Effects of parental psychiatric and physical illness on child development

2012 ◽  
pp. 1752-1758
Author(s):  
Paul Ramchandani ◽  
Alan Stein ◽  
Lynne Murray
Keyword(s):  
Significant Proportion ◽  
Postnatal Period ◽  
Physical Illness ◽  
Sub Saharan Africa ◽  
Adult Disease ◽  
Psychiatric Illnesses ◽  
Physical Conditions ◽  
The United Kingdom ◽  
Increased Risk ◽  
Sub Saharan

A broad range of physical and psychiatric illnesses commonly affect adults of parenting age. For example, approximately 13 per cent of women are affected by depression in the postnatal period, and the prevalence of depression in parents of all ages remains high. Many parents will also experience severe physical illness; breast cancer affects approximately 1 in 12 women in the United Kingdom, about a third of whom have children of school age. Worldwide HIV has an enormous impact on adults of parenting age. In some parts of sub-Saharan Africa up to 40 per cent of women attending antenatal clinics are HIV positive. Many of these parental disorders are associated with an increased risk of adverse emotional and social development in their children, and in some cases cognitive development and physical health are also compromized. It must be emphasized that a significant proportion of children at high risk do not develop problems and demonstrate resilience, and, many parents manage to rear their children well despite their own illness. Nonetheless these risks represent a significant additional impact and burden of adult disease (both physical and psychiatric) that is often overlooked. This chapter reviews the current state of evidence regarding selected examples of psychiatric and physical conditions, from which general themes can be extracted to guide clinical practice. Some of the key mechanisms whereby childhood disturbance does or does not develop in conjunction with parental illness are considered, and strategies for management and intervention reviewed.

Access to cancer chemotherapy and predictors of early mortality for childhood cancers in Uganda.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 10070-10070
Author(s):  
Innocent Mutyaba ◽  
Jackson Orem ◽  
Henry Wabinga ◽  
Warren Phipps ◽  
Corey Casper
Keyword(s):  
Childhood Cancer ◽  
Cancer Patients ◽  
Performance Status ◽  
Significant Proportion ◽  
Early Mortality ◽  
Sub Saharan Africa ◽  
Childhood Cancers ◽  
Risk Of Death ◽  
Increased Risk ◽  
Sub Saharan

10070 Background: Although many childhood cancers respond well to chemotherapy, survival among children with cancer in sub-Saharan Africa is poor. Little is known about children’s access to specialized cancer care in SSA or factors contributing to poor early outcomes. We aimed: 1) To estimate the proportion of childhood cancer patients without access to chemotherapy in Uganda; 2) To describe 30-day survival rates and predictors of mortality post diagnosis among children with lymphoma or Kaposi sarcoma (KS), the two most common pediatric cancers in Uganda. Methods: A retrospective study of incident childhood (age< 20 years) cancers diagnosed in Kyandondo County, Uganda from 2006-2009. We compared records of the population-based Kampala Cancer Registry (KCR) and patient records at the Uganda Cancer Institute (UCI), Uganda’s sole dedicated cancer treatment center. Patient characteristics were compared using Mann-Whitney and Pearson’s chi-square tests. Kaplan-Meier method and Cox regression models were used to describe mortality. Results: Of the 658 pediatric cases recorded in the KCR, only 238 (36%) presented to UCI. Patients identified in the KCR who did not present for care were more likely to be female, diagnosed in earlier years of the study, and to have a cancer other than KS or lymphoma. Of the 177 lymphoma and KS cases at UCI, 43.7% were Burkitt lymphoma (BL), 32.5% KS, and 23.8% other lymphomas. The post diagnosis 30-day overall survival rate was 77%. In multivariate analysis, age, gender, HIV status, platelets, and stage of cancer did not impact mortality. An increased risk of death at 30 days was predicted by presence of B-symptoms (HR=10.3, p=0.05), a diagnosis of BL compared to other lymphomas (HR=14.8, p=0.007), poor performance status (Karnofsky score <70, HR=14.7, p<0.001), and anemia (HR 1.5-fold per 1g/dL decrease in hemoglobin, p=0.002). Conclusions: Childhood cancer patients in Uganda have limited access to comprehensive care. Among those presenting to the UCI, a significant proportion die before they can benefit from chemotherapy. BL diagnosis, B-symptoms, performance status and hemoglobin level may be important predictors of early mortality among childhood cancer patients in sub-Saharan Africa.

scholarly journals Continuing high levels of HIV diagnoses in men who have sex with men in the United Kingdom

2008 ◽  
Vol 13 (14) ◽  
pp. 3-4
Author(s):  
B Rice ◽  
A Nardone ◽  
N Gill ◽  
V Delpech
Keyword(s):  
United Kingdom ◽  
Confidence Intervals ◽  
Sub Saharan Africa ◽  
Newly Diagnosed ◽  
The United Kingdom ◽  
Reporting Delays ◽  
Sub Saharan ◽  
Sex With Men ◽  
The Uk ◽  
Almost All

The latest HIV data for 2007 has recently been published for the United Kingdom (UK). During the year, an estimated 6,840 (95% confidence intervals 6,600-7,050) persons (adjusted for reporting delays) were newly diagnosed with HIV in the UK. This represents a 12% decline from a peak of new HIV diagnoses reported in 2005 (7,800). Almost all this decline in new HIV diagnoses was in HIV-infected heterosexuals from sub-Saharan Africa who were probably infected in their country of origin.

scholarly journals Identification and Characterization of Persistent Human Erythrovirus Infection in Blood Donor Samples

2004 ◽  
Vol 78 (22) ◽  
pp. 12169-12178 ◽  
Author(s):  
Daniel Candotti ◽  
Nermin Etiz ◽  
Armen Parsyan ◽  
Jean-Pierre Allain
Keyword(s):  
South Africa ◽  
United Kingdom ◽  
Persistent Infection ◽  
Parvovirus B19 ◽  
Sub Saharan Africa ◽  
Genotype 1 ◽  
Genotype 3 ◽  
Real Time Quantitative Pcr ◽  
The United Kingdom ◽  
Sub Saharan

ABSTRACT The presence of human erythrovirus DNA in 2,440 blood donations from the United Kingdom and sub-Saharan Africa (Ghana, Malawi, and South Africa) was screened. Sensitive qualitative and real-time quantitative PCR assays revealed a higher prevalence of persistent infection with the simultaneous presence of immunoglobulin G (IgG) and viral DNA (0.55 to 1.3%) than previously reported. This condition was characterized by a low viral load (median, 558 IU/ml; range, 42 to 135,000 IU/ml), antibody-complexed virus, free specific IgG, and potentially infectious free virus. Human erythrovirus genotype 1 (formerly parvovirus B19) was prevalent in the United Kingdom, Malawi, and South Africa. In contrast, only human erythrovirus genotype 3 (erythrovirus variant V9) was prevalent in Ghana. Genotype 3 had considerable genetic diversity, clustering in two probable subtypes. Genotype 1-based antibody assays failed to detect 38.5% of Ghanaian samples containing antibodies to genotype 3 virus but did not fail to detect cases of persistent infection. This study indicates a potential African origin of genotype 3 human erythrovirus and considerable shortcomings in the tools currently used to diagnose erythrovirus infection.

Rotavirus

2021 ◽  
Author(s):  
Sultan Mahmood
Keyword(s):  
Rna Virus ◽  
Sub Saharan Africa ◽  
Oral Rehydration ◽  
Degree Of Protection ◽  
Rotavirus Vaccines ◽  
Increased Risk ◽  
Hygiene Measures ◽  
Primary Means ◽  
Sub Saharan ◽  
Health System Responsiveness

Rotavirus is a double-stranded RNA virus that causes vomiting and diarrhea among children under 5 years. The main cause of mortality from rotavirus gastroenteritis (RVGE) is dehydration if not corrected appropriately with oral rehydration salts (ORS). Though the prevalence of RVGE is similar across countries and socio-economic groups, the higher mortality in Sub-Saharan Africa and South Asia is presumably due to poor awareness and poor health system responsiveness rather than poor hygiene. Enzyme immunoassays are the most commonly used tools for diagnosis of RVGE from stool samples. ORS and zinc remain the mainstay of treatment. Water, sanitation and hygiene measures did not appear to be very effective leaving vaccination among young children as the primary means of prevention. 4 WHO prequalified live attenuated, oral vaccines are available with different efficacy in high- versus low-mortality countries. There is a high degree of protection in countries with low RV mortality, and lower protection in countries with high RV morbidity and more fatalities. Rotavirus vaccines were associated with intussusception, though larger trials failed to establish increased risk in vaccinated groups compared to placebo recipients.

scholarly journals Homozygosity for TYK2 P1104A underlies tuberculosis in about 1% of patients in a cohort of European ancestry

2019 ◽  
Vol 116 (21) ◽  
pp. 10430-10434 ◽  
Author(s):  
Gaspard Kerner ◽  
Noe Ramirez-Alejo ◽  
Yoann Seeleuthner ◽  
Rui Yang ◽  
Masato Ogishi ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Genetic Basis ◽  
Sub Saharan Africa ◽  
European Ancestry ◽  
Uk Biobank ◽  
The United Kingdom ◽  
The Common ◽  
Sub Saharan ◽  
The Uk ◽  
High Level

The human genetic basis of tuberculosis (TB) has long remained elusive. We recently reported a high level of enrichment in homozygosity for the common TYK2 P1104A variant in a heterogeneous cohort of patients with TB from non-European countries in which TB is endemic. This variant is homozygous in ∼1/600 Europeans and ∼1/5,000 people from other countries outside East Asia and sub-Saharan Africa. We report a study of this variant in the UK Biobank cohort. The frequency of P1104A homozygotes was much higher in patients with TB (6/620, 1%) than in controls (228/114,473, 0.2%), with an odds ratio (OR) adjusted for ancestry of 5.0 [95% confidence interval (CI): 1.96–10.31, P = 2 × 10−3]. Conversely, we did not observe enrichment for P1104A heterozygosity, or for TYK2 I684S or V362F homozygosity or heterozygosity. Moreover, it is unlikely that more than 10% of controls were infected with Mycobacterium tuberculosis, as 97% were of European genetic ancestry, born between 1939 and 1970, and resided in the United Kingdom. Had all of them been infected, the OR for developing TB upon infection would be higher. These findings suggest that homozygosity for TYK2 P1104A may account for ∼1% of TB cases in Europeans.

Energy Poverty in India

2019 ◽  
Author(s):  
Praveen Kumar ◽  
Smitha Rao ◽  
Gautam N. Yadama
Keyword(s):  
South Asia ◽  
Significant Proportion ◽  
Sub Saharan Africa ◽  
Poor People ◽  
Unified Framework ◽  
Indian Government ◽  
Energy Poverty ◽  
Economic Implications ◽  
Non Profit ◽  
Sub Saharan

Energy poverty is lack of access to adequate, high-quality, clean, and affordable forms of energy or energy systems. It is a prominent risk factor for global burden of disease and has severe environmental, social, and economic implications. Despite recent international attention to address energy for the poor, there is a limited consensus over a unified framework defining energy poverty, which impacts almost 2.8 billion mostly poor people, especially in Asia, Latin America, and sub-Saharan Africa. Sub-Saharan Africa and South Asia have the largest number of energy poor. India, in South Asia, comprises a significant proportion of energy-impoverished households. There is a continued effort by the Indian government, non-profit agencies, and private organizations to address the needs of energy poor. Social workers have a significant role to play in these interventions addressing energy poverty in India. Emerging research and practice in the energy poverty field in India calls for transdisciplinary collaboration especially between social work practitioners of community development, environmental health, public health, and social policy.

Lung function in children with sickle cell disease from Central Africa

Thorax ◽  
2019 ◽  
Vol 74 (6) ◽  
pp. 604-606 ◽  
Author(s):  
Michele Arigliani ◽  
Robert Kitenge ◽  
Luigi Castriotta ◽  
Pathy Ndjule ◽  
Vincenzo Barbato ◽  
...  
Keyword(s):  
Lung Function ◽  
Sickle Cell ◽  
Sickle Cell Anaemia ◽  
Democratic Republic ◽  
Central Africa ◽  
Sub Saharan Africa ◽  
Increased Risk ◽  
Republic Of The Congo ◽  
Sub Saharan ◽  
Restrictive Pattern

Lung function in patients with sickle cell anaemia (SCA) living in sub-Saharan Africa is largely unknown. Anthropometry and spirometry were cross-sectionally evaluated in patients with SCA (HbSS) aged 6–18 years and in schoolchildren from the Democratic Republic of the Congo. The Global Lung Initiative 2012 spirometry reference values were used. A total of 112 patients and 377 controls were included. Twenty-six per cent of patients with SCA had spirometry findings suggestive of a restrictive pattern and 41% had a FEV1 z-score <5th percentile. Wasting, increasing age and female sex were independently associated with increased risk of restrictive spirometry pattern in patients with SCA. Longitudinal studies could clarify the prognostic meaning of these findings.

scholarly journals Malaria and risk of lymphoid neoplasms and other cancer: a nationwide population-based cohort study

BMC Medicine ◽  
2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Katja Wyss ◽  
Fredrik Granath ◽  
Andreas Wångdahl ◽  
Therese Djärv ◽  
Michael Fored ◽  
...  
Keyword(s):  
Cox Regression ◽  
Health Agency ◽  
Malaria Diagnosis ◽  
B Cell Lymphoma ◽  
Population Based ◽  
Sub Saharan Africa ◽  
Lymphoid Neoplasms ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Sub Saharan

Abstract Background Malaria is associated with Burkitt lymphoma among children in Sub-Saharan Africa. No longitudinal studies have assessed the long-term risk of other lymphoma or cancer overall. Here, we investigated the risk of lymphoid neoplasms and other cancer after malaria. Methods We included 4125 patients diagnosed with malaria in Sweden in 1987–2015, identified either through the National Surveillance Database at the Public Health Agency of Sweden, the National Inpatient and Outpatient Register, or by reports from microbiology departments. A comparator cohort (N = 66,997) matched on sex, age and birth region was retrieved from the general population and an additional cohort with all individuals born in Sub-Saharan Africa registered in the Total Population Register in 1987–2015 (N = 171,756). Incident lymphomas and other cancers were identified through linkage with the Swedish Cancer Register. Hazard ratios (HRs) were assessed using Cox regression with attained age as the timescale. Results A total of 20 lymphoid neoplasms and 202 non-haematological cancers were identified among malaria patients during a mean follow-up of 13.3 and 13.7 years, respectively. The overall risk of lymphoid neoplasms was not significantly increased (hazard ratio [HR] 1.24, 95% confidence interval [CI] 0.79–1.94), neither did we find any association with all-site non-haematological cancer (HR 0.89, 95% CI 0.77–1.02). However, in the Sub-Saharan Africa cohort, we observed an increased risk of lymphoid neoplasms after malaria diagnosis (HR 2.39, 95% CI 1.06–5.40), but no difference in the risk of other cancer (HR 1.01, 95% CI 0.70–1.45). The association could not be explained by co-infection with HIV or chronic hepatitis B or C, since the risk estimate was largely unchanged after excluding patients with these comorbidities (HR 2.63, 95% CI 1.08–6.42). The risk became more pronounced when restricting analyses to only including non-Hodgkin and Hodgkin lymphomas (HR 3.49, 95% CI 1.42–8.56). Conclusion Individuals born in malaria-endemic areas and diagnosed with malaria in Sweden had an increased risk of lymphoid neoplasms, especially B cell lymphoma. There was no association with cancer overall nor did single malaria episodes confer an increased risk in travellers.

scholarly journals Risk and protective factors for suicidal ideation and behaviour in Rwandan children

2015 ◽  
Vol 207 (3) ◽  
pp. 262-268 ◽  
Author(s):  
Lauren C. Ng ◽  
Catherine M. Kirk ◽  
Frederick Kanyanganzi ◽  
Mary C. Smith Fawzi ◽  
Vincent Sezibera ◽  
...  
Keyword(s):  
Mental Health ◽  
Suicidal Ideation ◽  
Mental Health Problems ◽  
Sub Saharan Africa ◽  
Hiv Positive ◽  
Hiv Status ◽  
Increased Risk ◽  
Matched Case ◽  
Sub Saharan ◽  
Control Study

BackgroundSuicide is a leading cause of death for young people. Children living in sub-Saharan Africa, where HIV rates are disproportionately high, may be at increased risk.AimsTo identify predictors, including HIV status, of suicidal ideation and behaviour in Rwandan children aged 10–17.MethodMatched case–control study of 683 HIV-positive, HIV-affected (seronegative children with an HIV-positive caregiver), and unaffected children and their caregivers.ResultsOver 20% of HIV-positive and affected children engaged in suicidal behaviour in the previous 6 months, compared with 13% of unaffected children. Children were at increased risk if they met criteria for depression, were at high-risk for conduct disorder, reported poor parenting or had caregivers with mental health problems.ConclusionsPolicies and programmes that address mental health concerns and support positive parenting may prevent suicidal ideation and behaviour in children at increased risk related to HIV.

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