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Temporal changes and correlates of tobacco and E-cigarettes use among school-going students in Albania: insights from global youth tobacco surveys (2015-2020)

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EUROPEAN CHILD & ADOLESCENT PSYCHIATRY 2024年 1-14页

作者： dadras, omid Univ Bergen Dept Global Publ Hlth & Primary Care Arstadveien 17 N-5009 Bergen Norway Univ Turku Res Ctr Child Psychiat Turku Finland

Tobacco use often starts during adolescence, with many adults beginning before 21. This study investigated the patterns and factors associated with tobacco and e-cigarette use among school-aged adolescents in Albania. Data were analyzed from two Albania Global Youth Tobacco Surveys (GYTS) conducted in 2015 and 2020. Participants included 7th-10th grade students (ages 12-16) who completed the survey (n = 9985). Descriptive statistics depicted demographic characteristics, tobacco, and e-cigarette use across survey years. Logistic regression assessed temporal changes and the odds of use across independent variables, adjusting for age and sex. From 2015 to 2020, tobacco and e-cigarette use among students aged 13-15 increased from 12.86 to 14.49% and from 6.8 to 8.8%, respectively. Cigarette smoking declined from 8.4 to 4.3%, but the use of other tobacco products nearly doubled, from 6.4 to 12.3%. Higher odds of use were found among males, older students, and those with more pocket money. Environmental factors like family, peer, and media exposure to smoking increased the likelihood of use. Anti-tobacco messages had no significant impact, while advertising strongly influenced usage. Knowledge of tobacco harms and anti-smoking attitudes correlated with lower odds of use. Increased availability of cigarettes near schools was linked to higher odds of tobacco use. The study highlights gaps in anti-tobacco messaging and the strong influence of advertising, underscoring the need for targeted and effective tobacco control strategies in Albania.

关键词： Tobacco use E-cigarettes Smoking, adolescents Temporal changes Correlates Albania

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Predictors of Suicidal Thoughts and Attempts among School-Going Thai Adolescents: A Sex-Specific Structural Equation Modelling Analysis

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CHILD PSYCHIATRY & HUMAN DEVELOPMENT 2024年 1-11页

作者： dadras, omid Univ Bergen Dept Global Publ Hlth & Primary Care Arstadveien 17 N-5009 Bergen Norway Univ Turku Res Ctr Child Psychiat Turku Finland

Adolescent suicide is a growing public health concern in Thailand. Identifying predictors of suicidal behaviors is essential for targeted prevention strategies. Using Structural Equation Modeling, this study explores the predictors of suicidal thoughts and attempts among a sample of 5657 Thai adolescents in grades 7-12, typically representing the age group 13-17 years, with nearly equal proportions of males (47%) and females (53%) participants. Data from the Thailand Global School-based Student Health Survey (GSHS) 2021 were analyzed. Explanatory Factor Analysis (EFA) identified key constructs, followed by SEM stratified by sex to examine relationships between constructs and suicidal behaviors. Reliability and validity were assessed using Cronbach's alpha and SEM fit indices. EFA identified five constructs: current substance use, history of violence, experiences of bullying, parental awareness, and poor mental health. SEM revealed poor mental health as a significant predictor for both sexes. Substance use, experiences of bullying, and a history of violence predicted suicidal behaviors in females. Parental vigilance was only a protective factor for males. The findings underscore the importance of gender-specific interventions and comprehensive mental health support to address the unique vulnerabilities of Thai adolescents, reducing suicidal thoughts and attempts.

关键词： Suicidal behaviors Adolescents Thailand Predictors

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Suicide Attempt and Its Correlates Among School-Going Argentinian Adolescents with Suicidal Thoughts: Insights from a National Survey

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SCHOOL MENTAL HEALTH 2024年第4期16卷 1311-1320页

作者： dadras, omid Univ Bergen Dept Global Publ Hlth & Primary Care Arstadveien 17 N-5009 Bergen Norway Haukeland Hosp Dept Addict Med Bergen Addict Res Bergen Norway

A combination of personal, psychological, and environmental factors contributes to the risk of suicide attempts among those with suicidal thoughts and warrants further research. The study explored the associations of demographic, psychosocial, and behavioral factors with suicide attempts among a nationally representative of school-going Argentinian adolescents who have suicidal thoughts. The study analyzed the data from the Argentina Global School-based Students Survey 2018. The sample was restricted to adolescents with suicidal thoughts. The chi-square test was used to examine the association, and logistic regression determined the odds of suicide attempts across risk factors including demographic factors, psychosocial and environmental risks, as well as substance use and risk sex behaviors. In total, 11,962 (21.46%) of school-going Argentinian adolescents had suicidal thoughts, of whom 6033 (51.67%) had suicide attempts at least once in the last 12 months. Findings indicated that female adolescents had higher odds of attempts, paralleling global trends, while grade differences suggested a transitional phase's significance. Among those with suicidal thoughts, psychosocial factors like loneliness, bullying, and school absenteeism played pivotal roles in enhancing the odds of suicide attempts. In addition, substance use, notably marijuana, amphetamines, alcohol, and early initiation were associated with a heightened risk of suicide attempts. Risky sexual behaviors, like early activity and multiple partners, were also associated with a higher likelihood of suicide attempts in suicide ideators. Emphasizing preventive measures targeting adolescents, particularly within school settings, is crucial for reducing suicide attempts among those experiencing suicidal thoughts.

关键词： Suicide attempt Suicide thoughts Argentina Adolescents

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Suicidal behaviours and their correlates in school-going Lebanese adolescents: findings from a national survey

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CHILD AND ADOLESCENT PSYCHIATRY AND MENTAL HEALTH 2023年第1期17卷 1页

作者： dadras, omid Wang, Chia-Wen Univ Bergen Dept Global Publ Hlth & Primary Care Bergen Norway Western Norway Univ Appl Sci Sect Global Hlth & Rehabil Bergen Norway Natl Univ Singapore Saw Swee Hock Sch Publ Hlth Singapore Singapore Natl Univ Hlth Syst Singapore Singapore Natl Univ Singapore Lloyds Register Fdn Inst Publ Understanding Risk Singapore Singapore

BackgroundAdolescent suicide is regarded as a serious phenomenon that affects the well-being of the youth. This study aims to investigate the prevalence of suicidal behaviours and their association with physical/psychological harm and substance use in a nationally representative sample of adolescents in Grades 7-12 in *** from the latest Global School-Based Student Health Survey conducted in 2017 were used in this study. The prevalence and correlates of suicidal ideation and suicide attempts among those who had considered committing suicide, at least once, were *** estimated 13.45% of Lebanese adolescents, particularly females in Grades 7-12 had considered suicide at least once in the past 12 months. More importantly, almost half of them had attempted it at least once in the past 12 months. Those who frequently felt lonely or worried (previous year), were involved in physical fights or assaults (previous year), had been verbally or physically bullied (previous month), had missed more school days, experienced food insecurity, and had a history of substance abuse (marijuana, amphetamine, alcohol, and tobacco products) were more likely to exhibit suicidal behaviours. Parental support and older age at drug initiation appeared to be protective *** findings characterise the correlates of suicidal behaviours among school-going Lebanese adolescents and determine the attributes of the risk group susceptible to engaging in suicide attempts. Future interventions and policies should consider these attributes when monitoring target groups, particularly those with the alarming behaviours identified in this study. In addition, awareness campaigns that engage all stakeholders, particularly parents, should be prioritised by the authorities.

关键词： Suicide Adolescent Substance use Bullying Physical harm Mental health

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Intimate Partner Violence and Children Under 5 Morbidities and Mortality in Afghanistan: Findings From a National Survey

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JOURNAL OF INTERPERSONAL VIOLENCE 2023年第17-18期38卷 10105-10126页

作者： dadras, omid Hazratzai, Mohammadsediq dadras, Fateme Univ Bergen Beregn Norway Hogskulen Pa Vestlandet HVL Bergen Norway Publ Hlth Institue PHI Oakland CA USA Univ Tehran Med Sci Tehran Iran Univ Bergen Dept Global Publ Hlth & Primary Care Arstadveien 17 N-5020 Bergen Norway

Limited knowledge exists concerning the prevalence and drivers of intimate partner violence (IPV) against Afghan women and its association with child morbidity and mortality in Afghanistan. The study used data from the 2015 Afghanistan Demographic and Health Survey (ADHS 2015). The prevalence and associated sociodemographic factors of IPV were described by analyzing the data from Afghan women aged 15 to 49 years selected for the IPV module in ADHS 2015 (n = 24,070) whose children under 5 (n = 22,927) were included in the further analysis to estimate the morbidity and mortality of children and its association with IPV. It appeared that more than half of the Afghan women aged 15 to 49 years experienced IPV in the past year. Illiteracy (odds ratio [OR] = 1.69;95% CI: 1.19, 2.39), living in rural areas (OR = 1.47;[1.19, 1.82]) being from the Pashtun, Tajik, Uzbek, and Pashai ethnic backgrounds were associated with a higher risk of IPV exposure. In general, the likelihood of child mortality within the first 5 years was higher among children born to mothers exposed to IPV, particularly physical and sexual even after adjustment for sociodemographic inequalities, the number of antenatal care, and marriage age. In addition, the odds of diarrhea, acute respiratory infection, and fever in the past 2 weeks were significantly higher among the children of victimized mothers in both adjusted and unadjusted models. Moreover, low birth weight and small birth size were more likely to be observed among the children of a mother who either experienced sexual or physical violence. The findings emphasized the elevated risk of morbidity and mortality among children under 5 born to mothers exposed to IPV and incorporating IPV screening into maternity and child care could reduce these adverse outcomes among Afghan women.

关键词： intimate partner violence children under 5 morbidity mortality Afghanistan

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Survey-based Women Empowerment Index for Afghanistan (SWEI-A): An Explanatory and Confirmatory Factor Analyses

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SOCIAL INDICATORS RESEARCH 2023年第3期170卷 1059-1074页

作者： dadras, omid Hazratzai, Mohammadsediq Univ Bergen Dept Global Hlth & Primary Care Bergen Norway Haukland Univ Hosp Dept Addict Med Bergen Addict Res Bergen Norway Publ Hlth Institue PHI Los Angeles CA USA

This study aimed to develop a country-specific index to measure women empowerment among married women aged 15-49 years in Afghanistan. The data from the 2015 Afghanistan demographic health survey (ADHS) was used to develop the index. The data on 26 variables across eight hypothesized domains related to women empowerment were used in EFA to probe the underlying domains in the data. CFA examined the structural validity of hypothesized factors in EFA. Four indicators were dropped during the analysis either due to the low and significantly different loading on one factor as compared to other indicators or due to overlap with other indicators loaded on different factors. The final model included 22 indicators across seven domains (labor force participation, attitude toward violence, decision-making, access to healthcare, literacy, age at critical life events, and property-owning) and had Cronbach's alpha = 0.69;indicative of good internal reliability. The goodness-of-fit test represented an acceptable level of construct validity with the likelihood ratio, RMSEA, and SRMR values <= 0.05 and CFI and TLI > 0.95. The developed index shares a common ground for future research concerning women empowerment in Afghanistan and can enhance the comparability of the results across future studies. In addition, having a standard index for women empowerment at the individual and country level could help assess the progress and efforts that have been made to achieve gender equality (SDG 5), and guide the direction of future policies and interventions.

关键词： Women empowerment Afghanistan Index Reliability Validity

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Child Marriage, Reproductive Outcomes, and Service Utilization among Young Afghan Women: Findings from a Nationally Representative Survey in Afghanistan

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STUDIES IN FAMILY PLANNING 2022年第3期53卷 417-431页

作者： dadras, omid Khampaya, Tanaporn Nakayama, Takeo Walailak Univ Excellent Ctr Dengue & Community Publ Hlth EC DAC Nakhon Si Thammarat Thailand Tehran Uni Med Sci Iranian Res Ctr HIV AIDS IRCHA Tehran Iran Walailak Univ Sch Publ Hlth Nakhon Si Thammarat Thailand Kyoto Univ Sch Publ Hlth Dept Hlth Informat Kyoto Japan

This study explored the prevalence of child marriage and its association with reproductive outcomes and service utilization among young women in Afghanistan. We conducted a secondary analysis of data from the 2015 Afghanistan Demographic and Health Survey (DHS), focusing on women aged 20-24 years old based on the United Nations' recommendation on child marriage study. Multivariate logistic models examined the association between child marriage, reproductive outcomes, and service utilization. An estimated 52% of the Afghan women aged 20-24 married at ages less than 18 years. Poverty and illiteracy were associated with the higher likelihood of early marriage. There was a significant negative relationship between child marriage and history of rapid repeat childbirth, delivery by skilled personnel, and institutional delivery. In both adjusted and unadjusted models, women married at age <= 14 were more likely to experience terminated or unintended pregnancy, inadequate ANC, unmet need for family planning, and fistula;while, for those married at age 15-17 years, only terminated or unintended pregnancy remained significant. Strict international law enforcement and advocacy are needed in the current situation of Afghanistan to increase young women's education, promote their civil rights, and improve their autonomy and role in decision-making concerning their fertility preferences and reproductive health.

关键词： Afghan women child marriage reproductive outcome Afghanistan

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Prevalence of stunting and its correlates among children under 5 in Afghanistan: the potential impact of basic and full vaccination

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BMC PEDIATRICS 2024年第1期24卷 436页

作者： dadras, omid Suwanbamrung, Charuai Jafari, Massoma Stanikzai, Muhammad Haroon Univ Bergen Dept Global Publ Hlth & Primary Care Bergen Norway Walailak Univ Sch Publ Hlth Publ Hlth Res Program Thai Buri Thailand Walailak Univ Excellent Ctr Dengue & Community Publ Hlth EC DACH Thai Buri Thailand McMaster Univ Hamilton ON Canada Kandahar Univ Fac Med Dept Publ Hlth Dist 10 Kandahar 3801 Afghanistan

Background Child stunting is prevalent in low and middle-income countries (LMICs), but an information gap remains regarding its current prevalence, correlates, and the impact of vaccination against this condition in Afghanistan. This study aimed to determine the prevalence and correlates of moderate and severe stunting and the potential impact of basic and full vaccination among children under five in Afghanistan. Methods This is a secondary analysis of the 2022-23 Afghanistan Multiple Indicators Cluster Survey (MICS) including 32,989 children under 5. Descriptive statistics were employed to describe the distribution of independent variables and the prevalence of stunting across them. Chi-square analysis was used to examine the association between each independent variable with stunting. Multinomial logistic regression was used to examine the risk of stunting across different independent variables. Results A total of 32,989 children under 5 years old were included in this study. Of those 44.7% were stunted with 21.74% being severely stunted. Children aged 24-35 and 36-47 months faced the highest risk as compared to those aged 1-5 months. The prevalence was lower in female children and they were less likely to experience severe stunting. Stunting was more prevalent in rural areas, with children there 1.16 to 1.23 times more likely to be affected than urban counterparts. Lower wealth correlated with higher stunting. Younger maternal age at birth (<= 18) correlated with increased stunting risks, particularly in severe cases. Parental education was inversely related to stunting;higher education levels in parents, especially fathers, were associated with lower stunting rates. Households with more than seven children showed a 25% and 44% higher risk of moderate and severe stunting, respectively, compared to families with 1-4 children. Improved sanitation, but not drinking water sources, was linked to reduced stunting in the adjusted model. Vaccination had a protective eff

关键词： Children under 5 stunting Afghanistan Prevalence Correlates

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Early childhood development and its associated factors among children aged 36-59 months in Afghanistan: evidence from the national survey 2022-2023

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BMC PEDIATRICS 2024年第1期24卷 1-9页

作者： dadras, omid Stanikzai, Muhammad Haroon Jafari, Massoma Tawfiq, Essa Univ Bergen Dept Global Publ Hlth & Primary Care Bergen Norway Kandahar Univ Fac Med Dept Publ Hlth Dist 10 Kandahar 3801 Afghanistan McMaster Univ Hamilton ON Canada UNSW Sydney Kirby Inst Sydney Australia

BackgroundUnderstanding the status of early childhood development (ECD) and its associated factors could serve as the basis for future policy efforts and interventions. Therefore, this study aimed to determine the status of ECD and its associated factors among children aged 36-59 months in *** used data from the Afghanistan Multiple Indicator Cluster Survey 2022-2023 (MICS) to assess ECD status. The outcome variable was a binary measure, indicating whether a child was developmentally on track or not. To explore the associations between ECD status and various explanatory variables, we applied binary logistic regression models, presenting both univariate and multivariate *** the 13,866 children aged 36 to 59 months included in the analysis, 29.95% (95% CI: 29.19-30.72%) were found to be developmentally on track. The likelihood of being developmentally on track was higher in children whose mothers had secondary [adjusted odds ratio (AOR) 1.36 (95%CI 1.04-1.77)] and higher education [1.73 (1.08-2.76)], in children whose fathers had primary [1.32 (1.05-1.67)], secondary [1.40 (1.10-1.79) and higher education [1.60 (1.21-2.11)], and in children belonging to the higher household wealth status [1.46 (1.18-1.82)]. On the other hand, the likelihood of being developmentally on track was lower in children aged 48-59 months [0.35 (0.30-0.40)], in children living in rural areas [0.77 (0.62-0.96)], in children with stunting [0.77 (0.61-0.96)], and in underweight children [0.61 (0.52-0.72)].ConclusionOur findings indicate that 29.95% of children aged 36-59 months in Afghanistan are developmentally on track. Positive associations were found between ECD and higher parental education and household wealth status. However, living in rural areas, underweight and stunted growth were negatively associated with ECD. To improve early childhood development programs in Afghanistan, targeted interventions are needed to address the factors identified in this s

关键词： Afghanistan Associated factors Developmental delays Early childhood development MICS

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Risk factors for non-communicable diseases in Afghanistan: insights of the nationwide population-based survey in 2018

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JOURNAL OF HEALTH POPULATION AND NUTRITION 2024年第1期43卷 1-13页

Background Noncommunicable diseases (NCDs) account for a substantial number of deaths in Afghanistan. Understanding the prevalence and correlates of major NCD risk factors could provide a benchmark for future public health policies and programs to prevent and control NCDs. Therefore, this study aimed to examine the prevalence and correlates of NCD risk factors among adults aged 18-69 years in Afghanistan. Methods We used data from the Afghanistan STEPS Survey 2018. The study population were 3650 (1896 males and 1754 females) adults aged 18-69 years sampled from all 34 provinces through a multistage cluster sampling process. Information on behavioural and biological risk factors was collected. We used STATA (version 18.0) for data analysis. Results Of the total participants, 42.8% were overweight or obese, 8.6% were current smokers, 26.9% had insufficient physical activities, 82.6% had low consumption of fruits and vegetables, and only 0.5% had ever consumed alcohol. Approximately 15% of participants had a high salt intake, while 25% and 8% had elevated blood pressure and blood glucose levels, respectively. Similarly, around 18% had elevated total cholesterol. The study revealed a lower prevalence of current smoking among females [AOR = 0.17, 95%CI (0.09-0.30)] compared with males, but a higher prevalence in those who had higher education levels [1.95 (1.13-3.36)] compared with those with no formal education. Insufficient physical activity was higher in participants aged 45-69 years [1.96 (1.39-2.76)], females [4.21 (1.98-8.84)], and urban residents [2.38 (1.46-3.88)] but lower in those with higher education levels [0.60 (0.37-0.95)]. Participants in the 25th to 75th wealth percentiles had higher odds of low fruit and vegetable consumption [2.11 (1.39-3.21)], while those in the > 75th wealth percentile had lower odds of high salt intake [0.63 (0.41-0.98)]. Being overweight/obese was more prevalent in participants aged 45-69 years [1.47 (1.03-2.11)], females [1.42 (0.

关键词： Non-communicable diseases NCD Risk factors Afghanistan WHO STEPS

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