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Roshanfekr P, Ahmadi S, Amirahmadi R, Karimijavan G, Yazarloo R, Hosseinabadi M, SoleimanvandiAzar N, Karimi SE. Sexual Behaviors in Iranian Working Children and the Correlated Risk Factors: Result of the Large-Scale Rapid Assessment and Response (RAR) Survey. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2024; 36:189-198. [PMID: 38616796 PMCID: PMC11008545 DOI: 10.1080/19317611.2024.2322978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 02/20/2024] [Indexed: 04/16/2024]
Abstract
This study aimed to investigate the sexual behaviors among working children and the associated factors. This cross-sectional study was conducted on a sample of 1937 working children in the 10-18 age range in 15 provincial capitals in 2019-20 (Feb-May); the Response rate was 94.9%. Univariate and multivariable logistic regression was used to examine the variable of sexual behaviors. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) are reported. The prevalence of sexual behaviors in working children was 4.2%. The results showed a significant difference between those who reported sexual behaviors and those who did not in terms of age, identity document (ID), running away from home, alcohol use, and substance use. There was a statistically significant relationship between fathers' unemployment and sexual behaviors among working children. Furthermore, we found that having divorced parents could increase the odds of sexual behaviors by 3.74 times. The findings showed that related welfare and support organizations should design and implement effective and continuous training and interventions to raise awareness and reduce the prevalence of high-risk sexual behaviors in working children. They should also provide family counseling and promote parental supervision of children.
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Affiliation(s)
- Payam Roshanfekr
- Social Welfare Management Research Center, Social Health Research Institute, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Sina Ahmadi
- Social Development & Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Gelavizh Karimijavan
- Department of Speech Therapy, Rehabilitation Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Yazarloo
- Department of social science, Payam_e_noor University, Tehran, Iran
| | - Mahmoud Hosseinabadi
- Social Injured Affairs Office, Social Deputy, State Welfare Organization, Tehran, Iran
| | - Neda SoleimanvandiAzar
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Department of Community and Family Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Salah Eddin Karimi
- Social Determinants of Health Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
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Zeleke TK, Alamirew BD, Bazezew ZA, Alemu MA, Jara AG, Abebe RB. The magnitude and predictors of self-medication amongst street dwellers in Ethiopia: a multicentre study. Drugs Context 2024; 13:2023-7-2. [PMID: 38264405 PMCID: PMC10803126 DOI: 10.7573/dic.2023-7-2] [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: 09/01/2023] [Accepted: 11/29/2023] [Indexed: 01/25/2024] Open
Abstract
Background Low levels of living standards amongst street dwellers worldwide limit their access to conventional healthcare services, resulting in self-medication use for the treatment of an illness. Nevertheless, self-medication use has risks, including adverse drug reactions, increased polypharmacy, drug resistance, drug dependence, drug interactions and incorrect diagnosis. Ethiopia has a large street-dwelling community; however, there are no studies conducted in Ethiopia assessing self-medication use amongst street dwellers. This study provides insight into self-medication use and predictors amongst street dwellers in Ethiopia. Methods A community-based, multicentre cross- sectional study was conducted amongst street dwellers from 1 September 2022 to 1 February 2023 at community drug-retail outlets in the three major cities in the Amhara region of Ethiopia. The data were obtained using an interviewer-administered questionnaire. Frequencies and percentages of descriptive statistics were calculated. Bivariable and multivariable logistic regression analyses were employed to indicate predictors of self-medication use. To determine statistical significance, a 95% confidence interval with a p value below 0.05 was utilized. Results The prevalence of self-medication use was 67.4%. Time and financial savings were reported as the reasons for most self-medication use. The most commonly reported illnesses for which people sought self-medication were gastrointestinal diseases. Low monthly income (adjusted OR 3.72, 95% CI 2.34-5.91) and residing near sewage areas (adjusted OR 3.37, 95% CI 2.03-5.58) were significantly associated with self-medication use. Conclusion Street dwellers had a high rate of self- medication use. Residing near sewage areas and having a low level of income were factors in self-medication use. Gastrointestinal diseases, respiratory ailments and dermatological conditions were the most frequently reported complaints, whereas antimicrobials and anthelmintics were the most commonly used medications. We recommend that healthcare services enhance outreach programmes to the most vulnerable people, such as street dwellers, especially those with lower monthly incomes and who live near sewage areas, to reduce self-medication rates.
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Affiliation(s)
- Tirsit Ketsela Zeleke
- Department of Pharmacy, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Bekalu Dessie Alamirew
- Department of Pharmacy, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Zegaye Agmassie Bazezew
- Department of Pharmacy, College of Medicine and Health Sciences, Bahr Dar University, Bahr Dar, Ethiopia
| | - Muluken Adela Alemu
- Department of Pharmacy, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Abdisa Gemedi Jara
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Rahel Belete Abebe
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Shah P, Kabuti R, Beksinska A, Nyariki E, Babu H, Kungu M, Jama Z, Ngurukiri P, Kaul R, Kyegombe N, Medley GF, Devries K, Seeley J, Weiss HA, Beattie TS, Kimani J. Childhood and adolescent factors shaping vulnerability to underage entry into sex work: a quantitative hierarchical analysis of female sex workers in Nairobi, Kenya. BMJ Open 2023; 13:e078618. [PMID: 38114279 DOI: 10.1136/bmjopen-2023-078618] [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: 12/21/2023] Open
Abstract
OBJECTIVE To explore factors associated with early age at entry into sex work, among a cohort of female sex workers (FSWs) in Nairobi, Kenya. BACKGROUND Younger age at sex work initiation increases the risk of HIV acquisition, condom non-use, violence victimisation and alcohol and/or substance use problems. This study aimed to understand factors in childhood and adolescence that shape the vulnerability to underage sex work initiation. DESIGN Building on previous qualitative research with this cohort, analysis of behavioural-biological cross-sectional data using hierarchical logistic regression. PARTICIPANTS AND MEASURES FSWs aged 18-45 years were randomly selected from seven Sex Workers Outreach Programme clinics in Nairobi, and between June and December 2019, completed a baseline behavioural-biological survey. Measurement tools included WHO Adverse Childhood Experiences, Alcohol, Smoking and Substance Involvement Screening Test and questionnaires on sociodemographic information, sexual risk behaviours and gender-based violence. Descriptive statistics and logistic regression were conducted using hierarchical modelling. RESULTS Of the 1003 FSWs who participated in the baseline survey (response rate 96%), 176 (17.5%) initiated sex work while underage (<18 years). In the multivariable analysis, factors associated with entering sex work while underage included incomplete secondary school education (aOR=2.82; 95% CI=1.69 to 4.73), experiencing homelessness as a child (aOR=2.20; 95% CI=1.39 to 3.48), experiencing childhood physical or sexual violence (aOR=1.85; 95% CI=1.09 to 3.15), young age of sexual debut (≤15 years) (aOR=5.03; 95% CI=1.83 to 13.79) and being childless at time of sex work initiation (aOR=9.80; 95% CI=3.60 to 26.66). CONCLUSIONS Lower education level and childhood homelessness, combined with sexual violence and sexual risk behaviours in childhood, create pathways to underage initiation into sex work. Interventions designed for girls and young women at these pivotal points in their lives could help prevent underage sex work initiation and their associated health, social and economic consequences.
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Affiliation(s)
- Pooja Shah
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine Faculty of Public Health and Policy, London, UK
| | - Rhoda Kabuti
- Partners for Health and Development in Africa, Nairobi, Kenya
| | - Alicja Beksinska
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine Faculty of Public Health and Policy, London, UK
| | - Emily Nyariki
- Partners for Health and Development in Africa, Nairobi, Kenya
| | - Hellen Babu
- Partners for Health and Development in Africa, Nairobi, Kenya
| | - Mary Kungu
- Partners for Health and Development in Africa, Nairobi, Kenya
| | - Zaina Jama
- Partners for Health and Development in Africa, Nairobi, Kenya
| | | | - Rupert Kaul
- Departments of Immunology and Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Nambusi Kyegombe
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine Faculty of Public Health and Policy, London, UK
| | - Graham F Medley
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine Faculty of Public Health and Policy, London, UK
| | - Karen Devries
- Department of Population Health, London School of Hygiene & Tropical Medicine Faculty of Epidemiology and Population Health, London, UK
| | - Janet Seeley
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine Faculty of Public Health and Policy, London, UK
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Wakiso, Uganda
| | - Helen Anne Weiss
- MRC International Statistics & Epidemiology Group, Department of Infectious Disease Epidemiology and International Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Tara S Beattie
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine Faculty of Public Health and Policy, London, UK
| | - Joshua Kimani
- Partners for Health and Development in Africa, Nairobi, Kenya
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Obimakinde AM, Shabir M. The family dynamics of children on the streets of Ibadan, Southwest Nigeria. S Afr Fam Pract (2004) 2023; 65:e1-e11. [PMID: 38112016 PMCID: PMC10730446 DOI: 10.4102/safp.v65i1.5774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 08/09/2023] [Accepted: 08/12/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND Children roaming the streets estimated at 1 in 10 by a 2021 United Nation Children's Funds (UNICEF) report is a growing problem, in cities of lower- and middle-income African countries. Studies of street children with no family ties abound, but there is a paucity of studies on children on the street who exist within families and return home daily. We explored the family dynamics of children on the streets of Ibadan, emphasising family structure, resources and relationships. METHODS Using an exploratory design based on a qualitative approach 53 participants were interviewed, including children on the streets, parental figures, child-welfare officers and street shop owners. Participants were selected from streets in the five urban local government areas of Ibadan, Nigeria. Recorded data were transcribed, and framework analysis was performed. RESULTS The family dynamics included family structural problems, poor family resources and poor parent-child relationships. The family structural problems included: broken homes, large families and ambivalence around polygamy as subthemes. Family resources comprised: poor economic resources, poor social resources, educational challenges, cultural ambivalence and spiritual backdrops. The family relationships patterns included: poor adaptability, economic-oriented partnership, poor growth support, poor emotional connection and poor family bonding. CONCLUSION The dynamics driving a family's choice for child streetism in Ibadan, mostly to hawk, are devaluation of family life, parenting irresponsibility, and poor filial relationship, underscored by economic constraints and socio-cultural decadence. The results of this research buttress the need for family-level interventions to forestall the escalating phenomenon of child streetism in Ibadan, Nigeria.Contribution: This research highlights the family dynamics of children on the streets, and buttresses family-level interventions are necessary to forestall escalating child-streetism in Ibadan, Nigeria.
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Affiliation(s)
- Abimbola M Obimakinde
- Family Medicine Unit, Community Medicine Department, Faculty of Clinical Sciences and Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria; and Department of Family Medicine, University College Hospital, Ibadan, Nigeria; and Department of Family Medicine and Primary Care, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg.
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Zewude B, Siraw G, Engdawork K, Tadele G. Health seeking behavior of street connected children in Addis Ababa, Ethiopia. FRONTIERS IN SOCIOLOGY 2023; 8:1188746. [PMID: 37609109 PMCID: PMC10441109 DOI: 10.3389/fsoc.2023.1188746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 07/21/2023] [Indexed: 08/24/2023]
Abstract
Background Street children are the most neglected segments of the society with limited access to healthcare services. The vulnerability of street children to various health risks has been found by previous studies but little is known about their perceived susceptibility, preventive behavior and illness responses. Hence, the purpose of this study was to identify the health seeking behavior of street children in Addis Ababa. The study focuses on perceived susceptibility to various health risks, sources of health risks, and behaviors pertaining to responding to perceived risks and experienced health problems among the most marginalized groups in Addis Ababa. Methods Using a mixed research approach, quantitative and qualitative data were collected through survey and interview methods from selected street children. SPSS and NVivo software were used to analyze the quantitative and qualitative data, respectively. Results Whereas the street children perceive to be susceptible for ill-health risks related with their living situations, responding to the perceived susceptibility mainly by maintaining personal hygiene and undertaking physical exercises have been identified. The study also revealed that street children were found to be vulnerable for the situations affecting their health and wellbeing mainly due to self-reported engagements in risky behaviors such as smoking cigarette (67.3%), sniffing glue or benzene (68.2%), sharing of personal materials having the potential of transmitting diseases from one person to another (25.5%), and unprotected sexual activities (14.1%). Experiences of visiting healthcare facilities in response to illness symptoms have also constituted an aspect of the health seeking behavior of the street children. Conclusion Awareness of the presence of health risks and perceived susceptibility to the risks promoted both preventive behavior and positive compliance in relation to illness response among children of the street in Addis Ababa.
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Affiliation(s)
- Bewunetu Zewude
- Department of Sociology, College of Social Science and Humanities, Wolaita Sodo University, Sodo, Ethiopia
| | - Getahun Siraw
- Department of Sociology, College of Social Sciences and Humanities, Dilla University, Dilla, Ethiopia
| | - Kibur Engdawork
- Department of Sociology, College of Social Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Getnet Tadele
- Department of Sociology, College of Social Science, Addis Ababa University, Addis Ababa, Ethiopia
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Armoon B, Griffiths MD, Mohammadi R, Ahounbar E. The global distribution and epidemiology of alcohol and drug use among street-involved children and youth: a meta-analysis. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2023; 49:381-398. [PMID: 37310881 DOI: 10.1080/00952990.2023.2201872] [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: 10/04/2022] [Revised: 03/14/2023] [Accepted: 03/28/2023] [Indexed: 06/15/2023]
Abstract
Background: Street-involved children and youth (SICY) who work and live on/of the streets are more likely to inject drugs and engage in psychoactive substance use.Objectives: The present study aimed to identify the prevalence, distribution, sociodemographic determinants, and risk-taking associated with alcohol and drug use among SICY.Methods: Studies published in English related to alcohol and drug use among SICY were searched for from December 1 1985 to July 1 2022, on PubMed, Scopus, Cochrane, and Web of Science.Results: After full-text paper evaluation, 73 studies were included in the meta-analysis. Results indicated that lifetime prevalence rates were 44% (alcohol), 44% (crack), 33% (inhalants), 44% (solvents), 16% (tranquilizer/sedatives), 22% (opioids), and 62% (polysubstance use). The current prevalence rates were 40% (alcohol), 21% (crack), 20% (inhalants), 11% (tranquilizer/sedatives), and 1% (opioids). Also, life-time and current prevalence of alcohol and crack use, current prevalence of tranquilizer/sedative use, and life-time prevalence of polysubstance use were higher among older age groups. Life-time prevalence of tranquilizer/sedative use was lower among older age groups.Conclusions: The high prevalence of using alcohol, crack, and inhalants is a major issue because they are used extensively among different age groups, including minors. Such findings are beneficial for policymakers, health authorities, and professionals in developing programs aimed at minimizing inhalant use and other types of substance use harms among this group. It is important to accurately monitor this risk-exposed population to understand the mechanisms that might help protect them from high-risk substance use.
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Affiliation(s)
- Bahram Armoon
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Rasool Mohammadi
- Department of Biostatistics and Epidemiology, School of Public Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Elaheh Ahounbar
- Orygen, The National Center of Excellence in Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Center for Youth Mental Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia
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Arabbadvi Z, Khoshnood Z, Foroughameri G, Mazallahi M. Education as an effective strategy to promote nutritional knowledge, attitudes, and behaviors in street children. BMC Public Health 2023; 23:989. [PMID: 37245021 DOI: 10.1186/s12889-023-15400-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 03/07/2023] [Indexed: 05/29/2023] Open
Abstract
BACKGROUND Lack of nutritional knowledge and ineffective attitudes can complicate the problems faced by this group of street children and have significant effects on their behaviors. This study aimed to examine the effect of nutrition education on nutritional knowledge, attitudes, and behaviors of street children in Kerman in 2021. METHODS This experimental study was conducted on 70 street children supported by Aftab Children Support Center in Kerman in 2021. The participants were selected using convenience sampling and were divided into two intervention and control groups using a random number table. A nutrition distance education program was implemented using an educational compact disk (CD) for the participants in the intervention group, while the children in the control group did not receive any training. The children's nutritional knowledge, attitudes, and behaviors were assessed before and one month after the intervention using the Nutritional Behavior Questionnaire. The collected data were analyzed with SPSS software (version 22) using the chi-square test, paired and independent samples t-test, and analysis of covariance (ANCOVA). RESULTS The results revealed a significant difference in nutritional knowledge, attitudes, and behaviors after the intervention (p < 0.001) due to the effect of the nutrition training program. Accordingly, the mean scores of the participants in the intervention group for nutritional knowledge, attitudes, and behaviors increased by 11.45, 14.80, and 6.05 units after the intervention compared to their scores before the intervention. Furthermore, the effects of the training program on the participants' nutritional knowledge, attitudes, and behaviors were 89.6%, 91.5%, and 64.3%, respectively. CONCLUSION The findings of this study concluded that training based on nutrition education improved the children's nutritional knowledge, attitudes, and behaviors. Thus, the officials in charge of promoting the health of vulnerable groups in the community need to provide the necessary facilities to implement effective training programs for street children and encourage them to participate in training programs.
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Affiliation(s)
- Zahra Arabbadvi
- Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Zohreh Khoshnood
- Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Golnaz Foroughameri
- Department of Community Health Nursing, Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, 7619813555, Iran.
| | - Mahboobeh Mazallahi
- Department of Critical Care Nursing, Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
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Zenebe GA, Alemu W, Muche T, Debela BG. Risky sexual practice and associated factors among street children of Wonago town, Gedeo zone, Southern Ethiopia. Front Public Health 2023; 11:1089499. [PMID: 37089490 PMCID: PMC10113472 DOI: 10.3389/fpubh.2023.1089499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 03/20/2023] [Indexed: 04/08/2023] Open
Abstract
IntroductionA “risky sexual practice” is any sexual act that might put an individual’s social, physical, and psychological health at risk and increase the likelihood of adverse sexual and reproductive health consequences. Street children have risky sexual practices, which place them at all kinds of health risks. Therefore, the aim of this study is to assess risky sexual practices and associated factors among street children in Wonago Town, southern Ethiopia.MethodsA community-based cross-sectional study design was employed. About 214 street children, aged 10–18, residing in Wonago Town from September 1–30, 2021, participated in the study. Data was gathered from all of the street children in Wonago town. A pre-tested and structured interviewer-administered questionnaire was used to collect data. Epi data software was used to enter the collected data, which was then exported to SPSS for analysis. A logistic regression model was applied to identify the associated factors. A p value <0.05 was used to declare the significant variables.ResultsA total of 214 street children were involved in the study. Overall, the magnitude of risky sexual practices was 43.46 percent (95% CI: 38.3–48.62). About 52.7% of participants had ever had sexual intercourse in the last year, and of them, around 43.5% had more than one sexual partner. Among sexually active street children, 40.9% never used a condom during sexual intercourse. Age (Adjusted Odd Ratio (AOR): 1.42, 95%CI: 1.03–2.37), educational status (AOR: 5.73, 95%CI: 1.49–10.51), substance use (AOR: 1.24, 95%CI: 1.03–2.07), duration on the street (AOR: 2.14, 95%CI: 1.03–4.12), and daily income (AOR: 0.68, 95%CI: 0.32–0.98) were found to be significantly associated with risky sexual practices.ConclusionRisky sexual practices among street children were more prevalent in Wonago Town, Southern Ethiopia. Children’s age, educational status, daily income, duration on the street, and status of substance use were the factors that contributed to risky sexual practices. As a result, conducting information and education campaigns, developing income-generating activities for children, increasing children’s school enrollment and attendance, improving access to sexual and reproductive health services, and providing capacity-building training for health care providers may all help to reduce risky sexual practices.
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Vameghi M, Roshanfekr P, Ghaedamini Harouni G, Takaffoli M, Bahrami G. Street Children in Iran: What Are Their Living and Working Conditions? Findings from a Survey in Six Major Cities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5271. [PMID: 37047887 PMCID: PMC10094613 DOI: 10.3390/ijerph20075271] [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: 11/15/2022] [Revised: 03/13/2023] [Accepted: 03/14/2023] [Indexed: 06/19/2023]
Abstract
UNLABELLED Street children are among the most marginalized children, globally, who experience severe violations of their rights and face multiple deprivations. This study aimed to describe street children's characteristics and working conditions in Iran. METHOD This cross-sectional rapid survey was conducted from March to May 2017 in six major cities in Iran. The sample group consisted of Iranian and non-Iranian girls and boys, aged 10 to 18, who worked on the streets for at least one month prior to the survey. Time-location based sampling was used. A total of 856 Children were randomly selected from 464 venues, including corners of streets, parks, metro gates, bus stations, shopping malls, and shopping centers frequented by street children. RESULTS Findings showed that 90% of participants were boys, 60% were between 10 and 14 years old, almost 50% attended school, 12% were illiterate, and 32% had quit school. Children of Afghan nationality comprised 54% of the study participants, and the rest were Iranian. Of all participants, 85% resided with family or relatives. Most children (75.5%) worked more than 5 h daily, and vending (71.2%) and waste picking (16.1%) were common activities. Street children suffered, mainly, from harsh weather (22.7%), insults and beatings of everyday people (21%), starvation (20.7%), and police repression (15.4%). More than half of the study participants were not involved in intervention programs, and just 7% of them had attended any health education programs. CONCLUSION Street children reported little to no service use, which may contribute to poor health. Street children require immediate attention to improve their wellbeing. Decision-makers and academicians should collaborate on intervention development research to design appropriate health and social interventions targeted at street children.
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Affiliation(s)
- Meroe Vameghi
- Social Welfare Management Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran 1985713871, Iran
| | - Payam Roshanfekr
- Social Welfare Management Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran 1985713871, Iran
| | - Gholamreza Ghaedamini Harouni
- Social Welfare Management Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran 1985713871, Iran
| | - Marzieh Takaffoli
- Social Welfare Management Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran 1985713871, Iran
| | - Giti Bahrami
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj 3149969415, Iran
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Wilson-Barthes M, Braitstein P, DeLong A, Ayuku D, Atwoli L, Sang E, Galárraga O. Cost Utility of Supporting Family-Based Care to Prevent HIV and Deaths among Orphaned and Separated Children in East Africa: A Markov Model-Based Simulation. MDM Policy Pract 2022; 7:23814683221143782. [PMID: 36601384 PMCID: PMC9806382 DOI: 10.1177/23814683221143782] [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: 03/15/2022] [Accepted: 11/15/2022] [Indexed: 12/24/2022] Open
Abstract
Purpose. Strengthening family-based care is a key policy response to the more than 15 million orphaned and separated children who have lost 1 or both parents in sub-Saharan Africa. This analysis estimated the cost-effectiveness of family-based care environments for preventing HIV and death in this population. Design. We developed a time-homogeneous Markov model to simulate the incremental cost per disability-adjusted life year (DALY) averted by supporting family-based environments caring for orphaned and separated children in western Kenya. Model parameters were based on data from the longitudinal OSCAR's Health and Well-Being Project and published literature. We used a societal perspective, annual cycle length, and 3% discount rate. Incremental cost-effectiveness ratios were simulated over 5- to 15-y horizons, comparing family-based settings to street-based "self-care." Parameter uncertainty was addressed via deterministic and probabilistic sensitivity analyses. Results. Under base-case assumptions, family-based environments prevented 422 HIV infections and 298 deaths in a simulated cohort of 1,000 individuals over 10 y. Compared with street-based self-care, family-based care had an incremental cost of $2,528 per DALY averted (95% confidence interval [CI]: 1,798, 2,599) and $2,355 per quality-adjusted life year gained (95% CI: 1,667, 2,413). The probability of family-based care being highly cost-effective was >80% at a willingness-to-pay (WTP) threshold of $2,250/DALY averted. Households receiving government cash transfers had minimally higher cost-effectiveness ratios than households without cash transfers but were still cost-effective at a WTP threshold of twice Kenya's GDP per capita. Conclusions. Compared with the status quo of street-based self-care, family-based environments offer a cost-effective approach for preventing HIV and death among orphaned children in lower-middle income countries. Decision makers should consider increasing resources to these environments in tandem with social protection programs. Highlights UNICEF and more than 200 other international organizations endorsed efforts to redirect services toward family-based care as part of the 2019 UN Resolution on the Rights of the Child; yet this study is one of the first to quantify the cost-effectiveness of family-based care environments serving some of the world's most vulnerable children.This health economic modeling analysis found that family-based environments would prevent 422 HIV infections and 298 deaths in a cohort of 1,000 orphaned and separated children over a 10-y time horizon.Compared with street-based "self-care," family-based care resulted in an incremental cost of $2,528 per DALY averted (95% CI: 1,798, 2,599) and $2,355 per quality-adjusted life year gained (95% CI: 1,667, 2,413) after 10 y.Annual per-child expenditures for children living in family-based care environments in sub-Saharan Africa could potentially be increased by at least 25% and remain highly cost-effective.
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Affiliation(s)
- Marta Wilson-Barthes
- Department of Epidemiology, Brown University
School of Public Health, Providence, RI, USA
| | - Paula Braitstein
- Division of Epidemiology, Dalla Lana School of
Public Health, University of Toronto, Toronto, Canada,Academic Model Providing Access to Healthcare
(AMPATH), Eldoret, Kenya,Department of Epidemiology and Medical
Statistics, College of Health Sciences, School of Public Health, Eldoret,
Kenya
| | - Allison DeLong
- Department of Biostatistics, Brown University
School of Public Health, Providence, RI, USA
| | - David Ayuku
- Department of Mental Health and Behavioral
Sciences, School of Medicine, College of Health Sciences, Moi University,
Eldoret, Kenya
| | - Lukoye Atwoli
- Department of Mental Health and Behavioral
Sciences, School of Medicine, College of Health Sciences, Moi University,
Eldoret, Kenya,Brain and Mind Institute, Department of
Internal Medicine, Aga Khan University Medical College, East Africa
| | - Edwin Sang
- Academic Model Providing Access to Healthcare
(AMPATH), Eldoret, Kenya
| | - Omar Galárraga
- Omar Galárraga, Department of Health
Services, Policy and Practice, Brown University School of Public Health, 121
South Main Street, Box G-S121-2, Providence, RI 02912, USA;
()
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Fornaro M, Dragioti E, De Prisco M, Billeci M, Mondin AM, Calati R, Smith L, Hatcher S, Kaluzienski M, Fiedorowicz JG, Solmi M, de Bartolomeis A, Carvalho AF. Homelessness and health-related outcomes: an umbrella review of observational studies and randomized controlled trials. BMC Med 2022; 20:224. [PMID: 35818057 PMCID: PMC9273695 DOI: 10.1186/s12916-022-02423-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 05/30/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Homelessness has been associated with multiple detrimental health outcomes across observational studies. However, relatively few randomized controlled trials (RCTs) have been conducted on people who experience homelessness (PEH). Thus, this umbrella review ranked the credibility of evidence derived from systematic reviews (SRs) and meta-analyses (MAs) of observational studies investigating the associations between homelessness and any health outcome as well as RCTs targeting health needs in this population. METHODS Several databases were systematically searched from inception through April 28, 2021. Any SR and/or MA reporting quantitative data and providing a control group were eligible for inclusion. The credibility of the evidence derived from observational studies was appraised by considering the significance level of the association and the largest study, the degree of heterogeneity, the presence of small-study effects as well as excess significance bias. The credibility of evidence was then ranked in five classes. For SRs and/or MAs of RCTs, we considered the level of significance and whether the prediction interval crossed the null. The AMSTAR-2 and AMSTAR-plus instruments were adopted to further assess the methodological quality of SRs and/or MAs. The Newcastle-Ottawa Scale (NOS) was employed to further appraise the methodological quality of prospective cohort studies only; a sensitivity analysis limited to higher quality studies was conducted. RESULTS Out of 1549 references, 8 MAs and 2 SRs were included. Among those considering observational studies, 23 unique associations were appraised. Twelve of them were statistically significant at the p≤0.005 level. Included cases had worst health-related outcomes than controls, but only two associations reached a priori-defined criteria for convincing (class I) evidence namely hospitalization due to any cause among PEH diagnosed with HIV infection, and the occurrence of falls within the past year among PEH. According to the AMSTAR-2 instrument, the methodological quality of all included SRs and/or MAs was "critically low." Interventional studies were scant. CONCLUSION While homelessness has been repeatedly associated with detrimental health outcomes, only two associations met the criteria for convincing evidence. Furthermore, few RCTs were appraised by SRs and/or MAs. Our umbrella review also highlights the need to standardize definitions of homelessness to be incorporated by forthcoming studies to improve the external validity of the findings in this vulnerable population.
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Affiliation(s)
- Michele Fornaro
- Section of Psychiatry, Department of Neuroscience, Reproductive Science, and Odontostomatology, Federico Ii University of Naples, Naples, Italy
| | - Elena Dragioti
- Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linköping University, SE-581 85 Linköping, Sweden
| | - Michele De Prisco
- Section of Psychiatry, Department of Neuroscience, Reproductive Science, and Odontostomatology, Federico Ii University of Naples, Naples, Italy
| | - Martina Billeci
- Section of Psychiatry, Department of Neuroscience, Reproductive Science, and Odontostomatology, Federico Ii University of Naples, Naples, Italy
| | - Anna Maria Mondin
- Section of Psychiatry, Department of Neuroscience, Reproductive Science, and Odontostomatology, Federico Ii University of Naples, Naples, Italy
| | - Raffaella Calati
- Department of Psychology, University of Milan-Bicocca, Piazza dell’Ateneo Nuovo, 1, 20126 Milan, Italy
- Department of Adult Psychiatry, Nimes University Hospital, 4 Rue du Professeur Robert Debré, 30029 Nimes, France
| | - Lee Smith
- Cambridge Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Simon Hatcher
- Department of Psychiatry, University of Ottawa, Ottawa, ON Canada
- Department of Mental Health, The Ottawa Hospital, Ottawa, ON Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON Canada
| | - Mark Kaluzienski
- Department of Psychiatry, University of Ottawa, Ottawa, ON Canada
- Department of Mental Health, The Ottawa Hospital, Ottawa, ON Canada
| | - Jess G. Fiedorowicz
- Department of Psychiatry, University of Ottawa, Ottawa, ON Canada
- Department of Mental Health, The Ottawa Hospital, Ottawa, ON Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON Canada
| | - Marco Solmi
- Department of Psychiatry, University of Ottawa, Ottawa, ON Canada
- Department of Mental Health, The Ottawa Hospital, Ottawa, ON Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON Canada
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology, London, UK
- Faculty of Environmental and Life Sciences, Center for Innovation in Mental Health, School of Psychology, University of Southampton, Southampton, UK
| | - Andrea de Bartolomeis
- Section of Psychiatry, Department of Neuroscience, Reproductive Science, and Odontostomatology, Federico Ii University of Naples, Naples, Italy
- UNESCO staff, Chair - “Education for Health and Sustainable Development”, University of Naples, Federico II Naples, Naples, Italy
| | - André F. Carvalho
- IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Australia
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12
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Tairou F, Diallo A, Sy O, Kone A, Manga IA, Sylla K, Lelo S, Fall CB, Sow D, Ndiaye M, Faye B, Tine RCK. Malaria-associated risk factors among adolescents living in areas with persistent transmission in Senegal: a case-control study. Malar J 2022; 21:193. [PMID: 35725475 PMCID: PMC9208171 DOI: 10.1186/s12936-022-04212-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 06/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In Senegal, malaria morbidity has sharply decreased over these past years. However, malaria epidemiology remains heterogeneous with persistent transmission in the southeastern part of the country and many cases among older children and adolescents. Little is known about factors associated with clinical malaria among this group. A better understanding of malaria transmission among this newly emerging vulnerable group will guide future interventions targeting this population group. This study aimed to identify factors associated with clinical malaria among adolescents in Senegal. METHODS A case-control study was conducted from November to December 2020 in four health posts located in the Saraya district. Cases were defined as adolescents (10-19 years) with an uncomplicated malaria episode with fever (temperature > 37.5°) or a history of fever and positive malaria rapid diagnostic test (RDT). Controls were from the same age group, living in the neighbourhood of the case, presenting a negative RDT. A standardized, pre-tested questionnaire was administered to each study participant followed by a home visit to assess the participant's living conditions. Factors associated with clinical malaria were assessed using stepwise logistic regression analysis. RESULTS In total, 492 individuals were recruited (246 cases and 246 controls). In a multivariate analysis, factors associated with clinical malaria included non-use of long-lasting insecticidal net (LLIN) (aOR = 2.65; 95% CI 1.58-4.45), non-use of other preventive measures (aOR = 2.51; 95% CI 1.53-4.11) and indoor sleeping (aOR = 3.22; 95% CI 1.66-6.23). Protective factors included 15-19 years of age (aOR = 0.38; 95% CI 0.23-0.62), absence of stagnant water around the house (aOR = 0.27; 95% CI 0.16-0.44), having a female as head of household (aOR = 0.47; 95% CI 0.25-0.90), occupation such as apprentice (OR = 0.24; 95% CI 0.11-0.52). CONCLUSIONS The study revealed that environmental factors and non-use of malaria preventive measures are the main determinants of malaria transmission among adolescents living in areas with persistent malaria transmission in Senegal. Strategies aimed at improving disease awareness and access to healthcare interventions, such as LLINs, are needed to improve malaria control and prevention among these vulnerable groups.
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Affiliation(s)
- Fassiatou Tairou
- Department of Medical Parasitology, University Cheikh Anta Diop of Dakar, Dakar, Senegal.
| | | | - Ousmane Sy
- Department of Medical Parasitology, University Cheikh Anta Diop of Dakar, Dakar, Senegal
| | - Aminatou Kone
- Department of Medical Parasitology, University Cheikh Anta Diop of Dakar, Dakar, Senegal.,Malaria Research and Training Center, University of Bamako, Bamako, Mali
| | - Isaac Akhenaton Manga
- Department of Medical Parasitology, University Cheikh Anta Diop of Dakar, Dakar, Senegal
| | - Khadim Sylla
- Department of Medical Parasitology, University Cheikh Anta Diop of Dakar, Dakar, Senegal
| | - Souleye Lelo
- Department of Medical Parasitology, University Cheikh Anta Diop of Dakar, Dakar, Senegal
| | - Cheikh Binetou Fall
- Department of Medical Parasitology, University Cheikh Anta Diop of Dakar, Dakar, Senegal
| | - Doudou Sow
- Department of Medical Parasitology, University Cheikh Anta Diop of Dakar, Dakar, Senegal
| | - Magatte Ndiaye
- Department of Medical Parasitology, University Cheikh Anta Diop of Dakar, Dakar, Senegal
| | - Babacar Faye
- Department of Medical Parasitology, University Cheikh Anta Diop of Dakar, Dakar, Senegal
| | - Roger C K Tine
- Department of Medical Parasitology, University Cheikh Anta Diop of Dakar, Dakar, Senegal
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13
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Bwambale MF, Birungi D, Moyer CA, Bukuluki P, van den Borne B. Migration, personal physical safety and economic survival: drivers of risky sexual behaviour among rural–urban migrant street youth in Kampala, Uganda. BMC Public Health 2022; 22:1119. [PMID: 35658856 PMCID: PMC9166484 DOI: 10.1186/s12889-022-13516-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 05/05/2022] [Indexed: 11/10/2022] Open
Abstract
Background Despite the vulnerabilities associated with the youth migration process, knowledge on the drivers of risky sexual behaviour among migrant street youth is limited. This study sought to explore the pathways driving risky sexual behaviour among rural–urban migrant street youth in Kampala, Uganda. Methods We conducted 11 focus-group discussions composed of 8–10 participants each, and 15 in-depth interviews with urban street adolescents and youth aged 12–24 years. We purposively recruited street youth who had migrated from other districts to Kampala, Uganda, and who identified themselves as street youth. Data were analysed thematically using an inductive approach facilitated by Dedoose software. Results The migration journey acted as a catalyst for risky sexual behaviour among the adolescents and youth moving from rural districts to Kampala. Three primary pathways were found to drive risky sexual behaviour of street youth: 1) rural–urban migration itself, through sexual exploitation of and violence toward street youth especially young girls during movement, 2) economic survival through engaging in casual jobs and sex work upon arrival in the city, and 3) personal physical safety through friendships and networks, which consequently lead to having multiple sexual partners and unprotected sex. Engagement in risky sexual behaviour, especially sex work, was found to be an adaptation to the challenging and complex street life within the city. Conclusions This study highlights the migration process, personal physical safety and economic survival as major pathways driving risky sexual behaviour among rural–urban street youth in Kampala. Interventions to improve sexual health, physical safety and protection of street youth during the migration process and within the city spaces should be prioritised.
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14
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Abate D, Eyeberu A, Adare D, Negash B, Alemu A, Beshir T, Deressa Wayessa A, Debella A, Bahiru N, Heluf H, Abdurke Kure M, Abdu A, Oljira Dulo A, Bekele H, Bayu K, Bogale S, Atnafe G, Assefa T, Belete R, Muzeyin M, Asmerom H, Arkew M, Mohammed A, Asfaw H, Taddesse B, Alemu D, Yihun D, Nigussie S, Yusuf Kebira J, Aliyi Adem S, Dirirsa G, Hailu S, Godana A, Mamo G, Bekele D, Dessie Y. Health status of street children and reasons for being forced to live on the streets in Harar, Eastern Ethiopia. Using mixed methods. PLoS One 2022; 17:e0265601. [PMID: 35303038 PMCID: PMC8932583 DOI: 10.1371/journal.pone.0265601] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 03/05/2022] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION In Ethiopia, more than four million children are anticipated to live under particularly difficult circumstances. Street children are subject to violence, a lack of health care, and a lack of education. Which denies them the right to live in a secure environment and exposes them to different health problems. Currently, little is known about the prevalence of Streetism, including health conditions. Therefore, this study was aimed to assess the health status of street children and determinants of Streetism. METHODS Mixed methods (sequential) were employed from February 1 to 28, 2021. Quantitative cross-sectional study design and phenomenological qualitative designs were applied. Overall, 220 street children were involved in the study. The most common reason that forced the children to resort to a street way of life is to look for a job and quarreled with parents. The data were collected using interviews methods. Chi-square test and multiple binary logistic regression were applied to examine the variations among variables with the health status of street children. Qualitative data were analyzed using the thematic analysis technique. RESULTS The study included a total of 220 street children. As to the quantitative study, the majority of study participants (92.73%) drank alcohol regularly. Depression (39.22%) and peer pressure (43.14%) were the most common initiation causes of drinking alcohol. According to a qualitative study report, "Street children are mostly affected by the communicable disease" and… They are addicted to substances like benzene" which had a profound effect on their health." Furthermore, the study discovered a statistically significant association between respondents' health status and sociodemographic characteristics (age and educational status), job presence, and drug use. CONCLUSION This study identified the factors that drove street children to live on the streets, such as the inability to find work and disagreements with their parents. The majority of the street children were affected by preventable and treatable diseases. Unfortunately, almost all street children reported drinking alcohol, which exposed them to a variety of health problems. In general, the study discovered that street children require immediate attention. Decision-makers and academicians should collaborate to develop a plan for these children's health and social interventions.
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Affiliation(s)
- Degu Abate
- Department of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Addis Eyeberu
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Dechasa Adare
- Department of Environmental Health, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Belay Negash
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Addisu Alemu
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Temam Beshir
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Alemayehu Deressa Wayessa
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Adera Debella
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Nebiyu Bahiru
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Helina Heluf
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Mohammed Abdurke Kure
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Ahmedmenewer Abdu
- Department of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Amanuel Oljira Dulo
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Habtamu Bekele
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kefelegn Bayu
- Department of Environmental Health, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Saron Bogale
- School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Genanaw Atnafe
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tewodros Assefa
- School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Rabuma Belete
- Department of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Mohammed Muzeyin
- Department of Environmental Health, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Haftu Asmerom
- Department of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Mesay Arkew
- Department of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Anumein Mohammed
- Department of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Henock Asfaw
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Barkot Taddesse
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Daniel Alemu
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Dawit Yihun
- School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Shambel Nigussie
- School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Jemal Yusuf Kebira
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Siraj Aliyi Adem
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Gebisa Dirirsa
- Department of Environmental Health, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Saba Hailu
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abduro Godana
- School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Galana Mamo
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Deribe Bekele
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Yadeta Dessie
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Muswede NJ, Tshivhase L, Mavhandu-Mudzusi AH. Condom use education, promotion and reasons for condom use: Perspectives of healthcare providers and young adults in Vhembe district, Limpopo province. S Afr Fam Pract (2004) 2021; 63:e1-e8. [PMID: 34879692 PMCID: PMC8661420 DOI: 10.4102/safp.v63i1.5326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 09/28/2021] [Accepted: 09/29/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Condom use is a critical component of a comprehensive and sustainable approach to the prevention of unintended pregnancies and sexually transmitted infections (STIs) (including HIV). Despite government making condoms freely available in the healthcare facilities in Vhembe district, there are reports of an increase in teenage pregnancies and STIs, including HIV, amongst young adults. The aim of the study was to gain an in-depth understanding of condom use promotion and reasons of condom use amongst young adults in Vhembe district, in Limpopo province. METHODS A descriptive phenomenological design was used to explore the reasons for promoting condom use amongst young adults themselves and from the perspectives of healthcare providers who are critical role players in condom education and provision. Purposive sampling was used to sample young adults and healthcare providers at three of Vhembe district's primary healthcare facilities. Individual semi-structured interviews were conducted, after which thematic data analysis was used to develop themes and subthemes. RESULTS Two superordinate themes emerged from data analysis, namely approaches to promote condom use and reasons for condom use. Two themes emerged in respect of approaches for promotion of condom use: information sharing in the form of education, the distribution of informative material, and the adoption of a multi-sectoral approach. Self-protection emerged as a reason for condom use, to prevent disease, pregnancy and 'u wela', and was indicative of not trusting a sexual partner. CONCLUSION To effectively promote condom use, a multidisciplinary team approach involving nurses, lay counsellors and peer educators need to be strengthened at local primary health facilities in order to facilitate the distribution of condoms and educate young adults on consistent condom use.
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16
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Bwambale MF, Bukuluki P, Moyer CA, Van den Borne BHW. Utilisation of sexual and reproductive health services among street children and young adults in Kampala, Uganda: does migration matter? BMC Health Serv Res 2021; 21:169. [PMID: 33622341 PMCID: PMC7903651 DOI: 10.1186/s12913-021-06173-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 02/14/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND While the nexus of migration and health outcomes is well acknowledged, the effect of rural-urban migration on the use of sexual and reproductive health (SRH) services has received less attention. We assessed the effect of rural-urban migration on the use of SRH services, while controlling for confounding, and whether there is a difference in the use of SRH services among migrant and non-migrant street children and young adults. METHODS Data were collected from 513 street children and young adults aged 12-24 years, using venue-based time-space sampling (VBTS). We performed multivariate logistic regression analysis using Stata 16.0 to identify factors associated with SRH services use, with rural-urban migration status as the main predictor. Participants were further classified as new migrants (≤ 2 years of stay in city), established migrants (> 2 years of stay in city) or non-migrants (lifelong native street children) with no rural-urban migration history. RESULTS Overall, 18.13% of the street children and young adults had used contraception/family planning, 58.67% had tested for human immunodeficiency virus (HIV) and knew their status and 34.70% had been screened for sexually transmitted infections (STIs). Non-migrants were 2.70 times more likely to use SRH services (HIV testing, STI screening and family planning) compared to the migrants (aOR = 2.70, 95% CI 1.23-5.97). Other factors associated with SRH services use among street children and young adults include age (aOR = 4.70, 95% CI 2.87-7.68), schooling status (aOR = 0.33, 95% CI 0.15-0.76), knowledge of place of care (aOR = 2.71, 95% CI 1.64-4.46) and access to SRH information (aOR = 3.23, 95% CI 2.00-5.24). CONCLUSIONS SRH services utilisation among migrant street children and young adults is low compared to their non-migrant counterparts and is independently associated with migration status, age, schooling status, knowledge of place of care and access to SRH information. Our findings call for the need to design and implement multi-dimensional interventions to increase the use of SRH services among street children and young adults, while taking into consideration their migration patterns.
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Affiliation(s)
- Mulekya F Bwambale
- Department of Health Promotion and Education, Faculty of Health Medicine and Life Sciences, Maastricht University Care and Public Health Research Institute (CAPHRI), Maastricht, Netherlands.
- Department of Social Work and Social Administration, School of Social Sciences, Makerere University College of Humanities and Social Sciences, Kampala, Uganda.
| | - Paul Bukuluki
- Department of Social Work and Social Administration, School of Social Sciences, Makerere University College of Humanities and Social Sciences, Kampala, Uganda
| | - Cheryl A Moyer
- Departments of Learning Health Sciences and Obstetrics and Gynaecology, University of Michigan Medical School, Ann Arbor, USA
| | - Bart H W Van den Borne
- Department of Health Promotion and Education, Faculty of Health Medicine and Life Sciences, Maastricht University Care and Public Health Research Institute (CAPHRI), Maastricht, Netherlands
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17
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Physical illnesses associated with childhood homelessness: a literature review. Ir J Med Sci 2020; 189:1331-1336. [PMID: 32385787 DOI: 10.1007/s11845-020-02233-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 04/09/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Childhood homelessness is a growing concern in Ireland [1] creating a paediatric subpopulation at increased risk of physical illnesses, many with life-long consequences [2]. AIM Our aim was to identify and categorize the physical morbidities prevalent in homeless children. METHODS A review of the English-language literature on physical morbidities affecting homeless children (defined as ≤ 18 years of age) published from 1999 to 2019 was conducted. RESULTS Respiratory issues were the most commonly cited illnesses affecting homeless children, including asthma, upper respiratory tract infections, and chronic cough [3]. Homeless children were described as being at increased risk for contracting infectious diseases, with many studies placing emphasis on the risks of sexually transmitted infections (STIs) and HIV/AIDS transmission [4, 5]. Dermatologic concerns for this population comprised of scabies and head lice infestation, dermatitis, and abrasions [3, 6]. Malnutrition manifested as a range of physical morbidities, including childhood obesity [7], iron deficiency anemia [4], and stunted growth [8]. Studies demonstrated a higher prevalence of poor dental [7] and ocular health [9] in this population as well. Many articles also commented on the risk factors predisposing homeless children to these physical health concerns, which can broadly be categorized as limited access to health care, poor living conditions, and lack of education [3, 10]. CONCLUSION This literature review summarized the physical illnesses prevalent among homeless children and the contributing factors leading to them. Gaps in the literature were also identified and included a dearth of studies focusing on younger children compared with adolescents. Further research into prevention and intervention programs for this vulnerable population is urgently needed.
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Ababor AA, Tesso DW, Cheme MC. Addressing the deprived: need and access of sexual reproductive health services to street adolescents in Ethiopia. The case of Nekemte town: mixed methods study. BMC Res Notes 2019; 12:827. [PMID: 31881920 PMCID: PMC6935099 DOI: 10.1186/s13104-019-4850-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 12/10/2019] [Indexed: 11/18/2022] Open
Abstract
Objectives Globally, the research knowledge gap exists in the sexual reproductive health (SRH) services of street adolescents. The intensity of the problem is high in settings like Ethiopia, where there are limited access and integration of services. This study aimed at exploring risky sexual behaviors, needs, and barriers of SRH services among street adolescents in Nekemte town. A community-based cross-sectional study design with mixed approaches was used on a sample size of 219 street adolescents. Supplementary qualitative data of 24 in-depth interviews were collected from the street adolescents and SRH service providers. Time-location sampling or venue sampling technique (VDT) was used for a quantitative study. Quantitative data were analyzed by SPSS version 24.0. Results About 93% of street adolescents reported difficulty in accessing contraceptives. Behavioral change and sustainable access to SRH services are lacking among street adolescents. The Knowledge gap is more evident in early adolescents (10–13) period than the other classes. In general, street adolescents are deprived of access to SRH services. Mobile and flexible access to contraceptives should be designed targeting street adolescents.
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Uchendu OC, Adeyera O, Owoaje ET. Awareness and utilization of female condoms among street youths in Ibadan, an urban setting in South-West Nigeria. Pan Afr Med J 2019; 33:168. [PMID: 31565129 PMCID: PMC6756805 DOI: 10.11604/pamj.2019.33.168.12733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 10/12/2018] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Female condom awareness and use have been poorly documented in sub-Saharan region especially among street youths. This study assessed its awareness and use among street youths. METHODS A cross-sectional study was conducted among 964 youths between ages 15 to 24 years old using questionnaires to elicit information. Univariate and multivariate analysis were conducted at 5% level of significance. RESULTS More than half (69.9%) were males and between 20-25 years of age (61.2%). More than three-quarter (81.0%) had initiated sexual activity. Almost half (47.9%) of the respondents have heard about female condoms however only 16.8% have ever seen while 4.3% have actually ever used a female condom. Age, education, current sexual activity and experience of rape attempt were predictors of female condom awareness. CONCLUSION Awareness of female condom was a significant predictor of utilization of female condoms. There is therefore a need for proper awareness and education on the effectiveness of female condoms.
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Affiliation(s)
- Obioma Chukwudi Uchendu
- Department of Community Medicine, Faculty of Public Health, University of Ibadan, Ibadan, Nigeria
| | - Oluwapelumi Adeyera
- Department of Community Medicine, Faculty of Public Health, University of Ibadan, Ibadan, Nigeria
| | - Eme Theodora Owoaje
- Department of Community Medicine, Faculty of Public Health, University of Ibadan, Ibadan, Nigeria
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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: 13] [Impact Index Per Article: 2.6] [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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Shah P, Kibel M, Ayuku D, Lobun R, Ayieko J, Keter A, Kamanda A, Makori D, Khaemba C, Ngeresa A, Embleton L, MacDonald K, Apondi E, Braitstein P. A Pilot Study of "Peer Navigators" to Promote Uptake of HIV Testing, Care and Treatment Among Street-Connected Children and Youth in Eldoret, Kenya. AIDS Behav 2019; 23:908-919. [PMID: 30269232 PMCID: PMC6458975 DOI: 10.1007/s10461-018-2276-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Research suggests a burden of HIV among street-connected youth (SCY) in Kenya. We piloted the use of peer navigators (PNs), individuals of mixed HIV serostatus and with direct experience of being street-connected, to link SCY to HIV testing and care. From January 2015 to October 2017, PNs engaged 781 SCY (585 male, 196 female), median age 16 (IQR 13-20). At initial encounter, 52 (6.6%) were known HIV-positive and 647 (88.8%) agreed to HIV testing. Overall, 63/781 (8.1%) SCY engaged in this program were HIV-positive; 4.6% males and 18.4% females (p < 0.001). Of those HIV-positive, 48 (82.8%) initiated ART. As of October 2017, 35 (60.3%) of the HIV-positive SCY were alive and in care. The pilot suggests that PNs were successful in promoting HIV testing, linkage to care and ART initiation. More research is needed to evaluate how to improve ART adherence, viral suppression and retention in care in this population.
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Affiliation(s)
- Pooja Shah
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
| | - Mia Kibel
- Department of Epidemiology, Dalla Lana School of Public Health, University of Toronto, 155 College Street, 5th Floor, Toronto, ON, M5T 3M7, Canada
| | - David Ayuku
- Department of Behavioral Sciences, School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya
| | - Regina Lobun
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
| | - John Ayieko
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
| | - Alfred Keter
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
| | | | - Dominic Makori
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
| | - Collins Khaemba
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
| | - Anthony Ngeresa
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
| | - Lonnie Embleton
- Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, Canada
| | - Katherine MacDonald
- Department of Pediatrics, School of Medicine, Indiana University, Indianapolis, USA
| | - Edith Apondi
- Moi Teaching and Referral Hospital, Eldoret, Kenya
| | - Paula Braitstein
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.
- Department of Epidemiology, Dalla Lana School of Public Health, University of Toronto, 155 College Street, 5th Floor, Toronto, ON, M5T 3M7, Canada.
- Department of Medicine, School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya.
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Johnson LR, Drescher CF, Assenga SH, Marsh RJ. Assessing Assets Among Street-Connected Youth: New Angles With Participatory Methods in Tanzania. JOURNAL OF ADOLESCENT RESEARCH 2019. [DOI: 10.1177/0743558418822334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Street-connected adolescents in sub-Saharan Africa have been neglected in scholarly research. Extant literature is largely problem focused. This study describes strengths and assets among street-connected youth in Tanzania, using a participatory, mixed methods approach. Adolescents ( N = 38, 13-17 years) in a rehabilitation center for street youth in Northern Tanzania completed a Swahili version of the Developmental Assets Profile (DAP). They engaged in participatory activities designed to capture multiple perspectives and promote maximal engagement. A subsample of youth ( n = 8) took part in photovoice to elucidate contextual details. Although exploratory, we expected (a) participants would have lower scores on the external versus internal domain of the DAP; (b) qualitative methods would support the DAP and provide complementary, contextual information; and (c) participatory methods would be important for providing varied perspectives and engaging youth in the research process. Results revealed a moderately high level of assets, with strengths in constructive use of time and commitment to school. External assets were higher than internal assets; however, different assets were emphasized across different methods. Overall, results supported the DAP framework. The participatory approaches effectively engaged youth and illuminated the culture and context of their development.
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Behzadifar M, Gorji HA, Rezapour A, Bragazzi NL. Prevalence of hepatitis C virus among street children in Iran. Infect Dis Poverty 2018; 7:88. [PMID: 30269685 PMCID: PMC6166285 DOI: 10.1186/s40249-018-0469-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 07/30/2018] [Indexed: 02/06/2023] Open
Abstract
Background Street children are forced to spend a lot of time away from their homes and some of them do not have homes at all, due to economic and family problems, which makes them exposed to many health problems, such as the hepatitis C virus (HCV) infection. Iran, like many other countries in the world, experiences the burden of street children, however, the rate of HCV among street children is virtually unknown. This study aimed to determine the prevalence of HCV among street children in Iran. Main body This systematic review and meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The study protocol of this review was registered in PROSPERO under identification term CRD42018082336. A comprehensive literature search was conducted to identify published studies reporting on the prevalence of HCV among street children in Iran. Several international scholarly databases, including Web of Science, PubMed®/MEDLINE®, Embase, Scopus®, Google Scholar and Directory of Open Access Journals, as well as Iranian databases such as MagIran and Barakathns were searched. Studies published between 1988 and December 2017 with any of the following keywords were selected: (street OR homeless OR labour) AND (children OR child OR infant) AND (hepatitis C OR hepatitis C virus OR HCV OR viral hepatitis OR hepatitis OR hepacivirus) AND Iran. Moreover, a grey literature search was performed in order to obtain other potentially relevant studies. The search was carried out without any language restrictions. Four studies, surveying a total of 1691 street children, conducted between 2006 and 2017 were found to be eligible for inclusion in the review and therefore analysed. Three studies were conducted in Tehran and one in Isfahan. The prevalence of HCV among street children in Iran was found to be high, at 2.4% (95% CI: 1.8–3.3). Conclusions Since the prevalence of HCV among street children in Iran is quite high, health decision- and policy-makers should pay more attention to street children and widen support channels, both social and economic. Further studies should be conducted among street children in different cities of Iran to add to the knowledge base of HCV among street children in the country. The health system should provide facilities for street children to be screened to quickly diagnose illnesses and prevent them from developing complications. Electronic supplementary material The online version of this article (10.1186/s40249-018-0469-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Masoud Behzadifar
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Hasan Abolghasem Gorji
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Aziz Rezapour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Nicola Luigi Bragazzi
- School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
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