Bimala Sharma

Factors Associated with Suicidal Ideation and Suicide Attempt among School-Going Urban Adolescents in Peru.

The study examines the prevalence of suicidal ideation and suicide attempt, and associated factors among school-going urban adolescents in Peru. A cross-sectional survey was conducted in a sample of 916 secondary school adolescents in 2014. A structured questionnaire adapted from Global School-based Student Health Survey was used to obtain information. Data were analyzed using logistic regression models at 5% level of significance. Overall, 26.3% reported having suicidal ideation, and 17.5% reported having attempted suicide during the past 12 months. Multivariate logistic regression analysis showed that female sex, being in a fight, being insulted, being attacked, perceived unhappiness, smoking and sexual intercourse initiation were significantly associated with increased risk of suicidal ideation, while female sex, being in a fight, being insulted, being attacked, perceived unhappiness, alcohol and illicit drug use were related to suicide attempt. The prevalence of suicidal ideation and suicide attempts observed in the survey area is relatively high. Female adolescents are particularly vulnerable to report suicidal ideation and suicide attempt. Interventions that address the issue of violence against adolescents, fighting with peers, health risk behaviors particularly initiation of smoking, alcohol and illicit drug use and encourage supportive role of parents may reduce the risk of suicidal behaviors.

Role of gender, family, lifestyle and psychological factors in self-rated health among urban adolescents in Peru: a school-based cross-sectional survey.

Objective We examined the role of gender, family, lifestyle and psychological factors in self-rated health. Design Cross-sectional study. Setting A total of 970 randomly selected students from 11 secondary schools in Lima and Callao, Peru, participated in 2014. Main outcome measure Self-rated health was measured with a single item: ‘In general, how would you rate your health?’ Responses were arranged along a five-point Likert-type scale: ‘excellent’, ‘very good’, ‘good’, ‘fair’ and ‘poor’. The outcome variable was dichotomised as ‘good’ (excellent, very good or good) or ‘poor/fair’ (poor or fair). Methods We calculated adjusted ORs (AORs) and 95% CIs for poor/fair self-rated health using multivariate logistic regression analyses at 3-graded levels. Results 32.5% of the respondents had fair/poor self-rated health, 23.7% of the total males and 40.0% of the total female samples. Males were less likely to have poor/fair self-rated health (AOR 0.61; CI 0.41 to 0.91). Poor family support strongly increased the likelihood of having poor/fair self-rated health (no support, (AOR 3.15; CI 1.63 to 6.09); low support, (AOR 2.50; CI 1.29 to 4.85)). The other associated variables were missed meals due to a shortage of food (AOR 1.97; CI 1.15 to 3.36), television watching during leisure time (AOR 1.70; CI 1.09 to 2.67), low physical activity (AOR 1.49; CI 1.03 to 2.15), school absenteeism (AOR 1.54; CI 1.03 to 2.31) and perceived life satisfaction (AOR 0.28; CI 0.15 to 0.25). Conclusions Gender, missing meals due to a shortage of food, family support, physical activity and life satisfaction influenced self-rated health among adolescents in Peru. Interventions that focus on promoting physical activity for at least 1 h each day for 3 or more days per week, food security and strengthening supportive family roles may improve self-rated health during adolescence.

Obesity and Hypertension among School-going Adolescents in Peru

Background Adolescent obesity and hypertension are global public health issues. The burden of adolescent obesity and hypertension in Peru is unclear. The aim of this study was to determine the prevalence of obesity and hypertension and their relationship among school-attending adolescents and to assess the need for health-promoting school programs in the study area. Methods A cross-sectional school-based survey was conducted in a randomly selected sample of 952 secondary school adolescents from 11 schools in Lima or Callao, Peru, in 2014. Weight, height, and blood pressure (BP) were measured and categorized. Obesity was defined as ≥ 95th percentile in body mass index (BMI) for age and sex. Hypertension was defined as average systolic blood pressure and/or diastolic blood pressure ≥95th percentile in BP for sex, age, and height. Chi-square test and univariate logistic regressions were used at a 5% significance level to determine the relationship between BMI and BP category. Results The mean age of subjects was 14.6 years; 46.4% were boys and 53.6% were girls. The prevalence of overweight and obesity was 20.2% and 9.5% overall, 17.4% and 11.1% for boys, and 22.5% and 8.0% for girls, respectively. The prevalence of hypertension was 26.7% overall, 34.8% for boys, and 19.6% for girls. In both sexes, BMI was strongly associated with BP (p < 0.01). Conclusion The prevalence of obesity and hypertension observed in the study area is relatively high. Overweight and obesity are strongly associated with BP status among adolescents. Health-promoting school programs may reduce the burdens of obesity and hypertension among school-going adolescents.

Loneliness, Insomnia and Suicidal Behavior among School-Going Adolescents in Western Pacific Island Countries: Role of Violence and Injury

This study aimed to examine whether being bullied, fighting, and injury, regarded in terms of frequency and nature, were significantly associated with psychological distress and suicidal behavior, independent of substance abuse and parental support in adolescents. Secondary analysis of data from the Global School-based Student Health Survey from Kiribati, the Solomon Islands, and Vanuatu was conducted. Binomial logistic regression analysis was used to examine the association of being bullied, fighting and injury with psychological health outcomes (loneliness, insomnia, suicidal ideation and suicide attempt) at a 5% level of significance. A total of 4122 students were included; 45.5% were male, and 52.0% were 14 years of age or younger. Of the total, 9.3% felt lonely and 9.5% had insomnia most of the time over the last 12 months; 27.6% had suicidal ideation, and 30.9% reported at least one suicide attempt in the last 12 months. Multivariable logistic regression analysis showed that being bullied, fighting and injury were significantly associated with psychological health outcomes; adjusted odds ratios (AORs) of loneliness, insomnia, suicidal ideation and suicide attempt increased with increased exposure to bullying, fighting, and injury compared to non-exposed group. Among the types of bullying victimization, the highest AORs of insomnia and suicide attempt were among students who were left out of activities, compared to the non-bullied. Among the causes of injury, adolescents injured due to a physical attack were the most likely to report the highest AORs of loneliness, insomnia and suicidal ideation compared to those not injured. Preventing violence and injury among adolescents might contribute to better mental health and reduction of suicidal behavior.

The influence of witnessing inter-parental violence and bullying victimization in involvement in fighting among adolescents: evidence from a school-based cross-sectional survey in Peru

Background Witnessing inter-parental violence and bullying victimization is common for many children and adolescents. This study examines the role of witnessing inter-parental violence and bullying victimization in involvement in physical fighting among Peruvian adolescents. Methods A cross-sectional study was conducted among 1,368 randomly selected adolescents in 2015. We conducted logistic regression analyses to obtain crude and adjusted odds ratios with 95% confidence intervals for involvement in fighting among male and female adolescents. Results Among all adolescents, 35.8% had been involved in fighting in the last 12 months, 32.9% had been victim of verbal bullying and 37.9% had been the victim of physical bullying. Additionally, 39.2% and 27.8% of adolescents witnessed violence against their mother and father, respectively, at least once in their lives. Multivariate logistic regression analyses found that late adolescence, participation in economic activities, being the victim of verbal bullying, stress, and witnessing violence against the father among male adolescents, and self-rated academic performance and being the victim of physical or verbal bullying among female adolescents were associated with higher odds of being involved in fighting. Conclusion Verbal bullying victimization and witnessing violence against the father in males and bullying victimization in females were associated with greater odds of adolescents being involved in fighting. Creating a non-violent environment at both home and school would be an effective strategy for reducing fighting among the adolescent population.

Condom Use at Last Sexual Intercourse and Its Correlates among Males and Females Aged 15–49 Years in Nepal

This study aimed to assess the prevalence and correlates of condom use at last sexual intercourse among people aged 15–49 years in Nepal. Secondary data analysis was performed using the Nepal Demographic and Health Survey 2011. The study was restricted to the respondents who reported ever having had sexual intercourse; 9843 females and 3017 males were included. Condom use was assessed by asking if respondents used condoms in their most recent sexual intercourse. Chi-square test and multivariate logistic regression analysis were performed using Complex Sample Analysis Procedure to adjust for sample weight and multistage sampling design. Overall, 7.6% of total, and 16.3% of males and 6.2% of females reported using condoms in their last sexual intercourse. Living in Far-Western region, age and wealth quintile were positively associated with condom use in both males and females. Being unmarried was the most important predictor of condom use among males. Higher education was associated with increased likelihood of condom use in females. However, mobility, having multiple sexual partners, and HIV knowledge were not significant correlates of condom use in both sexes. A big difference was observed in the variance accounted for males and females; indicating use of condoms is poorly predicted by the variables included in the study among females. Condom use was more associated with sociodemographic factors than with sexual behavior and HIV knowledge.

Socio-Environmental and Behavioral Correlates of Having Ever Had Sexual Intercourse Among Adolescents in Peru: A School-Based Cross-Sectional Study

ABSTRACT Objective: We assessed the socio-environmental and behavioral correlates of having ever had sexual intercourse among Peruvian adolescents aged 12–18 years in Lima. Methods: A cross-sectional study was conducted in 2014. Result: Of 950 participants, 26.5% of males and 13.0% of females had ever had sexual intercourse. Early adolescents who ever had sexual intercourse had higher odds of being insulted, being involved in a fight, and smoking; whereas late adolescents having sexual experiences were more likely to be male and to report smoking, alcohol consumption, involvment in a fight, and having no/low parental understanding. Conclusion: An integrated approach is useful in addressing risk behaviors in adolescents.

Television Viewing and Its Association with Sedentary Behaviors, Self-Rated Health and Academic Performance among Secondary School Students in Peru

The study assessed television viewing >2 h a day and its association with sedentary behaviors, self-rated health, and academic performance among secondary school adolescents. A cross-sectional survey was conducted among randomly selected students in Lima in 2015. We measured self-reported responses of students using a standard questionnaire, and conducted in-depth interviews with 10 parents and 10 teachers. Chi-square test, correlation and multivariate logistic regression analysis were performed among 1234 students, and thematic analysis technique was used for qualitative information. A total of 23.1% adolescents reported watching television >2 h a day. Qualitative findings also show that adolescents spend most of their leisure time watching television, playing video games or using the Internet. Television viewing had a significant positive correlation with video game use in males and older adolescents, with Internet use in both sexes, and a negative correlation with self-rated health and academic performance in females. Multivariate logistic regression analysis shows that television viewing >2 h a day, independent of physical activity was associated with video games use >2 h a day, Internet use >2 h a day, poor/fair self-rated health and poor self-reported academic performance. Television viewing time and sex had a significant interaction effect on both video game use >2 h a day and Internet use >2 h a day. Reducing television viewing time may be an effective strategy for improving health and academic performance in adolescents.