Special Studies in Rwanda

Special Studies Experience, Summer 2013 -- Kigali, Rwanda -- Partner Agencie(s): Women's Equity in Access to Care and Treatmenthttp://deepblue.lib.umich.edu/bitstream/2027.42/110166/1/Poster_Rudatsikira.pd

Determinants of Exposure to Second-Hand Tobacco Smoke (SHS) among Current Non-Smoking In-School Adolescents (aged 11–18 years) in South Africa: Results from the 2008 GYTS Study

The aim of this study was to estimate the prevalence and identify correlates of second-hand tobacco smoke (SHS) among 6,412 current non-smoking school-going adolescents (aged 11 to 18 years) in South Africa. A cross-sectional study was carried out in 2008 in South Africa within the framework of the Global Youth Tobacco Survey. Overall, 25.7% of students were exposed to SHS at home, 34.2% outside of the home and 18.3% were exposed to SHS at home and outside of the home. Parental and close friends smoking status, allowing someone to smoke around you and perception that passive smoking was harmful were significant determinants of adolescent’s exposure to both SHS at home and outside of the home. Identified factors can inform the implementation of public health interventions in order to reduce passive smoking among adolescents

Victimization from bullying among school-attending adolescents in grades 7 to 10 in Zambia

BACKGROUND: Among school- attending adolescents, victimization from bullying is associated with anxiety, depression and poor academic performance. There are limited reports on victimization from bullying in Zambia; we therefore conducted this study to determine the prevalence and correlates for victimization from bullying among adolescents in grades 7 to 10 in the country in order to add information on the body of knowledge on victimization from bullying. METHODS: The 2004 Zambia Global School-based Health Survey (GSHS) data among adolescents in grades 7 to 10 were obtained from the World Health Organization. We estimated the prevalence of victimization from bullying. We also conducted weighted multivariate logistic regression analysis to determine independent factors associated with victimization from bullying, and report adjusted odds ratios (AOR) and their 95% confidence intervals (CI). RESULTS: Of 2136 students who participated in the 2004 Zambia GSHS, 1559 had information on whether they were bullied or not. Of these, 1559 students, 62.8% (60.0% of male and 65.0% of female) participants reported having been bullied in the previous 30 days to the survey. We found that respondents of age less than 14 years were 7% (AOR=0.93; 95%CI [0.91, 0.95]) less likely to have been bullied compared to those aged 16 years or older. Being a male (AOR=1.07; 95%CI [1.06, 1.09]), lonely (AOR=1.24; 95%CI [1.22, 1.26]), worried (AOR=1.12; 95%CI [1.11, 1.14]), consuming alcohol (AOR=2.59; 95%CI [2.55, 2.64]), missing classes (AOR=1.30; 95%CI [1.28, 1.32]), and considering attempting suicide (AOR=1.20; 95%CI [1.18, 1.22]) were significantly associated with bullying victimization. CONCLUSIONS: Victimization from bullying is prevalent among in-school adolescents in grades 7 to 10 in Zambia, and interventions to curtail it should consider the factors that have been identified in this study

Current cigarette smoking among in-school American youth: results from the 2004 National Youth Tobacco Survey

Abstract Background Tobacco use is a leading cause of preventable morbidity and mortality. In the developed nations where the burden from infectious diseases is lower, the burden of disease from tobacco use is especially magnified. Understanding the factors that may be associated with adolescent cigarette smoking may aid in the design of prevention programs. Methods A secondary analysis of the 2004 United States National Youth Tobacco Survey was carried out to estimate the association between current cigarette smoking and selected smoking-related variables. Study participants were recruited from middle and high schools in the United States. Logistic regression analysis using SUDAAN software was conducted to estimate the association between smoking and the following explanatory variables: age, sex, race-ethnicity, peer smoking, living in the same household as a smoker, amount of pocket money at the disposal of the adolescents, and perception that smoking is not harmful to health. Results Of the 27727 respondents whose data were analysed, 15.9% males and 15.3% females reported being current cigarette smokers. In multivariate analysis, compared to Whites, respondents from almost all ethnic groups were less likely to report current cigarette smoking: Blacks (OR = 0.52; 95% CI [0.44, 0.60]), Asians (OR = 0.45; 95% CI [0.35, 0.58]), Hispanic (OR = 0.81; 95% CI [0.71, 0.92]), and Hawaii/Pacific Islanders (OR = 0.69; 95% CI [0.52, 0.93]). American Indians were equally likely to be current smokers as whites, OR = 0.98 [95% CI; 0.79, 1.22]. Participants who reported living with a smoker were more than twice as likely to smoke as those who did not live with a cigarette smoker (OR = 2.73; 95% CI [2.21, 3.04]). Having friends who smoked was positively associated with smoking (OR = 2.27; 95% CI [1.91, 2.71] for one friend who smoked, and OR = 2.71; 95% CI [2.21, 3.33] for two or more friends who smoked). Subjects who perceived that it was safe to smoke for one or two years were more likely to smoke than those who thought it was definitely not safe to do so. There was a dose-response relationship between age and the amount of money available to the respondents on one hand, and current smoking status on the other (p-value < 0.001). Conclusion We found that White non-Hispanic adolescents were as likely to be current smokers as American Indians but more likely to be smokers than all other racial/ethnic groups. Older adolescents, increase amounts of pocket money, and perception that smoking was not harmful to health. The racial/ethnic differences in prevalence of smoking among America youth deserve particular exploration

Cigarette smoking and associated factors among in-school adolescents in Jamaica: comparison of the Global Youth Tobacco Surveys 2000 and 2006

<p>Abstract</p> <p>Background</p> <p>We conducted this study to estimate the correlates of current cigarette smoking among in-school adolescents in Jamaica 2006 and compare prevalence of smoking and associated factors between 2000 and 2006.</p> <p>Results</p> <p>In 2006, 1854 participated of whom 49.5 were males and 50.5% females. 1752 adolescents, 48.8% male and 51.2% females participated in the 2000 survey. Between 2000 and 2006, the prevalence of smoking among Jamaican school-going adolescents went up slightly from 15.2% to 16.7% but this was not statistically significant (p = 0.22). The perception that smoking is not harmful increased from 10.9% to 15.9% while parental smoking decreased from 39.4% to 35.5%. There was a decrease in the rates of adolescents exposed to tobacco adverts on billboards (p-value = 0.037) and in newspapers/magazine (p-value < 0.001). The percentage of adolescents who reported having an item with a tobacco brand logo on it increased from 13.9% to 16.4%. The perception that boys and girls who smoked had more friends increased between 2000 and 2006 (p-values = 0.016 and 0.004 respectively). Current smoking was associated with male gender (OR = 1.55; 95% CI [1.09–2.19]), having smoking parents (OR = 1.75; 95% CI [1.23–2.50]), and smoking friends (OR = 14.94; 95% CI [8.61–25.92] for most or all friends smokers and OR = 4.38; 95% CI [2.93–6.56] for some friends smokers)).</p> <p>Conclusion</p> <p>Results from this study indicate smoking was positively associated with male gender, having smoking friends or parents. We observed a slightly non significant increase in the prevalence of smoking between 2000 and 2006 among adolescents in Jamaica. Although there was a decrease in the rates of adolescents exposed to advertisement, the percentage of those who had an item with a tobacco brand logo had increased. The possible impact of the Jamaica's ratification of the Framework Convention on Tobacco control remains to be observed.</p

Graduate Public Health Education in Africa: An Innovative Distance-Learning Model

This article describes the development and implementation of a distance graduate public health education program in Africa by Loma Linda University, Loma Linda, California, U.S.A. The program started in March 2000 and ended in September 2003 with formal teaching sessions on-site held twice a year at the University of Eastern Africa, Kenya. The instruction was given in English and French. Of the cohort of 67 students from 20 African countries who started the program, 57 received an M.P.H. degree and six received a certificate in public health. The experiential learning model allowed students to immediately put into practice what they had learned. Challenges included security-related problems, accommodation/travel logistics and communication. In addition to the graduates, successful outcomes included the formation of the Pan-African Public Health Association. The new cadre of trained public health professionals represents enhancement to public health capacity in Africa

Correlates of Diarrhoea among Children Below the Age of 5 Years in Sudan

Background The Millennium Development Goals recognise child health and survival as an important socio-development issue. Objectives To determine the correlates of diarrhoea among children aged below 5 years in north Sudan. Methods We conducted secondary data analysis of the Sudan Multiple Cluster Indicators Survey II. Results Altogether, 23,295 children were included in the survey. Half (50.0%) of the children were males, and 22.5% of them were of age less than one year. Boys were 3% (p=0.044) more likely to have diarrhoea compared to girls. Compared with the oldest age group (48–59 months), children less than 6 months of age and those aged 36–47 months had 25% and 18% lower prevalence of diarrhoea, respectively, while children aged 6–24 months and those aged 24–35 months had 1.5 fold and 1.17 fold higher prevalence of diarrhoea. Children in urban areas were 6% more likely to have diarrhoea. Children from households with 1 or 2 people per room were 8% less likely to have diarrhoea compared to children from households with more than 3 people per room. Conclusions Diarrhoea was associated with child\u27s age, gender, and social status. Our findings provide a useful baseline for interventions and comparisons with future studies

HIV and AIDS-related knowledge among women in Iraq

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Variables associated with physical fighting among US high-school students

Abstract Background Violence among adolescents is an important public health problem in the United States. This study was conducted to estimate the prevalence of having been engaged in physical fighting on school property and associated factors of the behavior among school-going adolescents in the United States. Methods This study was based on secondary analysis of the United States Youth Risk Behavior Survey (YRBS) conducted in 2005. The sampling frame included all private and public school in the country, stratified by region and urbanicity based on the US census bureau data. Frequencies and proportions were obtained for the outcome and explanatory variables. Logistic regression analysis was used to estimate the level of association between explanatory variables and the outcome (having been involved in a physical fight). Results Of the 13,857 respondents, 13.5% (18.2% for males and 8.8% for females) reported physical fighting onschool property in the last 12 months to the survey. Males were more likely to have been in a physical fight than females (OR = 2.23; 95% CI [1.89, 2.63]). Respondents aged 17 years or older were less likely to report physical fighting than those who were 14 years or younger. Compared to Whites, American Indians or Alaska Natives, Blacks, Native Hawaii or other Pacific Islanders, and Hispanics were more likely to report physical fighting on school property (OR = 2.11; 95% CI [1.22, 3.66], OR = 1.72; 95% CI [1.42, 2.0], OR = 2.18; 95% CI [1.01, 4.79], and OR = 1.74; 95% CI [1.41, 2.16] respectively). Physical fighting on school property was also positively associated with cigarette smoking (OR = 1.70; 95% CI [1.37, 2.10]), drinking alcohol (OR = 1.45; 95% CI [1.20, 1.76]), use of illegal drugs (OR = 1.73; 95% CI [1.42, 2.12]), having had property stolen or deliberately damaged on school property (OR = 2.06; 95% CI [1.74, 2.44]), having been threatened or injured with a weapon on school property (OR = 2.63; 95% CI [2.06, 3.34]), and playing videogame three or more hours a day (OR = 1.29; 95% CI [1.07, 1.56]). Conclusion These findings suggest that physical fighting among US High School students is widespread and positively associated with victimization (having been threatened or injured with a weapon on school property) and other risky behaviors such as smoking, alcohol and drugs use. Intervention programs to prevent/control those risky behaviors as well as further attention on the association between physical fighting and victimization at school through longitudinal research are warranted

Prevalence and associated factors of suicidal ideation among school-going adolescents in Guyana: results from a cross sectional study

Abstract Background Adolescent suicidal behaviour is a neglected public health issue especially in middle- and low-income countries. Informed policy decision-making on suicidal behaviour will need reliable information on the prevalence and correlates of suicidal ideation which is a determinant of suicidal behaviour. Methods We estimated the prevalence and associated factors of suicidal ideation among school-going adolescents using data from the Global School-Based Health Survey conducted in 2004 in Guyana. Results Of the 1197 respondents, 18.4% (14.9% males and 21.6% females)reported having seriously considered committing suicide in the last12 months. Males were less likely to seriously consider committingsuicide than females (OR = 0.45; 95% CI [0.30, 0.67]). Subjects whoreported having been bullied were more than twice as likely tocontemplate committing suicide as those who had not been bullied (OR = 2.46 [1.71, 3.54]). History of depression was positivelyassociated with suicidal ideation (OR = 2.67; 95% [1.87, 3.81] whilehaving close friends and understanding parents were negativelyassociated with suicide ideation (OR = 0.51; 95% CI [0.28, 0.94] and OR = 0.51; 95% CI [0.35, 0.76] respectively). Conclusion Suicidal ideation is a significant public health issue among in-school adolescents in Guyana that requires attention. The design, implementation and evaluation of suicidal behaviour interventions should incorporate our knowledge of these associated factors