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The socioeconomic status of children with epilepsy in Zambia: implications for long-term health and well-being.

ABSTRACT: Epilepsy is a highly stigmatized disorder in Zambia. Studies indicate that adults with epilepsy in many regions have significantly lower socioeconomic status (SES) than their peers. We conducted a case-control study of Zambian children with epilepsy (CWE) to assess their SES. Ninety-eight pairs of children were recruited (n=196); their mean age was 10.8 years, and 59.7% were male. The comparison group's medical conditions included asthma (54.0%), rheumatic heart disease (26.6%), type 1 diabetes (14.2%), and hypertension (5.2%). Compared with children with nonstigmatized chronic medical conditions, CWE have fewer educational opportunities, more environmental hazards, and poorer food quality and security (all P's<0.05). This deprivation may be related to lost maternal income for mothers who deferred employment so they could remain at home to care for their children. This early deprivation has long-term implications for health and well-being. Health care workers and child advocates need to be aware of the circumstances facing CWE in this region.

SUBMITTER: Chomba E

PROVIDER: S-EPMC2586063 | biostudies-literature | 2008 Nov

REPOSITORIES: biostudies-literature

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The socioeconomic status of children with epilepsy in Zambia: implications for long-term health and well-being.

Chomba Elwyn E Haworth Alan A Atadzhanov Masharip M Mbewe Edward E Birbeck Gretchen L GL

Epilepsy & behavior : E&B 20080812 4

Epilepsy is a highly stigmatized disorder in Zambia. Studies indicate that adults with epilepsy in many regions have significantly lower socioeconomic status (SES) than their peers. We conducted a case-control study of Zambian children with epilepsy (CWE) to assess their SES. Ninety-eight pairs of children were recruited (n=196); their mean age was 10.8 years, and 59.7% were male. The comparison group's medical conditions included asthma (54.0%), rheumatic heart disease (26.6%), type 1 diabetes ...[more]

PMID: 18602496

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Project description:BackgroundThere is a causal link between childhood socioeconomic status and health status in adulthood and beyond. It's vital to comprehend the relationship between childhood socioeconomic status and mental health among older Chinese individuals from the current generation who have undergone significant social changes in China. This understanding is critical to foster healthy demographic and social development in China.MethodsUsing data from the 2020 China Family Panel Studies, we investigate the relationship between childhood socioeconomic status and depression in older adults. Additionally, we examine the mediating role of adult socioeconomic status and subjective well-being.Results1) Childhood socioeconomic status of Chinese older adults differences by region of residence, while depression levels differences by gender, region of residence, and marital status. 2) Adult socioeconomic status mediated the relationship between childhood socioeconomic status and depression in older adults. 3) Adult socioeconomic status and subjective well-being had a chain-mediated role in the relationship between childhood socioeconomic status and depression in older adults.ConclusionsIn terms of childhood socioeconomic status, older adults in urban regions were significantly higher than those in rural regions. As for depression level, female older adults were more depressed than males; married older people have the lowest depression levels, while unmarried and widowed older people have higher depression levels; older adults in rural regions had higher depression levels than those in urban regions. Evidence from our study further suggests that childhood socioeconomic status can suppress the depression level in older adults through adult socioeconomic status; it can also further reduce the depression level in older adults through the chain mediation of adult economic status affecting subjective well-being. As depression is more prevalent among older individuals with a lower childhood socioeconomic status, it is vital to prioritize the extensive impact of childhood socioeconomic status as a distal factor and investigate "upstream" solutions to enhance childhood socioeconomic status and reduce the gap during the early years of life.

Project description:The effects of a regular and graduated walking program as a stand-alone intervention for individuals in long-term care are unclear. Exercise and fall prevention programs typically studied in long-term care settings tend to involve more than one exercise mode, such as a combination of balance, aerobic, strengthening, and flexibility exercises; and, measures do not always include mental health symptoms and behaviors, although these may be of even greater significance than physical outcomes.We are randomly assigning residents of long-term care facilities into one of three intervention groups: (1) Usual Care Group--individuals receive care as usual within their long-term care unit; (2) Interpersonal Interaction Group--individuals receive a comparable amount of one-on-one stationary interpersonal interaction time with study personnel administering the walking program; and, (3) Walking Program Group--individuals participate in a supervised, progressive walking program five days per week, for up to half an hour per day. Assessments completed at baseline, 2 and 4 months during intervention, and 2 and 4 months post-intervention include: gait parameters using the GAITRite® computerized system, grip strength, the Berg Balance Scale, the Senior Fitness Test, the Older Adult Resource Services Physical Activities of Daily Living, the Geriatric Depression Scale Short Form, the Cornell Scale for Depression in Dementia, the Revised Memory and Behavior Problems Checklist, the Short Portable Mental Status Questionnaire, the Coloured Analogue Scale, pain assessment scales, and the number and nature of falls. Sophisticated data analytic procedures taking into account both the longitudinal nature of the data and the potential for missing data points due to attrition, will be employed.Residents in long-term care have a very high number of comorbidities including physical, mental health, and cognitive. The presence of dementia in particular makes standardized research protocols difficult to follow, and staff shortages, along with inconsistencies related to shift changes may impact on the accuracy of caregiver-rated assessment scales. Practical challenges to data collection validity and maintenance of inter-rater reliability due to the large number of research staff required to implement the interventions at multiple sites are also posed.ClinicalTrials.gov NCT01277809.

Dataset Information

The socioeconomic status of children with epilepsy in Zambia: implications for long-term health and well-being.

Publications

The socioeconomic status of children with epilepsy in Zambia: implications for long-term health and well-being.

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