Browsing by Author "Darling, A. M."
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Item The age of opportunity: Prevalence of key risk factors among adolescents 10–19 years of age in nine communities in sub‐Saharan Africa(Wiley Online, 2020) Berhane, Y.; Canavan, C. R.; Darling, A. M.; Sudfeld, C. R.; Vuai, S.; Adanu, R.; Bärnighausen, T.; Dessie, Y.; Bukenya, J. N.To measure health-related behaviours and risk factors among sub-Saharan African adolescents. Cross-sectional study in nine communities in Burkina Faso, Ethiopia, Eswatini, Ghana, Nigeria, Tanzania and Uganda between 2015 and 2017. Community-representative samples of males and females 10–19 years of age were selected. All communities used a uniform questionnaire that was adapted from the WHO Global School-based Student Health Survey. Weighted prevalence estimates and 95% confidence intervals were calculated for each indicator and stratified by age and sex using SAS version 9.4. All prevalence estimates were pooled across communities through random-effects meta-analyses in Stata version 14.resultsA total of 8075 adolescents participated in the study. We observed a high prevalence of inadequate fruit consumption (57–63%) and low physical activity (82–90%); a moderate prevalence of inadequate vegetable consumption (21–31%), unprotected last sex (38–45%), age at first sex<15 years(21–28%) and bullying and physical fighting (12–35%); and a low prevalence of mental health risk factors (1–11%) and alcohol and substance use risk factors (0–6%). We observed a moderate to high prevalence of daily soft drink consumption (21–31%) for all adolescents. Among sexually active adolescents 15–19 years, 37% of females reported ever being pregnant and 8% of males reported to have ever made someone pregnant. Bullying (23%) and physical fighting (35%) were more common among younger male adolescents. The prevalence of low mood was generally higher among older (15–19 years) than younger adolescents (10–14 years). The proportion of adolescents reporting alcohol, drug or cigarette use was very small, with the exception of khat use in Ethiopia. Overall, diet and physical activity, violence, sexual and reproductive health, and depression are important risk factors for these sub-Saharan African communities. These findings suggest that more evidence is needed including novel efforts for the collection of sensitive information, as well as a need to move towards community-tailored interventions to reach adolescent populations with varying needs.Item Design and field methods of the ARISE network adolescent health study(Wiley Online, 2020) Darling, A. M.; Assefa, N.; Bärnighausen, T.; Berhane, Y.; Canavan, C. R.; Guwatudde, D.; Sudfeld, C.; Killewo, J.; Oduola, A.; Sando, M. M.; Sie, A.; Sudfeld, C.; Vuai, S.; Adanu, R.; Fawzi, W. W.The ARISE Network Adolescent Health Study is an exploratory, community‐based survey of 8075 adolescents aged 10–19 in 9 communities in 7 countries: Burkina Faso, Eswatini, Ethiopia, Ghana, Nigeria, Tanzania and Uganda. Communities were selected opportunistically and existing population cohorts maintained by health and demographic surveillance systems (HDSSs). The study is intended to serve as a first round of data collection for African adolescent cohorts, with the overarching goal of generating community‐based data on health‐related behaviours and associated risk factors in adolescents, to identify disease burdens and health intervention opportunities. Household‐based sampling frames were used in each community to randomly select eligible adolescents (aged 10–19 years). Data were collected between July 2015 and December 2017. Consenting participants completed face‐to‐face interviews with trained research assistants using a standardised questionnaire, which covered physical activity, cigarette and tobacco use, substance and drug use, mental health, sexual behaviours and practices, sexually transmitted infections, pregnancy, food security and food diversity, teeth cleaning and hand washing, feelings and friendship, school and home activities, physical attacks and injuries, health care, health status assessment and life satisfaction, as well as media and cell phone use and socio‐demographic and economic background characteristics. Results from this multi‐community study serve to identify major adolescent health risks and disease burdens, as well as opportunities for interventions and improvements through policy changes.Item Prevalence and risk factors associated with malnutrition among adolescents in rural Tanzania(Wiley Online, 2020) Ismail, A.; Darling, A. M.; Mosha, D.; Fawzi, W.; Sudfeld, C.; Sando, M. M.; Noor, R. A.; Charles, J.; Vuai, S.To determine the prevalence and risk factors associated with malnutrition among adolescents in a rural Tanzanian community. Cross-sectional survey of 1226 randomly selected adolescents from the Dodoma Health and Demographic Surveillance System (HDSS) in the Chamwino district in the Dodoma region. Anthropometric measurements for weight and height were collected. Height-for-age-z-scores (HAZs) and body mass index (BMI)-for-age-z-scores (BAZs) were computed. Descriptive estimates were documented in graphs and tables, and weighted linear regression models were used to examine predictors of malnutrition. Stunting prevalence was 18%, and thinness prevalence was 14%. Overweight and obesity affected 5.23% of participants. Girls had higher HAZs (b: 0.46, 95% CI 0.33, 0.59, P < 0.0001) and BAZs (b: 0.20, 95% CI 0.05, 0.35, P = 0.0098) than boys. Age was inversely associated with HAZs (b: _0.13, 95% CI _0.17, _0.08, P < 0.0001) and BAZs (b: _0.05, 95% CI _0.10, _0.004, P = 0.0327). Wealth score (b: 0.10, 95% CI 0.04, 0.16, P = 0.0009) and dietary diversity score (b: 0.04, 95% CI 0.01, 0.07, P = 0.0080) were positively associated with HAZs and BAZs. Out of school adolescents had higher HAZs (b: _0.49, 95% CI _0.75, _0.23, P = 0.0003) and BAZs (b:0.68, 95% CI _0.99, _0.37, P < 0.0001) than adolescents who attended school. There are substantial variations of HAZs and BAZs across gender, age, education and wealth, with an emerging burden of overweight and obesity among adolescents in this rural population. Interventions are urgently required to curb both ends of the malnutrition spectrum.