Is it Not Now? : School Counselors’ Training in Tanzania Secondary Schools

Counseling is currently becoming a necessary service for  school learners in the developing world, this is due to fact that, the challenges facing learners in their learning process results into both internalizing and externalizing problems which affect student’s learning in terms of social, psychology and academic. This paper explores the status of school counselor’s training, knowledge and skills in Tanzania secondary schools. It attempt to assess school counselor’s perception towards the existing school counseling services and the degree of readiness to attend a counseling training in order to improve their counseling skills. The sample for the study included 62 school counselors from 16 secondary schools in Dar es salaam and the data were collected through questionnaires and interviews. The findings indicate that, there is less training among school counselors in the studied secondary schools. It was also noted that, though some school counselors attended some trainings, their knowledge, skills and awareness to school counseling principles is very limited. However, school counselors’ perception towards counseling services in schools is good and their degree of readiness to attend counseling training is positive (M=1.39, SD= 0.554). It was therefore concluded that school counseling services need to be enhanced through provision of school counseling trainings to teachers who are appointed to serve as school counselors in various secondary schools. With the support from these findings, it is recommended that, seminars and workshops for raising awareness as well as long term trainings are important in order to make school counseling services effective. Therefore, future research can also observe the extent to which the counseling component is taught in teacher colleges and universities so as to test the rationale for appointing teachers to work as school counselors even without any specified training on counseling. Key words: School counselor, Training, Perception, Knowledg

Prevalence and co-existence of morbidity of posttraumatic stress and functional impairment among Burundian refugee children and their parents

Scharpf F, Kyaruzi E, Landolt MA, Hecker T. Prevalence and co-existence of morbidity of posttraumatic stress and functional impairment among Burundian refugee children and their parents. European Journal of Psychotraumatology. 2019;10(1): 1676005.Background: Although the family constitutes the prime source of risk and resilience for the well-being of children growing up in adverse conditions, the mental health of children living in refugee camps has rarely been investigated in conjunction with their parents’ mental health. Objectives: To examine the prevalence of posttraumatic stress disorder (PTSD) and other mental health problems among Burundian refugee children and their parents living in Tanzanian refugee camps and to identify patterns of comorbidity among children and their parents based on PTSD symptom levels and functional impairment. Methods: We recruited a representative sample of 230 children aged 7–15 years and both of their parents (n = 690) and conducted separate structured clinical interviews. Latent Class Analysis was applied to identify patterns of comorbidity. Results: Children and parents were exposed to multiple traumatic event types. In total, 5.7% of children fulfilled DSM-5 criteria for PTSD in the past month and 10.9% reported enhanced levels of other mental health problems. 42.6% indicated clinically significant functional impairment due to PTSD symptoms. PTSD prevalence was higher among mothers (32.6%) and fathers (29.1%). Latent Class Analysis (LCA) revealed a familial accumulation of PTSD symptoms as children with high symptom levels and impairment were likely to live in families with two traumatized parents. Conclusions: Although the number of children who need support for trauma-related mental health problems was relatively low, taking into account parental trauma could aid to identify at-risk children with elevated PTSD symptom levels and impairment even in the face of existing barriers to mental health care access for children in refugee camp settings (e.g. lack of targeted services, prioritization of managing daily stressors)

Factors Contributing to Violence Against Children: Insights From a Multi-informant Study Among Family-Triads From Three East-African Refugee Camps

Hecker T, Kyaruzi E, Borchardt J, Scharpf F. Factors Contributing to Violence Against Children: Insights From a Multi-informant Study Among Family-Triads From Three East-African Refugee Camps. Journal of interpersonal violence. 2021.Parental violence poses a considerable, yet mitigable risk for the mental health and well-being of refugee children living in resource-poor refugee camps. However, little is known about potential risk factors for parental violence in these settings. Using an ecological systems perspective and a multi-informant approach, we investigated ontogenic (parental childhood experiences of violence), microsystem (parents' and children's psychopathology) and exosystem (families' monthly household income) risk factors for child-directed parental violence in a sample of 226 Burundian families living in refugee camps in Tanzania. Data were collected through individual structured clinical interviews with mothers, fathers, and children. In the child-report path model [chi2 (6) = 7.752, p = .257, comparative fit index (CFI) = 0.99, root mean square error of approximation (RMSEA) = 0.036 (p = .562)], children's posttraumatic stress disorder (PTSD) symptoms, externalizing symptoms and paternal PTSD symptoms were positively associated with violence by both parents. Maternal psychosocial impairment was positively associated with child-reported paternal violence. In the parent-report path model [chi2 (6) = 7.789, p = .254, CFI = 0.97, RMSEA = 0.036 (p = .535)], children's externalizing problems as well as a lower monthly household income were positively related to maternal violence. Each parent's childhood victimization was positively linked to their use of violence against children. Maternal psychosocial impairment and paternal alcohol abuse were positively associated with paternal violence. Child and paternal psychopathology, maternal psychosocial impairment, parents' childhood victimization, and families' socioeconomic status may be important targets for prevention and intervention approaches aiming to reduce parental violence against refugee children living in camps

Prevalence of suicidality and associated factors of suicide risk in a representative community sample of families in three East African refugee camps

Scharpf F, Masath FB, Mkinga G, et al. Prevalence of suicidality and associated factors of suicide risk in a representative community sample of families in three East African refugee camps. Social Psychiatry and Psychiatric Epidemiology. 2023.**Purpose** To assess the prevalence of suicidality and associated factors of suicide risk in a sample of Burundian refugee families living in three refugee camps in Tanzania. **Methods** Children (n = 230) and their parents (n = 460) were randomly selected and interviewed about suicidality (suicidal ideation, plans, and attempts) and a range of sociodemographic, psychological, and environmental factors. Multinomial logistic regression analyses were conducted to examine factors associated with children and parents’ lower and moderate or high current suicide risk. **Results** Past-month prevalence of suicidal ideation, plans, and attempts were 11.3%, 0.9% and 0.9%, respectively, among children; 37.4%, 7.4% and 5.2%, respectively, among mothers; and 29.6%, 4.8% and 1.7%, respectively, among fathers. Older age in years (aORlower = 2.20, 95% CI 1.38–3.51; aORmoderate/high = 3.03, 95% CI 1.15–7.99) and higher levels of posttraumatic stress disorder symptoms (aORlower = 1.64, 95% CI 1.05–2.57; aORmoderate/high = 2.30, 95% CI: 1.02–5.16), internalizing (aORmoderate/high = 2.88, 95% CI 1.33–6.26) and externalizing problems (aORlower = 1.56, 95% CI: 1.06–2.31; aORmoderate/high = 3.03, 95% CI 1.42–6.49) were significantly positively associated with children’s current suicide risk. For mothers, higher perceived instrumental social support (aORmoderate/high = 0.05, 95% CI lower = 1.97, 95% CI 1.30–2.99; aORmoderate/high = 1.59, 95% CI 1.00–2.52), living in larger households (aORlower = 1.74, 95% CI 1.17–2.57), and higher psychological distress (aORmoderate/high = 1.67, 95% CI 1.05–2.67) were significantly positively associated with suicide risk. For fathers, higher perceived instrumental social support (aORmoderate/high = 0.04, 95% CI moderate/high = 0.58, 95% CI 0.34–0.98) were significantly negatively and exposure to war-related trauma (aORmoderate/high = 1.81, 95% CI 1.03–3.19) was significantly positively associated with suicide risk. **Conclusion** Prevention programs should target psychopathology, community violence and social support to mitigate children and parents’ current suicide risk

Attributable risk factors for asymptomatic malaria and anaemia and their association with cognitive and psychomotor functions in schoolchildren of north-eastern Tanzania.

In Africa, children aged 5 to 15 years (school age) comprises more than 50% (>339 million) of the under 19 years population, and are highly burdened by malaria and anaemia that impair cognitive development. For the prospects of improving health in African citizens, understanding malaria and its relation to anaemia in school-aged children, it is crucial to inform targeted interventions for malaria control and accelerate elimination efforts as part of improved school health policy. We conducted a study to determine the risk factors for asymptomatic malaria and their association to anaemia. We explored the prevalence of antimalarial drug resistance as well as the association of asymptomatic malaria infection and anaemia on cognitive and psychomotor functions in school-aged children living in high endemic areas. This study was a comprehensive baseline survey, within the scope of a randomised, controlled trial on the effectiveness and safety of antimalarial drugs in preventing malaria and its related morbidity in schoolchildren. We enrolled 1,587 schoolchildren from 7 primary schools located in Muheza, north-eastern Tanzania. Finger-pricked blood samples were collected for estimation of malaria parasitaemia using a microscope, haemoglobin concentration using a haemoglobinometer, and markers of drug resistance processed from dried blood spots (DBS). Psychomotor and Cognitive functions were assessed using a '20 metre Shuttle run' and a test of everyday attention for children (TEA-Ch), respectively. The prevalence of asymptomatic malaria parasitaemia, anaemia and stunting was 26.4%, 49.8%, and 21.0%, respectively with marked variation across schools. In multivariate models, asymptomatic malaria parasitaemia attributed to 61% of anaemia with a respective population attribution fraction of 16%. Stunting, not sleeping under a bednet and illiterate parent or guardian were other factors attributing to 7%, 9%, and 5% of anaemia in the study population, respectively. Factors such as age group (10-15 years), not sleeping under a bednet, low socioeconomic status, parents' or guardians' with a low level of education, children overcrowding in a household, and fewer rooms in a household were significantly attributed to higher malaria infection. There was no significant association between malaria infection or anaemia and performance on tests of cognitive function (sustained attention) or psychomotor function (VO2 max). However, a history of malaria in the past one month was significantly associated with decreased cognitive scores (aOR = -4.1, 95% CI -7.7-0.6, p = 0.02). Furthermore, stunted children had significantly lower VO2max scores (aOR = -1.9, 95% CI -3.0-0.8, p = 0.001). Regarding the antimalarial drug resistance markers, the most prevalent Pfmdr1 86-184-1034-1042-1246 haplotypes were the NFSND in 47% (n = 88) and the NYSND in 52% (n = 98). The wild type Pfcrt haplotypes (codons 72-76, CVMNK) were found in 99.1% (n = 219) of the samples. Malaria, stunting and parents' or guardians' illiteracy were the key attributable factors for anaemia in schoolchildren. Given malaria infection in schoolchildren is mostly asymptomatic; an addition of interventional programmes such as intermittent preventive treatment of malaria in schoolchildren (IPTsc) would probably act as a potential solution while calling for an improvement in the current tools such as bednet use, school food programme, and community-based (customised) health education with an emphasis on nutrition and malaria control