Dawit Shawel Abebe

Prevalence of pulmonary tuberculosis and associated risk factors in Eastern Ethiopian prisons.

OBJECTIVES To determine the prevalence of pulmonary tuberculosis (PTB) and associated risk factors among inmates in three major prison settings of Eastern Ethiopia. DESIGN Between July and November, 2008, 371 prisoners with a history of cough of ≥ 2 weeks were screened for PTB using direct smear microscopy and culture. Data were analysed using descriptive statistics and multivariable logistic regression. RESULTS Of 371 PTB suspects identified by active screening, 33 (8.9%) were confirmed as smear- or culture-positive PTB. Together with the 11 PTB patients already on treatment, the point prevalence of PTB was 1913 per 100,000 (95%CI 1410-2580), about seven times higher than that of the general population. Eleven newly diagnosed PTB patients were sharing a cell with known TB patients. Factors significantly associated with PTB were young age (15-44 years of age) (OR 3.73), urban residence (OR 3.59), having a cough >4 weeks (OR 3.15), and sharing a cell with a TB patient (OR 3.39) or a prisoner with chronic cough (OR 4.5). CONCLUSIONS The study documented a high prevalence of PTB among Ethiopian prisoners. Socio-demographic and TB management factors were identified to be underlying causes of the high transmission rate and the acquisition of new cases. Active surveillance of TB and implementing prevention and control guidelines are imperative.

What we know and don't know about mental health problems among immigrants in Norway.

Mental health problems have been regarded as one of the main public health challenges of immigrants in several countries. Understanding and generating research-based knowledge on immigrant health problems is highly relevant for planning preventive interventions, as well as guiding social and policy actions. This review aims to map the available knowledge on immigrants’ mental health status and its associated risk factors in Norway. The reviewed literature about mental health problems among immigrant populations in Norway was found through databases, such as PUBMED, EMBASE, PsychINFO and MEDLINE. About 41 peer-reviewed original articles published since 1990s were included. In the majority of the studies, the immigrant populations, specifically adult immigrants from low and middle income countries, have been found with a higher degree of mental health problems compared to Norwegians and the general population. Increased risk for mental illness is primarily linked to a higher risk for acculturative stress, poor social support, deprived socioeconomic conditions, multiple negative life events, experiences of discrimination and traumatic pre-migration experiences. However, research in this field has been confronted by a number of gaps and methodological challenges. The available knowledge indicates a need for preventive interventions. Correspondingly, it strongly recommends a comprehensive research program that addresses gaps and methodological challenges.

The development of bulimic symptoms from adolescence to young adulthood in females and males: a population-based longitudinal cohort study.

OBJECTIVE To investigate age-related trends in bulimic symptoms and associated putative risk factors among Norwegian youth. METHOD A sample of 3,150 participants, 1,421 (45.1%) males and 1,759 (54.9%) females, was prospectively followed for 11 years at three time points from adolescence to adulthood. Linear random coefficient models were applied. RESULTS For females, bulimic symptoms increased from age 14 to 16 and declined slowly thereafter. For males, the symptoms decreased between ages 14 and 16 and returned in the early 20s. Females had higher levels of symptoms than males at every age. Age-associated trends in body mass index, appearance satisfaction, and symptoms of anxiety and depression were associated with some of the trends for both genders. For females, changes in alcohol consumption and cohabitation status functioned as predictors as well. DISCUSSION Males and females show distinct developmental trajectories of bulimic symptoms during adolescence and in the transition to adulthood. Prevention interventions should focus on putative risk factors in mid-adolescence for females and in the early 20s for males.

Picky eating in preschool children: The predictive role of the child's temperament and mother's negative affectivity

OBJECTIVE The objective of this study is to describe the development and examine predictors of picky eating from 1.5 to 4.5 years of age in a community sample of children. METHODS Mothers completed a questionnaire, assessing picky eating and a range of child and maternal factors, when their children were aged 1.5 (n = 913), 2.5 (n = 777), and 4.5 (n = 727) years. RESULTS Picky eating increased significantly from 1.5 to 4.5 years. Lower maternal age, higher levels of child emotionality, and maternal negative affectivity at the childs age 1.5 predicted an increase in picky eating from 1.5 years to 2.5 and 4.5 years. Having siblings protected against the development of picky eating. CONCLUSION Child and maternal temperament at a very early stage in the childs life increase the risk for picky eating later on.

Regional inequality and vaccine uptake: a multilevel analysis of the 2007 Welfare Monitoring Survey in Malawi

BackgroundA significant part of childhood mortality can be prevented given the existence of a well functioning health care system that can deliver vaccines to children during their first year of life. This study assesses immunization differentials between regions in Malawi, and attempts to relate regional disparities in immunization to factors on individual, household and village level.MethodWe used data from the 2007 Welfare Monitoring Survey which includes 18 251 children ages 10–60 months. Multilevel logistic regression models were applied for data analysis.ResultsMajor differences in full vaccine coverage (children receiving all of the 9 recommended vaccines) were documented between the 27 official regions, called districts, of Malawi. The vaccine coverage among regions varied from 2% to 74% when all children 10 – 60 months old were included. Vaccine coverage was significantly higher for women that had their delivery attended by a midwife/nurse, or gave birth at a hospital or maternity clinic. Regions with a high percentage of deliveries attended by health personnel were also characterized by a higher coverage. Characteristics of health care utilization on the individual level could in part account for the observed regional variations in coverage.Several factors related to socio-demographic characteristics of individuals and households were significantly correlated with coverage (child’s age, illiteracy, income, water and sanitary conditions), implying a lower coverage among the most vulnerable parts of the population. However, these factors could only to a minor extent account for the regional variation in coverage.ConclusionsThe persistent regional inequalities suggest that the low immunization coverage in Malawi is less likely to be a result of geographical clustering of social groups with difficult level-of living conditions. Although the mean vaccine coverage in Malawi is low, some regions have succeeded in reaching a relatively high proportion of their children. The relative success of some regions implies that there is a substantial potential for political intervention to improve vaccine coverage. One important negative implication of regional inequality is the presence of clusters with under-vaccinated children, leading to an increased vulnerability during outbreaks of vaccine-preventable diseases.

Municipal-level differences in depressive symptoms among adolescents in Norway: Results from the cross-national Ungdata study.

Aim: This study aimed to investigate municipal-level variations and individual- and municipal-level predictors of high levels of depressive symptoms among Norwegian adolescents. Methods: We used data from the Norwegian cross-national Ungdata study. We included 77,424 adolescents from 171 municipalities attending junior high school (Grades 8–10; age 13–16 years) from 2011 to 2013. Multilevel (two-level) logistic regression models were applied for the data analyses. Results: The study revealed that 11% of adolescents reported high levels of depressive symptoms. The median odds ratio without adjusting for any individual- or municipal-level predictors was 1.24, indicating a small between-municipalities variability for high levels of depressive symptoms. All individual-level factors, such as gender, school grade, family income, substance use behaviours, bullying and dissatisfaction with different aspects of life, were significantly associated with high levels of depressive symptoms (p < 0.05). As to municipal-level factors, a low annual budgets for municipal health services was the sole significant predictor of high levels of depressive symptoms between municipalities. Municipal-level factors and variables related to survey characteristics explained a moderate proportion of the variation in high levels of depressive symptoms between municipalities. Conclusions: The cluster heterogeneity in high levels of depressive symptoms was small between municipalities in Norway. Further research should examine the geographic clustering of mental health problems at the school and neighbourhood level.

Predictors of Disordered Eating in Adolescence and Young Adulthood: A Population-Based, Longitudinal Study of Females and Males in Norway

We investigated longitudinal predictors for disordered eating from early adolescence to young adulthood (12–34 years) across gender and different developmental phases among Norwegian young people. Survey data from a population-based sample were collected at four time points (T) over a 13-year time span. A population-based sample of 5,679 females and males at T1 and T2, 2,745 at T3 and 2,718 at T4 were included in analyses, and linear regression and random intercept models were applied. In adolescence, initial disordered eating and parental overprotectiveness were more strongly related to disordered eating among females, whereas loneliness was a stronger predictor for adolescent males. Initial disordered eating during early adolescence predicted later disordered eating more strongly in late- than mid-adolescence. In young adulthood, no significant gender-specific risk factors were found. The findings provide support for both shared and specific risk factors for the developmental psychopathology of disordered eating.

Mental health problems among individuals with persistent health challenges from adolescence to young adulthood: a population-based longitudinal study in Norway

BackgroundPersistent health challenges are increasing throughout the world. It has been shown that adolescents with persistent health challenges are at greater risk of having mental health problems than their healthy peers. However, these studies are mainly cross-sectional, and little is known about the transition to adulthood. Thus, the aim of this study was to examine how mental health problems in adolescents and young adults with persistent health challenges vary during adolescence and in the transition to young adulthood.MethodsThe study used longitudinal and time-series data from the “Young in Norway” study. A sample of adolescents was prospectively followed from adolescence to young adulthood with measures at four different time points (n = 3,087; T1–T4): 2921 adolescents (12–19 years) participated at T1 and T2, while 2448 young adults participated at T3 and T4. Persistent health challenges, age, gender, mental health problems and parental socio-economic status were measured in the longitudinal survey. Regression models were applied to estimate associations between persistent health challenges (understood as having a chronic health condition or disability) and mental health problems during adolescence and young adulthood. Different models were tested for chronic health conditions and disability.ResultsAdolescents with disability had higher scores for depressive and anxiety symptoms, loneliness and self-concept instability, and lower scores for self-worth, appearance satisfaction, scholastic competence and social acceptance compared with adolescents without disability. In young adulthood, there were also significant associations between disability and most mental health problems. The longitudinal associations between chronic health conditions and mental health problems during adolescence and young adulthood showed that significant associations between chronic health conditions and mental health problems were only found during adolescence.ConclusionsThis longitudinal survey revealed that on average, adolescents with disability had more mental health problems than those with a chronic health condition. In addition, the problems followed into adulthood for adolescents with disability. Thus, disability seems to be a much higher risk factor for developing and maintaining mental health problems than having a chronic health condition. These findings need to be followed up in further studies.

Socio-Economic Gradients and Disability During The Transition to Young Adulthood: A Longitudinal Survey and Register Study in Norway

ABSTRACT The study aimed to investigate trends and explanatory factors for socio-economic inequalities associated with disability during the transition to young adulthood. A sample of 2606 participants (56% females and 44% males) was prospectively followed from adolescence to young adulthood. Disability status, age, gender, mental health problems, scholastic competence and social acceptance were measured from the longitudinal survey Young in Norway, while socio-economic indicators such as participants’ and their parents’ levels of education, annual income, unemployment and welfare benefits were extracted from the National Population Register in Norway. Regression models were applied to estimate associations between disability and socio-economic outcomes. The findings show that disabled adolescents have a significantly greater risk of achieving lower levels of education and are unemployed and over-represented in welfare benefits during the transition to young adulthood. Most of these associations between disability and socio-economic outcomes were explained by mental wellbeing and self-perceptions. The study suggests that interventions addressing mental wellbeing and social competence might reduce the development of socio-economic inequalities among young people with disability.

Erratum to: individual-level changes in self-rated health before and during the economic crisis in Europe

Unfortunately, after publication of this article [1], it was noticed that there errors within the article. In the Background and Conclusion sections, the two uses of the word “casual” was intended to be “causal”. In the Results section, the text “elven countries” should instead read “eleven countries”.