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Persisting mental health problems among AIDS-orphaned children in South Africa

Identifieur interne : 000033 ( PascalFrancis/Checkpoint ); précédent : 000032; suivant : 000034

Persisting mental health problems among AIDS-orphaned children in South Africa

Auteurs : Lucie D. Cluver [Royaume-Uni, Afrique du Sud] ; Mark Orkin [Afrique du Sud] ; Frances Gardner [Royaume-Uni] ; Mark E. Boyes [Royaume-Uni]

Source :

RBID : Pascal:12-0224574

Descripteurs français

English descriptors

Abstract

Background: By 2008, 12 million children in sub-Saharan Africa were orphaned by AIDS. Cross-sectional studies show psychological problems for AIDS-orphaned children, but until now no longitudinal study has explored enduring psychological effects of AIDS-orphanhood in the developing world. Methods: A 4-year longitudinal follow-up of AIDS-orphaned children with control groups of other-orphans and non-orphans. 1021 children (M = 13.4 years, 50% female, 98% isiXhosa-speaking) were interviewed in 2005 and followed up in 2009 with 71% retention (49% female, M= 16.9 years), in poor urban South African settlements. Children were interviewed using sociodemographic questionnaires and well-validated standardised scales for assessing depression, anxiety, and post-traumatic stress. Data were analysed using mixed-design ANOVA and backward-stepping regression. Results: AIDS-orphaned children showed higher depression, anxiety, and post-traumatic stress disorder (PTSD) scores in both 2005 and 2009 when compared with other-orphans and non-orphans. Backward-stepping regression, controlling for baseline mental health, and sociodemographic cofactors such as age, gender, and type of bereavement, revealed that being AIDS-orphaned in 2005 was associated with depression, anxiety, and PTSD scores in 2009. This was not the case for other-orphaned or non-orphaned children. Age interacted with orphan status, such that there was a steep rise in psychological distress in the AIDS-orphaned group, but no rise with age amongst other-orphans and non-orphans. Conclusions: Negative mental health outcomes amongst AIDS-orphaned children are maintained and worsen over a 4-year period. It is important that psychosocial support programmes are sustained, and focus on youth as well as young children.


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<div type="abstract" xml:lang="en">Background: By 2008, 12 million children in sub-Saharan Africa were orphaned by AIDS. Cross-sectional studies show psychological problems for AIDS-orphaned children, but until now no longitudinal study has explored enduring psychological effects of AIDS-orphanhood in the developing world. Methods: A 4-year longitudinal follow-up of AIDS-orphaned children with control groups of other-orphans and non-orphans. 1021 children (M = 13.4 years, 50% female, 98% isiXhosa-speaking) were interviewed in 2005 and followed up in 2009 with 71% retention (49% female, M= 16.9 years), in poor urban South African settlements. Children were interviewed using sociodemographic questionnaires and well-validated standardised scales for assessing depression, anxiety, and post-traumatic stress. Data were analysed using mixed-design ANOVA and backward-stepping regression. Results: AIDS-orphaned children showed higher depression, anxiety, and post-traumatic stress disorder (PTSD) scores in both 2005 and 2009 when compared with other-orphans and non-orphans. Backward-stepping regression, controlling for baseline mental health, and sociodemographic cofactors such as age, gender, and type of bereavement, revealed that being AIDS-orphaned in 2005 was associated with depression, anxiety, and PTSD scores in 2009. This was not the case for other-orphaned or non-orphaned children. Age interacted with orphan status, such that there was a steep rise in psychological distress in the AIDS-orphaned group, but no rise with age amongst other-orphans and non-orphans. Conclusions: Negative mental health outcomes amongst AIDS-orphaned children are maintained and worsen over a 4-year period. It is important that psychosocial support programmes are sustained, and focus on youth as well as young children.</div>
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<s2>NW</s2>
</fC07>
<fC07 i1="04" i2="X" l="FRE">
<s0>Retroviridae</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="04" i2="X" l="ENG">
<s0>Retroviridae</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="04" i2="X" l="SPA">
<s0>Retroviridae</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="05" i2="X" l="FRE">
<s0>Virus</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="05" i2="X" l="ENG">
<s0>Virus</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="05" i2="X" l="SPA">
<s0>Virus</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="06" i2="X" l="FRE">
<s0>Afrique</s0>
<s2>NG</s2>
</fC07>
<fC07 i1="06" i2="X" l="ENG">
<s0>Africa</s0>
<s2>NG</s2>
</fC07>
<fC07 i1="06" i2="X" l="SPA">
<s0>Africa</s0>
<s2>NG</s2>
</fC07>
<fC07 i1="07" i2="X" l="FRE">
<s0>Homme</s0>
</fC07>
<fC07 i1="07" i2="X" l="ENG">
<s0>Human</s0>
</fC07>
<fC07 i1="07" i2="X" l="SPA">
<s0>Hombre</s0>
</fC07>
<fC07 i1="08" i2="X" l="FRE">
<s0>Immunodéficit</s0>
<s5>37</s5>
</fC07>
<fC07 i1="08" i2="X" l="ENG">
<s0>Immune deficiency</s0>
<s5>37</s5>
</fC07>
<fC07 i1="08" i2="X" l="SPA">
<s0>Inmunodeficiencia</s0>
<s5>37</s5>
</fC07>
<fC07 i1="09" i2="X" l="FRE">
<s0>Immunopathologie</s0>
<s5>39</s5>
</fC07>
<fC07 i1="09" i2="X" l="ENG">
<s0>Immunopathology</s0>
<s5>39</s5>
</fC07>
<fC07 i1="09" i2="X" l="SPA">
<s0>Inmunopatología</s0>
<s5>39</s5>
</fC07>
<fC07 i1="10" i2="X" l="FRE">
<s0>Trouble de l'humeur</s0>
<s5>40</s5>
</fC07>
<fC07 i1="10" i2="X" l="ENG">
<s0>Mood disorder</s0>
<s5>40</s5>
</fC07>
<fC07 i1="10" i2="X" l="SPA">
<s0>Trastorno humor</s0>
<s5>40</s5>
</fC07>
<fC07 i1="11" i2="X" l="FRE">
<s0>Affect affectivité</s0>
<s5>41</s5>
</fC07>
<fC07 i1="11" i2="X" l="ENG">
<s0>Affect affectivity</s0>
<s5>41</s5>
</fC07>
<fC07 i1="11" i2="X" l="SPA">
<s0>Afecto afectividad</s0>
<s5>41</s5>
</fC07>
<fC07 i1="12" i2="X" l="FRE">
<s0>Trouble anxieux</s0>
<s5>42</s5>
</fC07>
<fC07 i1="12" i2="X" l="ENG">
<s0>Anxiety disorder</s0>
<s5>42</s5>
</fC07>
<fC07 i1="12" i2="X" l="SPA">
<s0>Trastorno ansiedad</s0>
<s5>42</s5>
</fC07>
<fN21>
<s1>170</s1>
</fN21>
</pA>
</standard>
</inist>
<affiliations>
<list>
<country>
<li>Afrique du Sud</li>
<li>Royaume-Uni</li>
</country>
<region>
<li>Angleterre</li>
<li>Gauteng</li>
<li>Oxfordshire</li>
</region>
<settlement>
<li>Johannesbourg</li>
<li>Oxford</li>
</settlement>
<orgName>
<li>Université d'Oxford</li>
<li>Université du Witwatersrand</li>
</orgName>
</list>
<tree>
<country name="Royaume-Uni">
<region name="Angleterre">
<name sortKey="Cluver, Lucie D" sort="Cluver, Lucie D" uniqKey="Cluver L" first="Lucie D." last="Cluver">Lucie D. Cluver</name>
</region>
<name sortKey="Boyes, Mark E" sort="Boyes, Mark E" uniqKey="Boyes M" first="Mark E." last="Boyes">Mark E. Boyes</name>
<name sortKey="Gardner, Frances" sort="Gardner, Frances" uniqKey="Gardner F" first="Frances" last="Gardner">Frances Gardner</name>
</country>
<country name="Afrique du Sud">
<noRegion>
<name sortKey="Cluver, Lucie D" sort="Cluver, Lucie D" uniqKey="Cluver L" first="Lucie D." last="Cluver">Lucie D. Cluver</name>
</noRegion>
<name sortKey="Orkin, Mark" sort="Orkin, Mark" uniqKey="Orkin M" first="Mark" last="Orkin">Mark Orkin</name>
</country>
</tree>
</affiliations>
</record>

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