibling. Three studies examined somatic symptoms in children with an unspecified ill relative. The strongest relationship between child somatization and familial illness was found with children with a chronically ill parent (13/17 studies). Evidence for somatic symptoms in children with an ill sibling was mixed (4/7 studies found a positive association). CONCLUSIONS The literature on somatic symptoms in children suggests that parental illness is related to increased somatic symptoms in children. Research examining the effects of having a sibling with an illness on somatic symptoms is mixed. Several areas of future research are outlined to further clarify the relationship between familial chronic illness and somatic symptoms.
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Maepa MP, Ojedokun O, Idemudia ES, Morubane P. Gendered adversity and mental health of adolescents orphaned by AIDS in a rural South African community: An exploratory study. JOURNAL OF PSYCHOLOGY IN AFRICA 2019. [DOI: 10.1080/14330237.2019.1603341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Mokoena P. Maepa
- Clinical Psychology Department, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Oluyinka Ojedokun
- Department of Pure & Applied Psychology, Adekunle Ajasin University, Akungba-Akoko, Ondo State, Nigeria
| | - Erhabor S. Idemudia
- School of Postgraduate Studies, North-West University (MC), Mmabatho, South Africa
| | - Palesa Morubane
- Clinical Psychology Department, Vryburg Hospital, North West Province, Vryburg, South Africa
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Thornton VJ, Asanbe CB, Denton EGD. Clinical risk factors among youth at high risk for suicide in South Africa and Guyana. Depress Anxiety 2019; 36:423-432. [PMID: 30900366 DOI: 10.1002/da.22889] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 12/21/2018] [Accepted: 02/25/2019] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Suicide is the second leading cause of death among youth worldwide, but low- and middle-income countries (LMICs) account for 78% of all suicides. The LMICs South Africa and Guyana rank high in the global suicide rates. To better understand and prevent suicide among the youth, the present study targets youths at high risk for suicide, in an LMIC, to contextually and representatively identify clinical risk factors for suicide. METHODS One hundred-ninety youths, aged 11-21, separated from biological parents at the time of assessment, in South Africa and Guyana, were administered the Child Behavior Checklist and Behavior Assessment System for Children to assess clinical symptoms. The youths were asked about current suicide ideation and previous attempt(s). Self-report responses to clinical items yielded scale scores for depression, social stress, atypicality, somatization, anxiety, and ADHD. Using an integrative data analytic technique, clinical scale scores were standardized and used to predict suicidal behaviors in a binary logistic regression analysis. RESULTS Approximately 22% of Black South African youths and 60% of Guyanese youths endorsed suicide ideation and attempt or suicide attempt only. In fully adjusted analyses, the odds of atypicality and somatization were 1.96 and 1.67 times greater among the youths who endorsed suicidal ideation when compared with those who did not (p < .04). Youth social stress was significantly associated with the suicide attempt, controlling for model covariates (odds ratio [OR], 1.88, p = .05). Gender moderated the effect of somatization on youth suicide. CONCLUSION Our results contextualize how social stress, atypicality, and somatization relate to LMIC youth suicide. Further study on high-risk samples will contribute to generalizable suicide-prevention models.
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Affiliation(s)
- Veronica J Thornton
- Department of Human Development and Family Studies, The University of North Carolina at Greensboro, Greensboro, North Carolina
| | - Comfort B Asanbe
- Department of Psychology, City University of New York College of Staten Island, Staten Island, New York
| | - Ellen-Ge D Denton
- Department of Psychology, City University of New York College of Staten Island, Staten Island, New York
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