scholarly journals Interpersonal violence in peacetime Malawi

2018 ◽  
Vol 3 (1) ◽  
pp. e000252 ◽  
Author(s):  
Rebecca G Maine ◽  
Brittney Williams ◽  
Jennifer A Kincaid ◽  
Gift Mulima ◽  
Carlos Varela ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Interpersonal Violence ◽  
Partner Violence ◽  
Sub Saharan Africa ◽  
Collective Violence ◽  
Level Of Evidence ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Trauma Victims ◽  
Sub Saharan

BackgroundThe contribution of interpersonal violence (IPV) to trauma burden varies greatly by region. The high rates of IPV in sub-Saharan Africa are thought to relate in part to the high rates of collective violence. Malawi, a country with no history of internal collective violence, provides an excellent setting to evaluate whether collective violence drives the high rates of IPV in this region.MethodsThis is a retrospective review of a prospective trauma registry from 2009 through 2016 at Kamuzu Central Hospital in Lilongwe, Malawi. Adult (>16 years) victims of IPV were compared with non-intentional trauma victims. Log binomial regression determined factors associated with increased risk of mortality for victims of IPV.ResultsOf 72 488 trauma patients, 25 008 (34.5%) suffered IPV. Victims of IPV were more often male (80.2% vs. 74.8%; p<0.001), younger (median age: 28 years (IQR: 23–34) vs. 30 years (IQR: 24–39); p<0.001), and were more often admitted at night (47.4% vs. 31.9%; p<0.001). Of the IPV victims, 16.5% admitted alcohol use, compared with only 4.4% in other trauma victims (p<0.001). In regression modeling, compared with extremity injuries, head injuries (3.14, 2.24–4.39; p<0.001) and torso injuries (4.32, 2.98–6.27; p<0.001) had increased risk of mortality. Compared with other or unknown mechanisms, penetrating injuries also had increased risk of mortality (1.46, 95% CI 1.17 to 1.81, p=0.001). Alcohol use was associated with a lower risk of mortality (0.54, 95% CI 0.39 to 0.75; p<0.001).DiscussionEven in a sub-Saharan country that never experienced internal collective violence, IPV injury rates are high. Public health efforts to measure and address alcohol use, and studies to determine the role of “mob justice,” poverty, and intimate partner violence in IPV, in Malawi are needed.Level of evidenceLevel III.

scholarly journals Alcohol use and intimate partner violence among women and their partners in sub-Saharan Africa

2017 ◽  
Vol 4 ◽  
Author(s):  
M. C. Greene ◽  
J. C. Kane ◽  
W. A. Tol
Keyword(s):  
Intimate Partner Violence ◽  
Risk Factor ◽  
Alcohol Use ◽  
Partner Violence ◽  
Male Partner ◽  
Intimate Partner ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Sub Saharan ◽  
The Relationship

Background:Alcohol use is a well-documented risk factor for intimate partner violence (IPV); however, the majority of research comes from high-income countries.Methods:Using nationally representative data from 86 024 women that participated in the Demographic and Health Surveys, we evaluated the relationship between male partner alcohol use and experiencing IPV in 14 countries in sub-Saharan Africa (SSA). Using multilevel mixed-effects models, we calculated the within-country, between-country, and contextual effects of alcohol use on IPV.Results:Prevalence of partner alcohol use and IPV ranged substantially across countries (3–62 and 11–60%, respectively). Partner alcohol use was associated with a significant increase in the odds of reporting IPV for all 14 countries included in this analysis. Furthermore, the relationship between alcohol use and IPV, although largely explained by partner alcohol use, was also attributable to overall prevalence of alcohol use in a given country. The partner alcohol use–IPV relationship was moderated by socioeconomic status (SES): among women with a partner who used alcohol those with lower SES had higher odds of experiencing IPV than women with higher SES.Conclusions:Results of this study suggest that partner alcohol use is a robust correlate of IPV in SSA; however, drinking norms may independently relate to IPV and confound the relationship between partner alcohol use and IPV. These findings motivate future research employing experimental and longitudinal designs to examine alcohol use as a modifiable risk factor of IPV and as a novel target for treatment and prevention research to reduce IPV in SSA.

scholarly journals Pooled analysis of the association between alcohol use and violence against women: evidence from four violence prevention studies in Africa

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e049282
Author(s):  
Leane Ramsoomar ◽  
Andrew Gibbs ◽  
Esnat D Chirwa ◽  
Kristin Dunkle ◽  
Rachel Jewkes
Keyword(s):  
Alcohol Use ◽  
Violence Against Women ◽  
Partner Violence ◽  
Pooled Analysis ◽  
Sub Saharan Africa ◽  
Data Sets ◽  
Cross Sectional ◽  
Harmful Alcohol ◽  
Prevention Studies ◽  
Sub Saharan

ObjectivesTo test associations between men’s past year alcohol use and patterns of drinking, and their perpetration of intimate partner violence (IPV) and non-partner sexual violence (NPSV). To test the associations between women’s reports of partner alcohol use and their experience of IPV, in three countries in Africa.DesignPooled analysis of cross-sectional baseline data from men and women participating in four IPV prevention studies across Africa and Asia.SettingData from five data sets generated by four violence against women and girls prevention studies in three countries in sub-Saharan Africa, South Africa, Ghana and Rwanda.Participants8104 men 18+ years old and 5613 women 18+ years old from a mix of volunteer and randomly selected samples.Main outcome measuresStudies employed comparable measures of past year alcohol use, harmful alcohol use (Alcohol Use Disorder Identification Test scale) and items from modified WHO Women’s Health and Domestic Violence to measure physical IPV and NPSV perpetration among men and IPV experience among women.FindingsOverall harmful alcohol use among men was associated with a substantially increased odds of perpetrating physical IPV (adjusted OR (aOR)=3.45 (95% CI 2.56 to 4.64)) and NPSV (aOR=2.64 (95% CI 1.85 to 3.76)) compared with non-drinkers. Women who had seen their partner occasionally drunk (aOR=2.68 (95% CI 2.13 to 3.36)) or frequently drunk (aOR=5.94 (95% CI 4.19 to 8.41)) in the past 12 months had an increased odds of experiencing physical IPV.ConclusionsAlcohol use is associated with increased IPV and NPSV perpetration for men and (physical) IPV experience for women. Reported frequency of IPV and NPSV increase with increasing levels and frequency of alcohol use. Interventions aimed at reducing alcohol may also lead to reductions in IPV and NPSV perpetration and experience.

scholarly journals Alcohol use during pregnancy in Rakai, Uganda

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256434
Author(s):  
Adriane Wynn ◽  
Dorean Nabukalu ◽  
Tom Lutalo ◽  
Maria Wawer ◽  
Larry W. Chang ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Pregnant Women ◽  
Partner Violence ◽  
Sub Saharan Africa ◽  
Hiv Status ◽  
Cross Sectional ◽  
The Past ◽  
Catholic Religion ◽  
Sub Saharan ◽  
Living With Hiv

Introduction Antenatal alcohol use is linked to adverse maternal and neonatal outcomes. Uganda has one of the highest rates of alcohol use in sub-Saharan Africa, but the prevalence of antenatal alcohol use has not been reported in the Rakai region. Methods We used cross-sectional data from pregnant women in the Rakai Community Cohort Study between March 2017 and September 2018. Using bivariate and multivariable analyses, we assessed associations between self-reported antenatal alcohol use and sociodemographic characteristics, intimate partner violence (IPV), and HIV status. Results Among 960 pregnant women, the median age was 26 years, 35% experienced IPV in the past 12 months, 13% were living with HIV, and 33% reported alcohol use during their current pregnancy. After adjusting for marital status, education, smoking, and HIV status; Catholic religion (AOR: 3.54; 95% CI: 1.89–6.64; compared to other), bar/restaurant work (AOR: 2.40; 95% CI: 1.17–4.92; compared to agriculture), >one sex partner in past year (AOR: 1.92; 95% CI: 1.17–3.16), a partner that drank before sex in past year (AOR: 2.01; 95% CI: 1.48–2.74), and past year IPV (AOR: 1.55; 95% CI: 1.14–2.11) were associated with antenatal alcohol use. Conclusion We found that alcohol use during pregnancy was common and associated with religion, occupation, higher numbers of past year sex partners, having a partner who drank before sex in the past 12 months, and IPV experience. More research is needed to understand the quantity, frequency, and timing of antenatal alcohol use; and potential impacts on neonates; and to identify services that are acceptable and effective among pregnant women.

scholarly journals An update on alcohol use and risk of HIV infection in sub-Saharan Africa: Meta-analysis and future research directions

2013 ◽  
Vol 2 (1) ◽  
pp. 99-110 ◽  
Author(s):  
Sarah E Woolf-King ◽  
Craig M Steinmaus ◽  
Arthur L Reingold ◽  
Judith A Hahn
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Use ◽  
Hiv Infection ◽  
Meta Analysis ◽  
Sub Saharan Africa ◽  
Future Research ◽  
Research Directions ◽  
Increased Risk ◽  
Future Research Directions ◽  
Sub Saharan

Woolf-King, S., Steinmaus, C. M., Reingold, A. L. & Hahn, J. A. (2013). An update on alcohol use and risk of HIV infection in sub-Saharan Africa: Meta-analysis and future research directions. International Journal of Alcohol and Drug Research, 2(1), 99-110.  doi: 10.7895/ijadr.v2i1.45 (http://dx.doi.org/10.7895/ijadr.v2i1.45)Aims: Sub-Saharan Africa is disproportionately affected by HIV/AIDS, and growing evidence suggests that alcohol consumption is a co-occurring problem in the region.  We conducted a meta-analysis on studies of alcohol use and HIV infection in sub-Saharan Africa in order to assess associations, evaluate heterogeneity in the literature, identify susceptible subgroups, and suggest avenues for future research.Design: We performed a systematic review, including published review articles and electronic database searches, and identified 35 studies on alcohol use and HIV.Setting and participants: All of the studies included in the meta-analysis occurred with adults in sub-Saharan Africa.Measurements: Pooled odds ratio (OR) estimates were calculated using both the fixed inverse variance weighting method and the random effects method when evidence of heterogeneity was present.Findings: The pooled OR estimate for all studies was 1.61 (95% CI: 1.44–1.80).  The association between alcohol use and prevalence or incident HIV infection was particularly large among samples who reported problem drinking (OR = 2.17, 95% CI: 1.64–2.87) and drinking in sexual contexts (OR = 1.79, 95% CI: 1.55–2.06).  Some evidence of publication bias was present; however, the OR remained statistically significant in small and large studies and with population-based and high-risk samples.Conclusions: These results suggest that alcohol consumption, particularly at high levels and in sexual contexts, is associated with an increased risk of HIV infection.  An increased focus on methods that allow for more sensitive tests of the event-level association between alcohol consumption and risk of HIV infection may provide a better understanding of the causal mechanisms underlying this relationship.

The burden and risk factors for postnatal depression and depressive symptomatology among women in Kampala

2019 ◽  
Vol 49 (3) ◽  
pp. 170-177 ◽  
Author(s):  
Margaret Nampijja ◽  
Barnabas Natamba ◽  
Richard Mpango ◽  
Eugene Kinyanda
Keyword(s):  
Risk Factors ◽  
Partner Violence ◽  
Depressive Symptomatology ◽  
Sub Saharan Africa ◽  
Increased Risk ◽  
High Prevalence ◽  
Postnatal Women ◽  
Postnatal Mothers ◽  
Dsm Iv ◽  
Sub Saharan

Major depressive disorder (MDD) is a major global health challenge and postnatal women may be at an increased risk for this disorder. Very few studies have tested this hypothesis in sub-Saharan Africa (SSA), so it is uncertain whether risk factors implicated elsewhere in the world are relevant in SSA. We explored prevalence and risk factors for MDD and depressive symptomatology among postnatal mothers in Kampala. Three hundred postnatal mothers at Nsambya Hospital were assessed for MDD using the DSM IV-based MINI; prevalence and risk factors were determined using frequencies and regressions, respectively. Four women (1.33%) had MDD; however, 94 (31%) had ‘sub-threshold’ or depressive symptomatology, with which partner violence is particularly associated. MDD is rare among postnatal women in a paying hospital in Kampala; however, the high prevalence of depressive symptomatology suggests susceptibility to MDD. Longitudinal studies should investigate this hypothesis and the susceptibility due to partner violence should guide appropriate interventions.

scholarly journals Burden of depressive symptoms and non-alcohol substance abuse; and their association with alcohol use and partner violence: a cross-sectional study in four sub-Saharan Africa countries

2018 ◽  
Vol 5 ◽  
Author(s):  
F. Bajunirwe ◽  
S. Maling ◽  
H.-O. Adami ◽  
I. O. Ajayi ◽  
J. Volmink ◽  
...  
Keyword(s):  
Risk Factors ◽  
Substance Abuse ◽  
Depressive Symptoms ◽  
Alcohol Use ◽  
Partner Violence ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Sectional Study ◽  
Cross Sectional ◽  
Sub Saharan

In sub-Saharan Africa, there are limited data on burden of non-alcohol substance abuse (NAS) and depressive symptoms (DS), yet potential risk factors such as alcohol and intimate partner violence (IPV) are common and NAS abuse may be the rise. The aim of this study was to measure the burden of DS and NAS abuse, and determine whether alcohol use and IPV are associated with DS and/or NAS abuse. We conducted a cross-sectional study at five sites in four countries: Nigeria (nurses), South Africa (teachers), Tanzania (teachers) and two sites in Uganda (rural and peri-urban residents). Participants were selected by simple random sampling from a sampling frame at each of the study sites. We used a standardized tool to collect data on demographics, alcohol use and NAS use, IPV and DS and calculated prevalence ratios (PR). We enrolled 1415 respondents and of these 34.6% were male. DS occurred among 383 (32.3%) and NAS use among 52 (4.3%). In the multivariable analysis, being female (PR  =  1.49, p  =  0.008), NAS abuse (PR  =  2.06, p  =  0.02) and IPV (PR  =  2.93, p < 0.001) were significantly associated with DS. Older age [odds ratio (OR) = 0.31, p < 0.001)], female (OR = 0.48, p  =  0.036) were protective of NAS but current smokers (OR = 2.98, p < 0.001) and those reporting IPV (OR  =  2.16, p  =  0.024) were more likely to use NAS. Longitudinal studies should be done to establish temporal relationships with these risk factors to provide basis for interventions.

scholarly journals Intimate Partner Violence against Women Living in Inadequate Conditions in Sub-Saharan Africa: A Meta-Analysis of Demographic and Health Survey Data

2021 ◽  
Vol 18 (19) ◽  
pp. 10138
Author(s):  
Yaqing Gao ◽  
Yinping Wang ◽  
Xiaoyi Mi ◽  
Mo Zhou ◽  
Siyu Zou ◽  
...  
Keyword(s):  
Intimate Partner Violence ◽  
Partner Violence ◽  
Meta Analysis ◽  
Intimate Partner ◽  
Living Conditions ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Major Public Health Problem ◽  
Sub Saharan ◽  
Country Specific

Intimate partner violence (IPV) against women is a major public health problem and is widespread in sub-Saharan Africa (SSA). However, little is known about its environmental determinants. This study aimed to investigate whether inadequate living conditions are associated with IPV victimization in women in SSA. We analyzed cross-sectional data for 102,714 women in 25 SSA countries obtained from the Demographic and Health Surveys Program. Logistic regression was used to estimate the country-specific effects of inadequate living conditions (housing with at least one of four characteristics of unimproved water, unimproved sanitation, insufficient space, and unfinished materials) on multiple forms of IPV. Random effects meta-analysis was used to combined the country-specific estimates. We found an association between inadequate living conditions and a higher likelihood of experiencing any (OR = 1.12, 95% CI 1.03 to 1.23, p = 0.012), sexual (OR = 1.18, 95% CI 1.05 to 1.34, p = 0.008), emotional (OR = 1.12, 95% CI 1.02 to 1.23, p = 0.023), and physical (OR = 1.15, 95% CI 1.03 to 1.28, p = 0.010) IPV. The associations were stronger for rural and less-educated women. These findings suggest that future research to establish a causal link between living conditions and IPV and to elucidate the underlying pathways is crucial to design IPV interventions in SSA.

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.

Elite violence and elite numeracy in Africa from 1400 CE to 1950 CE

2021 ◽  
Author(s):  
Joerg Baten ◽  
Kleoniki Alexopoulou
Keyword(s):  
Early Development ◽  
Interpersonal Violence ◽  
Sub Saharan Africa ◽  
African History ◽  
African Development ◽  
Sub Saharan

Abstract How can we trace early African development? The share of rulers’ known birth year has been identified as an indicator of elite numeracy in African regions since 1400, and the share of murdered rulers allows us to gain insights into interpersonal violence behaviour of African elites. From this emerges a dynamic picture of quantitative African history: the absence of elite violence and high elite numeracy developed jointly in sub-Saharan Africa. Some African regions, such as today’s Ethiopia and Angola, took the lead in early development but also experienced severe declines. Development in Africa was, on average, later than in Northwestern Europe.

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