To do's after war: Priorities for acute diarrheal diseases intervention among under-five children in conflict settings of Raya Kobo district, Northeastern Ethiopia
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ABSTRACT:
SUBMITTER: Yonas B
PROVIDER: S-EPMC11021898 | biostudies-literature | 2024 Mar
REPOSITORIES: biostudies-literature
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Project description:Secondary traumatic stress (STS) has been studied in therapists, spouses, and mainly in children of traumatised individuals. To date, the relationship between children's posttraumatic stress disorder (PTSD) symptoms and their parents' mental health outcomes have been understudied, and specifically, long term STS symptoms of parents of war veterans were not investigated. The current study examined PTSD symptoms among veterans of the 2014 Israel-Gaza war and STS among their parents, five years after the war. The control group consisted of veterans from combat military units who were on active duty at the time of the war but did not actively participate in the war (stand-by units) - providing a natural experiment condition. We found that PTSD symptoms were almost twice as high in the directly active war veterans (DAV, N = 32) group compared to the indirectly active war veterans (IAV, N = 26) group. Results showed that mothers had higher STS symptoms in general, and DAV PTSD symptoms correlated with their fathers STS symptoms. The current study provides novel evidence for: (a) subclinical PTSD symptoms in war veterans 5 years after the war, and (b) transmission of trauma from war veterans to their parents. The overall negative effect of sending a child to war on the parents are also discussed.
| S-EPMC10375916 | biostudies-literature
Project description:Aceh Province had the highest rate of leprosy in Indonesia; in 2014, 436 new Multibacillary cases were reported. Nagan Raya was the District in Aceh with the highest number of cases; new cases in 2015 comprised 26 with Paucibacillary (PB) and 21 with Multibacillary (MB) with a total of 4.26% with Grade II disability. The phenomena of handling and treatment by the people in Nagan Raya involve treatment by traditional healers, "Tabib", to treat the leprosy, with treatments known as Peundang locally. The purpose of this study was to find out and to take steps to improve the effectiveness of the Tabib in controlling leprosy in Nagan Raya. The main object of this study, which used a quasi-experimental design, was to find out and to improve the treatment of leprosy patients by the Tabib who treat them there. Data was gathered using a questionnaire with an interview and the intervention was to provide training and a pocket book about leprosy and how to detect, control, and manage it there and the role that the Tabib can play in controlling leprosy in the future. The results of the study showed that there was a significant difference in knowledge about leprosy between the EG (Experimental Group) Tabib after they got the training including the pocket book and the Tabib in the Control Group (CG); i.e., that did not get any training nor the pocket book. Furthermore, after the training, there was also a significant difference in the attitude towards leprosy between the EG and the CG of Tabib. There was also a significant difference in the future role of the Tabibs to control the spread of leprosy between the EG and the CG. Based on these results, it is hoped that the District Health Department can implement a partnership model with the Tabib in Nagan Raya (and elsewhere) to use the pocket book with training to implement a program to control the spread of leprosy and also to always support the Tabib to improve their role in controlling and eliminating leprosy amongst the village people.
| S-EPMC6011098 | biostudies-literature
Project description:BackgroundLimited knowledge exists to inform the selection and introduction of locally relevant, feasible, and effective mental health interventions in diverse socio-cultural contexts and health systems. We examined stakeholders' perspectives on mental health-related priorities, help-seeking behaviors, and existing resources to guide the development of a maternal mental health component for integration into non-specialized care in Soroti, eastern Uganda.MethodsWe employed rapid ethnographic methods (free listing and ranking; semi-structured interviews; key informant interviews and pile sorting) with community health workers (n = 24), primary health workers (n = 26), perinatal women (n = 24), traditional and religious healers (n = 10), and mental health specialists (n = 9). Interviews were conducted by trained Ateso-speaking interviewers. Two independent teams conducted analyses of interview transcripts following an inductive and thematic approach. Smith's Salience Index was used for analysis of free listing data.ResultsWhen asked about common reasons for visiting health clinics, the most salient responses were malaria, general postnatal care, and husbands being absent. Amongst the free listed items that were identified as mental health problems, the three highest ranked concerns were adeka na aomisio (sickness of thoughts); ipum (epilepsy), and emalaria (malaria). The terms epilepsy and malaria were used in ways that reflected both biomedical and cultural concepts of distress. Sickness of thoughts appeared to overlap substantially with major depression as described in international classification, and was perceived to be caused by unsupportive husbands, intimate partner violence, chronic poverty, and physical illnesses. Reported help-seeking for sickness of thoughts included turning to family and community members for support and consultation, followed by traditional or religious healers and health centers if the problem persisted.ConclusionOur findings add to existing literature that describes 'thinking too much' idioms as cultural concepts of distress with roots in social adversity. In addition to making feasible and effective treatment available, our findings indicate the importance of prevention strategies that address the social determinants of psychological distress for perinatal women in post-conflict low-resource contexts.
| S-EPMC5803865 | biostudies-literature
Project description:BackgroundDespite global interventions to prevent and control diarrhea, it still remains a public health problem leading to childhood morbidity and mortality majorly in developing countries. In Uganda, diarrhea is amongst the five leading causes of under-five mortality, contributing to more than 140,000 deaths every year and this accounts for 7.1% of all under-five mortalities in Uganda. Efforts to prevent and lower diarrheal diseases need to be informed by data on determinants of diarrhea. The study assessed factors associated with diarrheal diseases among children below five years in selected slum settlements in Entebbe municipality, Wakiso District, Uganda.MethodsThe study employed a cross-sectional study design covering 384 randomly selected households having children < 5 years old in the study area using quantitative research methods. Data was collected using close-ended questionnaires and diarrhea disease history was captured for the last month before the survey. Bivariate and multivariate logistic regression analyses were used to identify the risk factors associated with childhood diarrhea considering a 95% confidence level.ResultsThe prevalence of Diarrhea disease in children among the selected slum settlements in Entebbe municipality was found to be at 62.4%. Access to water from a protected water source (deep well and borehole), presence of a vent in toilets, age, and child birth weight were found to be significantly associated with diarrheal diseases among children below five years in the selected slum settlements in Entebbe municipality.ConclusionThe prevalence of childhood diarrhea among children < 5 years of age in selected slums of Entebbe municipality was found high. Use of water from a protected source, presence of a vent in toilets, age, child birth and weight were identified as predictors of diarrhea occurrence. These findings imply that community health education is urgently needed for fighting childhood diarrhea in the study area to eliminate the predisposing factors to diarrhea.
| S-EPMC9264597 | biostudies-literature
Project description:Invasive fungal infections (IFIs) are opportunistic, especially in immunocompromised and hospitalized patients. Children with IFIs are more vulnerable to a fatal outcome. For early diagnosis and treatment, knowledge of the spectrum and frequency of IFIs among children is prerequisite. In this prospective observational study, we enrolled 168 children of 2-59 months old of either sex from March 2018 to December 2019 admitted to the Dhaka hospital, icddr,b. Study participants with suspected IFIs were with or without severe acute malnutrition (SAM) along with sepsis/pneumonia and fulfilled any of the following criteria: (i) failure to respond to injectable antibiotics, (ii) development of a late-onset hospital-acquired infection, (iii) needed ICU care for >7 days, (iv) took steroids/antibiotics for >2 weeks before hospitalization, and (v) developed thrush after taking injectable antibiotics. The comparison group included non-SAM (weight-for-length Z score ≥ -2) children with diarrhea and fever <3 days in the absence of co-morbidity. We performed real-time PCR, ELISA, and blood culture for the detection of fungal pathogen. Study group children with SAM, positive ELISA and PCR considered to have a IFIs. In the study group, 15/138 (10.87%) children had IFIs. Among IFIs, invasive candidiasis, aspergillosis, histoplasmosis detected in 6 (4.53%), 11 (7.97%), and 1 (0.72%) children, respectively, and (3/15 [2.17%]) children had both candidiasis and aspergillosis. Children with IFIs more often encountered septic shock (26.7% vs. 4.9%; p = 0.013) and had a higher death rate (46.7% vs. 8.9%; p < 0.001) than those without IFIs. IFIs were independently associated with female sex (OR = 3.48; 95% CI = 1.05, 11.55; p = 0.042) after adjusting for potential confounders. Our findings thus implicate that, malnourished children with septic shock require targeted screening for the early diagnosis and prompt management of IFIs that may help to reduce IFIs related deaths.
| S-EPMC8777596 | biostudies-literature
Project description:BackgroundThe health extension program is a community-based health care delivery program with eighteen defined packages. The main aim of the health extension program is to help to reduce child mortality. So, the aim of this study is to assess the impact of a health extension program on diarrheal disease under-five children in the rural community of Kalu district, Northeast Ethiopia, 2021.MethodsA community-based cross-sectional study design was conducted from March to April/2021. A Multi-stage sampling technique was used to get a total sample size of 556 (182 model households and 374 non-model households) with a response rate of 92.22%. Binary logistic regression analysis was done, and P-value < 0.05 was considered statistically significant. Propensity score matching analysis was used to determine the contribution of health extension program "model households" on diarrhea diseases among under-five children. The average treatment effect on the treated was calculated to compare the means of outcomes across model and non-model households.ResultsHealth extension program (HEP) model household contributed a 17.7% (t = -5.02) decrease in children's diarrheal diseases among under-five children compared with HEP non-model households. Mothers from non-model households were 2.19 times more likely to develop under-five children diarrheal diseases AOR (Adjusted Odds Ratio): 2.19, 95% CI: 1.34-3.57 than mothers from model households. Households who got no frequent home visits were 3.28 times more likely to develop under-five diarrheal diseases AOR (Adjusted Odds Ratio): 3.28, 95% CI: 1.40-7.68.ConclusionWhen the health extension program is implemented fully (model household), the prevalence of under-five diarrheal disease in the rural community could decrease. The need to develop supportive strategies for the sustainability of model households and encouraging households to be model households is very important.
| S-EPMC8830013 | biostudies-literature
Project description:Humanitarian agencies are increasingly engaged in research in conflict and post-conflict settings. This is justified by the need to improve the quality of assistance provided in these settings and to collect evidence of the highest standard to inform advocacy and policy change. The instability of conflict-affected areas, and the heightened vulnerability of populations caught in conflict, calls for careful consideration of the research methods employed, the levels of evidence sought, and ethical requirements. Special attention needs to be placed on the feasibility and necessity of doing research in conflict-settings, and the harm-benefit ratio for potential research participants.
| S-EPMC2717053 | biostudies-literature
Project description:Does armed conflict influence female teen marriage? Despite increasing attention to early marriage, its drivers and consequences, quantitative research on whether teen unions are affected by situations of armed violence is minimal. This paper addresses this gap by examining the relationship between exposure to the conflict in Nagorno-Karabakh over 1992-1996 and teen marriage outcomes in Azerbaijan. Using data from the 2006 Demographic and Health Survey and the Uppsala Conflict Data Program, I compare cohorts at risk of teen union before and during the conflict climax years with a modelling strategy that exploits information on forced displacement and spatial variation in conflict violence. Results show that experiencing war violence in adolescent ages, its intensity and frequency are associated with a lower risk of teen marriage. Reductions are largest for the cohorts who spent most of their adolescent ages under conflict and who were displaced as a result. For never-migrant conflict-affected girls, declines extend to the youngest cohorts. The combination of age at conflict occurrence and the experience of disruptive events like forced migration matters for teen marriage outcomes.Supplementary informationThe online version contains supplementary material available at 10.1007/s10680-022-09645-0.
| S-EPMC9727014 | biostudies-literature
Project description:BackgroundThe people in Ethiopia have developed their own specific knowledge to use, manage and conserve plant resources, giving traditional medicine its diverse nature. Documenting and investigating the traditional and cultural use of remedial plants is vital to extract bioactive chemicals and preserve plant species. This research was conducted with the aim of documenting ethnobotanical and associated knowledge on medicinal plants in Asagirt District, northeastern Ethiopia.MethodologyThe study was conducted from September 27, 2018, to April 9, 2019. A total of 367 informants (244 males and 123 females) were involved in the interviews. General informants (n = 349) were randomly selected, whereas key informants (n = 18) were selected purposively. Data were collected by using semistructured interviews, group discussions and guided field walks. We performed direct matrix ranking and preference ranking, and calculated the fidelity level and informant consensus factor (ICF). Descriptive statistics, including analysis of variance (ANOVA) and independent sample t-test were used to analyse the data.ResultsOverall, 103 medicinal plant species belonging to 96 genera under 45 plant families were recorded to be used by Asagirt people to alleviate different health problems. The species used to heal human diseases only were (64%, 66 species) followed by both livestock and human ailments (31%, 32 species) and livestock diseases only (5%, 5 species). Asteraceae and Fabaceae were best-represented (10.7%, 11 species each). The most frequently used plant parts were leaves (28%, 29 species), followed by seeds (16%, 17 species). The most important method of herbal remedy preparation was crushing (20.4%, 21 species). The common route of administration was oral (46.6%, 48 species), followed by dermal (22.3%, 23 species). Febrile illness, fever, headache, amoebiasis, typhoid and diarrhoea ailment categories had the highest ICF value (0.99). Ocimum lamiifolium Hochst. ex Benth. scored the maximum fidelity level value (98%).ConclusionAsagirt District is comparatively rich in medicinal plants and their associated knowledge. However, firewood collection, construction, the expansion of agricultural activities and timber production are the major challenges to medicinal plants. Hence, joint management with the people in Asagirt District in overall medicinal plant conservation would save medicinal plant resources.
| S-EPMC9827656 | biostudies-literature
Project description:BackgroundWar-affected youth often suffer from multiple co-occurring mental health problems. These youth often live in low-resource settings where it may be infeasible to provide mental health services that simultaneously address all of these co-occurring mental health issues. It is therefore important to identify the areas where targeted interventions would do the most good.MethodsThis analysis uses observational data from 3 waves of a longitudinal study on mental health in a sample of 529 war-affected youth (24.2% female; ages 10-17 at T1, 2002) in Sierra Leone. We regressed 4 mental health outcomes at T3 (2008) on internalizing (depression/anxiety) and externalizing (hostility/aggression) problems and prosocial attitudes/behaviors and community variables at T2 (2004) controlling for demographics, war exposures, and previous mental health scores at T1, allowing us to assess the relative impact of potential mental health intervention targets in shaping mental health outcomes over time.ResultsControlling for baseline covariates at T1 and all other exposures/potential intervention targets at T2, we observed a significant association between internalizing problems at T2 and 3 of the 4 outcomes at T3: internalizing (β = 0.27, 95% confidence interval [CI]: 0.11-0.42), prosocial attitudes (β = -0.20, 95% CI: -0.33 to -0.07) and posttraumatic stress symptoms (β = 0.22, 95% CI: 0.02-0.43). No other potential intervention target had similar substantial effects.ConclusionsReductions in internalizing may have multiple benefits for other mental health outcomes at a later point in time, even after controlling for confounding variables.
| S-EPMC8352079 | biostudies-literature