Adverse childhood experiences and associations with mental health, substance use, and violence perpetration among young adults in sub-Saharan Africa.

Journal: Child abuse & neglect

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Affiliated Institutions:  Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, USA. Electronic address: rvt@cdc.gov. Department of Psychiatry, Interfaith Medical Center, Brooklyn, NY, USA. Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, USA. Levine College of Health Sciences, Wingate University, Wingate, NC, USA. National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, USA. Division of Global Health HIV and TB, Centers for Disease Control and Prevention, Namibia. Division of Global Health HIV and TB, Centers for Disease Control and Prevention, Kenya. Division of Global Health HIV and TB, Centers for Disease Control and Prevention, Mozambique. Department of Public Health, Felix Houphouet Boigny University, Abidjan, Cote d'Ivoire. Division of Global Health HIV and TB, Centers for Disease Control and Prevention, Cote d'Ivoire. International Center for AIDS Care and Treatment Program (ICAP) at Columbia University, NY, USA. Instituto Nacional de Saude (INS), Mozambique.

Abstract summary 

Adverse childhood experiences (ACEs) can have debilitating effects on child well-being, with consequences persisting into adulthood. Most ACE studies have been conducted in high-income countries and show a graded relationship between multiple ACE exposures and adverse health outcomes. Less is known about the types and burden of ACEs in sub-Saharan Africa (SSA).To estimate the pooled prevalence of six individual and cumulative ACE exposures (physical, sexual, and emotional violence; orphanhood; witnessing interparental and community violence) and assess their association with mental health outcomes, substance use, and violence perpetration among young adults in SSA.Aggregate data from the Violence Against Children and Youth Survey (VACS) in Cote d'Ivoire 2018, Kenya 2019, Lesotho 2018, Mozambique 2019, and Namibia 2019 included a sample of 11,498 young adults aged 18-24 years.Cumulative ACEs were defined by an integer count of the total number of individual ACEs (0 to 6). Weighted prevalence and adjusted odds ratios were estimated.ACEs prevalence ranged from 7.8 % (emotional violence) to 55.0 % (witnessing community violence). Strong graded relationships between cumulative ACE exposure and all study outcomes for both males and females were observed. Among females, witnessing interparental violence was the only individual ACE risk factor significantly associated with increased odds of substance use; among males, emotional violence was significantly associated with all outcomes.ACEs are associated with adverse mental health, substance use, and violence perpetration in SSA. Gender-specific and culturally sensitive intervention strategies are needed to effectively mitigate ACEs in this population.

Authors & Co-authors:  Brown Colvette C Nkemjika Stanley S Ratto Jeffrey J Dube Shanta R SR Gilbert Leah L Chiang Laura L Picchetti Viani V Coomer Rachel R Kambona Caroline C McOwen Jordan J Akani Bangaman B Kamagate Maman Fathim MF Low Andrea A Manuel Pedro P Agusto Angelo A Annor Francis B FB

Study Outcome 

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Citations : 
Authors :  16
Identifiers
Doi : 10.1016/j.chiabu.2023.106524
SSN : 1873-7757
Study Population
Males,Females
Mesh Terms
Other Terms
Adverse childhood experiences;Mental health;Sub-Saharan Africa;Substance use;Suicide attempt;Violence perpetration
Study Design
Study Approach
Country of Study
Namibia
Publication Country
England