The prevalence of mental health problems in Ethiopian child laborers

BACKGROUND: Child labor refers to a state when a child is involved in exploitative economical activities that are mentally, physically, and socially hazardous. There are no prevalence studies on the magnitude of psychiatric disorders among child laborers. METHODS: A cross-sectional population survey was conducted in Addis Ababa using the Diagnostic Interview for Children and Adolescents (DICA). Subjects were a random sample of 528 child laborers aged between 5 and 15 years and comprising child domestics, street-workers and private enterprise workers. These were compared with 472 non-economically active controls. RESULTS: The aggregate prevalence of any DSM-III-R childhood emotional and behavioral disorders was found to be 16.5%, with 20.1% and 12.5% among child laborers and controls respectively, OR = 1.89 (95% CI, 1.34-2.67, p < .01). Internalizing disorders such as mood disorders were significantly higher among the laborers than the non-laborers, OR = 6.65 (95% CI, 2.20-22.52, p = .0001). Anxiety disorder was seen over twofold among child laborers while psychosocial stressors were one and half times more likely among the study subjects than controls. When all factors were taken into account, child labor status was the only significant factor in determining DSM-III-R diagnosis. CONCLUSION: In this study childhood emotional and behavioral disorders are found to be more common among child laborers than among non-laborers. We recommend a larger study to look into childhood disorders and risk factors in child labor. As part of the concerted effort, government, NGOs, and the public should at least view child labor as a menace in a child's development, with risk of psychosocial difficulties.     

Increase in the incidence of non-Hodgkin’s lymphoma, clinical features and long-term follow-up

We detail time trends in the incidence of non-Hodgin’s lymphoma over the period 1980–1894 and analyze prognostic factors in a retrospective study. To that end, 587 patients were diagnosed of non-Hogdkin’s lymphoma from 1980 to 1994. Average annual incidence rate of non-Hodgkin’s lymphoma per 100,000 persons in our study has risen from 5.5 in 1981–1985 to 8.6 in 1991–1994. The incidence rate increased by almost 22% in males, and by 79% in females. In patients 75 years and older the incidence has increased 98%. The largest increases of incidence were observed in extranodal involvement (86%), stage IV (77%) and intermediate grade (53%). Prognostic factors for the overall survival in the multivariate analysis were: histology (p<9.00001), International Prognostic Index (p<0.00001), largest site localization (p=0.0002) and mediastinal involvement (p=0.003). We conclude that to the known prognostic factors as histology and International Prognostic Index, mediastinal involvement and the largest site remain independently significant in multivariate analysis. There was an overall increase in incidence of non-Hodgkin’s lymphoma. It was slightly more marked in patients older than 74 years, women, intermediate-grade lymphoma, stage IV and extranodal disease. Explanations accounting for all the increases in rates are not readily available.     

Bacteraemia among severely malnourished children in jimma university hospital, ethiopia

Background

Sever acute malnutrition severely suppresses every component of the immune system leading to increased susceptibility and severity to infection. However, symptoms and signs of infections are often unapparent making prompt clinical diagnosis and early treatment very difficult. The aim of the study was to determine the magnitude of bacteraemia and antimicrobial sensitivity among severely malnourished children.

Methods

Severely malnourished children admitted in Jimma University Specialized Hospital were enrolled between October, 2009 to May, 2010. Blood samples were collected, processed and bacterial isolates were identified using standard bacteriological procedures. Then, antibiotic susceptibility pattern of the isolates was determined by using Kirby-Bauer technique.

Results

Bacteraemia was seen in 35 (20.6%) of the 170 study subjects. There were a total of 35 bacterial isolates, Gram positive bacteria constitute 24(68.6%) of the isolates, where Staphylococcus aureus was the leading Gram positive isolate while Klebsiella species were the dominant Gram negative isolates. Twelve (7.1%) children died and 4 (33.3%) of them had bacteraemia. While susceptibility was more than 80% to Gentamicin, Ciprofloxacin and Ceftriaxone, increased level of resistance was documented to commonly used antibiotics, such as Amoxycillin, Co-trimoxazole and Chloramphenicol.

Conclusion

High prevalence of bacteraemia with predominating Gram positive isolates and increased level of resistance to commonly used antibiotics was shown among severely malnourished children in Jimma. Further studies are required to revise the current guideline for antibiotic choice.     

Correction to: Sex estimation of infants through geometric morphometric analysis of the ilium

International Journal of Legal Medicine - After publication of the original article, it was brought to authors’ attention two errors that were included in the final publication.     

Smoothed time-dependent receiver operating characteristic curve for right censored survival data

The prediction reliability is of primary concern in many clinical studies when the objective is to develop new predictive models or improve existing risk scores. In fact, before using a model in any clinical decision making, it is very important to check its ability to discriminate between subjects who are at risk of, for example, developing certain disease in a near future from those who will not. To that end, the time-dependent receiver operating characteristic (ROC) curve is the most commonly used method in practice. Several approaches have been proposed in the literature to estimate the ROC nonparametrically in the context of survival data. But, except one recent approach, all the existing methods provide a nonsmooth ROC estimator whereas, by definition, the ROC curve is smooth. In this article we propose and study a new nonparametric smooth ROC estimator based on a weighted kernel smoother. More precisely, our approach relies on a well-known kernel method used to estimate cumulative distribution functions of random variables with bounded supports. We derived some asymptotic properties for the proposed estimator. As bandwidth is the main parameter to be set, we present and study different methods to appropriately select one. A simulation study is conducted, under different scenarios, to prove the consistency of the proposed method and to compare its finite sample performance with a competitor. The results show that the proposed method performs better and appear to be quite robust to bandwidth choice. As for inference purposes, our results also reveal the good performances of a proposed nonparametric bootstrap procedure. Furthermore, we illustrate the method using a real data example.     

Patterns of racial/ethnic disparities in baseline health-related quality of life and relationship with overall survival in patients with colorectal cancer

Quality of Life Research - Racial disparities are evident in colorectal cancer (CRC) prognosis with black patients experiencing worse outcomes than Hispanics and whites, yet mediators of these...     

Influencia del género sobre factores de protección y vulnerabilidad,la adherencia y calidad de vida en pacientes con enfermedad cardiovascular

ObjectivesTo examine gender differences on specific protective factors (PF: acceptance and resilience), vulnerability factors (VF: anger, depression, and anxiety; adherence to treatment and quality of life (QoL) in cardiovascular patients, as well as to study separately the relationships of these factors with adherence and QoL in females and males.DesignObservational and cross-sectional.SettingTwo Primary Care Centres in Gran Canaria.ParticipantsOne hundred and ninety-eight cardiovascular patients (91 males and 107 females) participated.Main measurementsAcceptance was assessed by the ICQ scale; resilience by the CD-RISC; depression by the PHQ-9; anxiety by the HADS; Anger-In and Anger-Out by the STAXI-2; QoL by the SF-36; and adherence by a self-reported scale.ResultsFemales exhibited higher anxiety (95% CI: 6.3-7.9) and adherence to reducing smoking (95% CI: 9.4-10.0) and drinking (95% CI: 9.6-10.1), and lower Anger-Out (95% CI: 8.9-10.0), mental QoL (95% CI: 47.0-51.3) and adherence to medication (95% CI: 22.2-23.3) compared to males. Acceptance was associated with better adherence only in women. There were more VF related to worse adherence in males. Anxiety had a negative impact on adherence, and QoL was positively associated with PF, and negatively with VF in both groups.ConclusionsGender differences in QoL, some VF, and adherence are observed, in addition to the beneficial role of Acceptance in women.