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Baroudi, M., Petersen, S., Namatovu, F., Annelie, C., Ivarsson, A. & Norström, F. (2019). Preteen children’s health related quality of life in Sweden: changes over time and disparities between different sociodemographic groups. BMC Public Health, 19, Article ID 139.
Open this publication in new window or tab >>Preteen children’s health related quality of life in Sweden: changes over time and disparities between different sociodemographic groups
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2019 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 19, article id 139Article in journal (Refereed) Published
Abstract [en]

Background: Assessing disparities in health-related quality of Life (HRQoL) is important as a part of health-related disparities in the society. The aim of this study was to explore HRQoL among 12-year-olds in Sweden in terms of differences between years 2005 and 2009 and disparities related to sociodemographic background.

Methods: During the school years 2005 and 2009, a total of 18,325 sixth grade students in Sweden were invited to a celiac disease screening study; 13,279 agreed to participate. Jointly with the celiac screening, the children answered a questionnaire that included EuroQol 5 Dimensions-youth (EQ-5D-Y) and their parents responded to separate questionnaires about their own and their child’s country of birth, family structure, their employment status, occupation, and education. In total 11,009 child-parent questionnaires were collected. Logistic regression was used to study differences in HRQoL between 2005 and 2009, and between various sociodemographic subgroups.

Results: Compared with 2005, children in 2009 reported more pain (OR: 1.20, 95% CI: 1.1–1.3) and more mood problems (OR: 1.35, 95% CI: 1.2–1.5). In general, girls reported more pain and mood problems and had more disparities than boys. There were no significant differences based on parents’ occupation, however, children of parents with low or medium education levels reported less “mood problems” than those of parents with high education levels (OR: 0.65, 95% CI: 0.46–0.92) and (OR: 0.84, 95% CI: 0.73–0.96), respectively. A slight variation was seen in HRQoL between children with different migration background. Girls living in small municipalities reported more pain (OR: 1.51, 95% CI: 1.14–2.01), and problems performing usual activities (OR: 3.77, 95% CI: 2.08–6.84), compared to girls living in large municipalities. In addition, children living with two parents had less mood problems than children living in other family constellations.

Conclusion: More children reported pain and mood problems in 2009 compared with 2005. To study future trends, health outcomes among children in Sweden should continue to be reported periodically. More efforts should be invested to increase the awareness of health-related disparities as highlighted in this study especially for girls living in small municipalities and children of parents with high education level.

Place, publisher, year, edition, pages
BioMed Central, 2019
Keywords
Preteen children health, Health inequity, Quality of life, HRQoL, Sociodemographic disparities
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-155944 (URN)10.1186/s12889-019-6429-6 (DOI)000457471800001 ()30704442 (PubMedID)
Funder
Swedish Research Council, 521-2004-7093Swedish Research Council, 521-2007-2953Swedish Research Council Formas, 222-2004-1918Swedish Research Council Formas, 222-2007-1394
Available from: 2019-02-01 Created: 2019-02-01 Last updated: 2019-02-25Bibliographically approved
Namatovu, F., Strandh, M., Ivarsson, A. & Nilsson, K. (2018). Effect of childhood coeliac disease on ninth grade school performance: evidence from a population-based study. Archives of Disease in Childhood, 103(2), 143-148
Open this publication in new window or tab >>Effect of childhood coeliac disease on ninth grade school performance: evidence from a population-based study
2018 (English)In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 103, no 2, p. 143-148Article in journal (Refereed) Published
Abstract [en]

Background: Coeliac disease might affect school performance due to its effect on cognitive performance and related health consequences that might increase school absenteeism. The aim of this study was to investigate whether children with coeliac disease performed differently on completion of ninth grade in school compared with children without coeliac disease.

Methods: Analysis was performed on a population of 445 669 children born in Sweden between 1991 and 1994 of whom 1767 were diagnosed with coeliac disease. School performance at ninth grade was the outcome and coeliac disease was the exposure. Other covariates included sex, Apgar score at 5 min, small for gestational age, year of birth, family type, parental education and income.

Results: There was no association between coeliac disease and school performance at ninth grade (adjusted coefficient -2.4, 95% CI 5.1 to 0.4). A weak association was established between late coeliac diagnosis and higher grades, but this disappeared after adjusting for parent socioeconomic conditions. Being small for gestational age affected performance negatively (adjusted coefficient -6.9, 95% CI 8.0 to 5.7). Grade scores were significantly lower in children living with a single parent (adjusted coefficient -20.6, 95% CI 20.9 to 20.2), compared with those with married/cohabiting parents. A positive association was found between scores at ninth grade and parental education and income.

Conclusion: Coeliac disease diagnosis during childhood is not associated with poor school performance at ninth grade.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2018
Keywords
achievement, celiac, disease, education, grades, income, performance and school
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-139901 (URN)10.1136/archdischild-2017-312830 (DOI)000424019400011 ()28844065 (PubMedID)
Available from: 2017-09-26 Created: 2017-09-26 Last updated: 2018-06-09Bibliographically approved
Wagman, J. A., Gray, R. H., Nakyanjo, N., McClendon, K. A., Bonnevie, E., Namatovu, F., . . . Nalugoda, F. (2018). Process evaluation of the SHARE intervention for preventing intimate partner violence and HIV infection in Rakai, Uganda. Evaluation and Program Planning, 67, 129-137
Open this publication in new window or tab >>Process evaluation of the SHARE intervention for preventing intimate partner violence and HIV infection in Rakai, Uganda
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2018 (English)In: Evaluation and Program Planning, ISSN 0149-7189, E-ISSN 1873-7870, Vol. 67, p. 129-137Article in journal (Refereed) Published
Abstract [en]

The Safe Homes And Respect for Everyone (SHARE) intervention introduced an intimate partner violence (IPV) prevention approach into Rakai Health Sciences Program, an established HIV research and service organization in Uganda. A trial found exposure to SHARE was associated with reductions in IPV and HIV incidence. This mixed methods process evaluation was conducted between August 2007 and December 2009, with people living in SHARE intervention clusters, to assess awareness about/participation in SHARE, motivators and barriers to involvement, and perceptions of how SHARE contributed to behavior change. Surveys were conducted with 1407 Rakai Community Cohort Study participants. Qualitative interviews were conducted with 20 key informants. Most (77%) were aware of SHARE, among whom 73% participated in intervention activities. Two-thirds of those who participated in SHARE felt it influenced behavior change related to IPV. While some felt confident to take part in new IPV-focused activities of a well-established program, others were suspicious of SHARE's motivations, implying awareness raising is critical. Many activities appealed to the majority (e.g., community drama) while interest in some activities was limited to men (e.g., film shows), suggesting multiple intervention components is ideal for wide-reaching programming. The SHARE model offers a promising, acceptable approach for integrating IPV prevention into HIV and other established health programs in sub-Saharan Africa.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Process evaluation, SHARE intervention, Intimate partner violence, HIV infection, Mixed methods, kai, Uganda
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-146560 (URN)10.1016/j.evalprogplan.2017.12.009 (DOI)000428097000016 ()29310019 (PubMedID)
Available from: 2018-05-16 Created: 2018-05-16 Last updated: 2018-06-09Bibliographically approved
King, E. J., Maman, S., Namatovu, F., Kiwanuka, D., Kairania, R., Ssemanda, J. B., . . . Wagman, J. A. (2017). Addressing intimate partner violence among female clients accessing HIV testing and counseling services: pilot testing tools in Rakai, Uganda. Violence against Women, 23(13), 1656-1668
Open this publication in new window or tab >>Addressing intimate partner violence among female clients accessing HIV testing and counseling services: pilot testing tools in Rakai, Uganda
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2017 (English)In: Violence against Women, ISSN 1077-8012, E-ISSN 1552-8448, Vol. 23, no 13, p. 1656-1668Article in journal (Refereed) Published
Abstract [en]

The World Health Organization recommends that HIV counseling and testing (HCT) programs implement strategies to address how intimate partner violence (IPV) influences women's ability to protect themselves from and seek care and treatment for HIV infection. We discuss the process used to adapt a screening and brief intervention (SBI) for female clients of HCT services in Rakai, Uganda-a setting with high prevalence of both HIV and IPV. By outlining our collaborative process for adapting and implementing the SBI in Rakai and training counselors for its use, we hope other HCT programs will consider replicating the approach in their settings.

Place, publisher, year, edition, pages
Sage Publications, 2017
Keywords
HIV testing and counseling, intimate partner violence, Uganda
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-127488 (URN)10.1177/1077801216663657 (DOI)000412911900006 ()27586170 (PubMedID)
Available from: 2016-11-14 Created: 2016-11-14 Last updated: 2018-06-09Bibliographically approved
Namatovu, F. N. (2017). Disability and family formation. Paper presented at 10th European Public Health Conference Sustaining resilient and healthy communities Stockholm, Sweden 1–4 November 2017. European Journal of Public Health, 27(Suppl_3), 352
Open this publication in new window or tab >>Disability and family formation
2017 (English)In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 27, no Suppl_3, p. 352-Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Few studies have investigated family formation among people with disabilities. Available evidence on disability and family formation shows people with disabilities to have a low propensity of finding a life partner. Being married or cohabiting has been associated with improved health in children. There is a general lack of investigations on how family formation among people with disability has changed in recent decades. Important to note, there is scanty of evidence of how the situation of disability and family formation looks like in Sweden today.

Methods: Using Swedish national register data obtained from the Umeå SIMSAM Lab, the study applies statistical life course techniques such as Cox regression and sequence analysis to identify factors affecting the relationship between disability and family formation. We follow the life courses of persons with disability born in 1973-1977 up to when they are aged 16-37 years, which is in 1990 and 2010. The selected age interval represents the time when crucial transitioning often takes place i.e. transition into education, independent living, work and family formation. Disability based on having received early retirement pension during the follow-up period.

Results: Out of 700000 individuals born during 1973-1977, the study shows differences in partnership chances for people with disability and not.

Conclusions: There is need for further investigations on why people with work related disability have lower rates of cohabitation and marriage compared to the general population.

Key messages:

  • Despite the major improvements in the lives of people with disability.
  • There is need for to look into ways of increasing their chances of finding a partner.
Place, publisher, year, edition, pages
OXFORD UNIV PRESS, 2017
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-143076 (URN)10.1093/eurpub/ckx189.128 (DOI)000414389804022 ()
Conference
10th European Public Health Conference Sustaining resilient and healthy communities Stockholm, Sweden 1–4 November 2017
Available from: 2017-12-15 Created: 2017-12-15 Last updated: 2018-06-09Bibliographically approved
Wagman, J. A., King, E. J., Namatovu, F., Kiwanuka, D., Kairania, R., Semanda, J. B., . . . Brahmbhatt, H. (2016). Combined Intimate Partner Violence and HIV/AIDS Prevention in Rural Uganda: Design of the SHARE Intervention Strategy. Health Care for Women International, 37(3), 362-385
Open this publication in new window or tab >>Combined Intimate Partner Violence and HIV/AIDS Prevention in Rural Uganda: Design of the SHARE Intervention Strategy
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2016 (English)In: Health Care for Women International, ISSN 0739-9332, E-ISSN 1096-4665, Vol. 37, no 3, p. 362-385Article in journal (Refereed) Published
Abstract [en]

Intimate partner violence (IPV) has a bidirectional relationship with HIV infection. Researchers from the Rakai Health Sciences Program (RHSP), an HIV research and services organization in rural Uganda, conducted a combination IPV and HIV prevention intervention called the Safe Homes and Respect for Everyone (SHARE) Project between 2005 and 2009. SHARE was associated with significant declines in physical and sexual IPV and overall HIV incidence, and its model could be adopted as a promising practice in other settings. In this article we describe how SHARE's IPV-prevention strategies were integrated into RHSP's existing HIV programming and provide recommendations for replication of the approach.

Keywords
HIV Infections, uganda, Sexual Behavior, Spouse Abuse
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-119121 (URN)10.1080/07399332.2015.1061526 (DOI)000370965600008 ()26086189 (PubMedID)
Available from: 2016-04-12 Created: 2016-04-12 Last updated: 2018-06-07Bibliographically approved
Wagman, J. A., Paul, A., Namatovu, F., Ssekubugu, R. & Nalugoda, F. (2016). Ethical Challenges of Randomized Violence Intervention Trials: Examining the SHARE intervention in Rakai, Uganda. Psychology of Violence, 6(3), 442-451
Open this publication in new window or tab >>Ethical Challenges of Randomized Violence Intervention Trials: Examining the SHARE intervention in Rakai, Uganda
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2016 (English)In: Psychology of Violence, ISSN 2152-0828, E-ISSN 2152-081X, Vol. 6, no 3, p. 442-451Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: We identify complexities encountered, including unanticipated crossover between trial arms and inadequate 'standard of care' violence services, during a cluster randomized trial (CRT) of a community-level intimate partner violence (IPV) and HIV prevention intervention in Uganda.

METHODS: Concepts in public health ethics - beneficence, social value of research, fairness, standard of care, and researcher responsibilities for post-trial benefits - are used to critically reflect on lessons learned and guide discussion on practical and ethical challenges of violence intervention CRTs.

RESULTS: Existing ethical guidelines provide incomplete guidance for responding to unexpected crossover in CRTs providing IPV services. We struggled to balance duty of care with upholding trial integrity, and identifying and providing appropriate standard of care. While we ultimately offered short-term IPV services to controls, we faced additional challenges related to sustaining services beyond the 'short-term' and post-trial.

CONCLUSION: Studies evaluating community-level violence interventions, including those combined with HIV reduction strategies, are limited yet critical for developing evidence-based approaches for effectively preventing IPV. Although CRTs are a promising design, further guidance is needed to implement trials that avoid introducing tensions between validity of findings, researchers' responsibilities to protect participants, and equitable distribution of CRT benefits.

Keywords
intimate partner violence, cluster randomized trial, research ethics, HIV, Rakai, Uganda
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-127489 (URN)10.1037/vio0000037 (DOI)000385914700009 ()27453794 (PubMedID)
Available from: 2016-11-14 Created: 2016-11-14 Last updated: 2018-06-09Bibliographically approved
Namatovu, F., Olsson, C., Lindkvist, M., Myléus, A., Högberg, U., Ivarsson, A. & Sandström, O. (2016). Maternal and perinatal conditions and the risk of developing celiac disease during childhood.. BMC Pediatrics, 16, Article ID 77.
Open this publication in new window or tab >>Maternal and perinatal conditions and the risk of developing celiac disease during childhood.
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2016 (English)In: BMC Pediatrics, ISSN 1471-2431, E-ISSN 1471-2431, Vol. 16, article id 77Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Celiac disease (CD) is increasing worldwide, which might be due to the changing environmental and lifestyle exposures. We aimed to explore how conditions related to maternity, delivery and the neonatal period influence CD onset during childhood.

METHODS: Using Sweden's national registers we had access to information on 1 912 204 children born between 1991 and 2009, 6 596 of whom developed CD before 15 years of age. Logistic regression analyses were performed to determine how CD is associated with maternity, delivery and the neonatal period.

RESULTS: Regardless of sex, a reduction in CD risk was observed in children born to mothers aged ≥35 years (odds ratio [OR] 0.8; 95 % confidence interval [CI] 0.7-0.9) and with high maternal income (OR 0.9; 95 % CI 0.8-0.9). Being a second-born child, however, was positively associated with CD. Among boys, elective caesarean delivery increased the risk of CD (OR 1.2; 95 % CI 1.0-1.4), while maternal overweight (OR 0.9; 95 % CI 0.8-0.9), premature rupture of the membrane (OR 0.4; 95 % CI 0.2-0.8) and low birth weight showed a negative association. Girls had an increased CD risk compared to boys and in girls the risk was increased by repeated maternal urinary tract infections (OR 1.1; 95 % CI 1.0-1.2).

CONCLUSIONS: Elective caesarean delivery and repeated maternal urinary tract infections during pregnancy are associated with increased risk of CD onset during childhood, suggesting the role of dysbiosis during early life. High maternal age and high income reduced the risk of CD, which might be due to infant-feeding practices and life style.

National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-122411 (URN)10.1186/s12887-016-0613-y (DOI)000377535900001 ()27267234 (PubMedID)
Available from: 2016-06-17 Created: 2016-06-17 Last updated: 2019-06-05Bibliographically approved
Nyagwui, A. E., Fredinah, N., Che, L. B. & Yulia, B. (2016). Motorcycle injury among secondary school students in the Tiko municipality, Cameroon. Pan African Medical Journal, 24, Article ID 116.
Open this publication in new window or tab >>Motorcycle injury among secondary school students in the Tiko municipality, Cameroon
2016 (English)In: Pan African Medical Journal, ISSN 1937-8688, E-ISSN 1937-8688, Vol. 24, article id 116Article in journal (Refereed) Published
Abstract [en]

Introduction: injury from motorcycle is a considerable cause of disability and death in the world and especially in low and middle-income countries; it is one of the most serious public health problems. In Cameroon, motorcycle is commonly used for transportation particularly among students. The aim of this paper is to study the risk-factors of the motorcycle-related accidents and injuries among secondary school students’ in the Tiko municipality, Cameroon.

Methods: a cross sectional study was conducted in January 2012 on 391 students age 16-24 from public and private schools in the Tiko Municipality. Logistic regression was used to estimate the association between risk factors and injuries. A closed-ended and few open-ended questionnaire was used to collect data.

Results: the study showed that over 70% of students used motorcycles always or often. Few had undergone any formal training for driving a motorcycle. The vast majority reported not wearing protective gear while driving or riding a motorcycle. Usage of protective gear was particularly low among girls. Over 16% reported using a motorbike always or occasionally under the influence of alcohol or drugs. Over 58% of respondents reported having an accident and over 35% were injured when driving or riding a motorcycle. Those who lived at the Tiko-Douala road have three times higher probability to sustain accidents and injuries than students residing elsewhere (OR 3.19 (1.20-8.46).

Conclusion: it is deeply alarming that every second respondent in the study reported having been in an accident and every third motorcycle user was somehow injured. We therefore call for an immediate attention and a deeper investigation into the highlighted situation, particularly at Tiko-Douala road.

Keywords
Awareness, practice, safety, accident, injury, students
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-132059 (URN)10.11604/pamj.2016.24.116.5069 (DOI)000391669700003 ()27642454 (PubMedID)
Available from: 2017-03-10 Created: 2017-03-10 Last updated: 2018-06-09Bibliographically approved
Namatovu, F., Lindkvist, M., Olsson, C., Ivarsson, A. & Sandström, O. (2016). Season and region of birth as risk factors for coeliac disease a key to the aetiology?. Archives of Disease in Childhood, 101(12), 1114-1118
Open this publication in new window or tab >>Season and region of birth as risk factors for coeliac disease a key to the aetiology?
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2016 (English)In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 101, no 12, p. 1114-1118Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Coeliac disease (CD) incidence has increased in recent decades, characterised by variations according to sex, age at diagnosis, year of birth, month of birth and region of birth. Genetic susceptibility and exposure to gluten are the necessary factors in CD aetiology, although several environmental factors are considered.

METHODS: A nationwide prospective cohort longitudinal study was conducted consisting of 1 912 204 children aged 0-14.9 years born in Sweden from 1991 to 2009. A total of 6569 children were diagnosed with biopsy-verified CD from 47 paediatric departments. Using Cox regression, we examined the association between CD diagnosis and season of birth, region of birth and year of birth.

RESULTS: Overall, CD risk was higher for children born during spring, summer and autumn as compared with children born during winter: adjusted HR for spring 1.08 (95% CI 1.01 to 1.16), summer 1.10 (95% CI 1.03 to 1.18) and autumn 1.10 (95% CI 1.02 to 1.18). Increased CD risk was highest if born in the south, followed by central Sweden when compared with children born in northern Sweden. Children diagnosed at <2 years had an increased CD risk if born in spring while those diagnosed at 2-14.9 years the risk was increased for summer and autumn births. The birth cohort of 1991-1996 had increased CD risk if born during spring, for the 1997-2002 birth cohort the risk increased for summer and autumn births, while for the birth cohort of 2003-2009 the risk was increased if born during autumn.

CONCLUSIONS: Season of birth and region of birth are independently and jointly associated with increased risk of developing CD during the first 15 years of life. Seasonal variation in infectious load is the likely explanation.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2016
National Category
Public Health, Global Health, Social Medicine and Epidemiology Gastroenterology and Hepatology Pediatrics
Identifiers
urn:nbn:se:umu:diva-124646 (URN)10.1136/archdischild-2015-310122 (DOI)000388822900011 ()27528621 (PubMedID)
Available from: 2016-08-19 Created: 2016-08-19 Last updated: 2018-06-07Bibliographically approved
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ORCID iD: ORCID iD iconorcid.org/0000-0001-5471-9043

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