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Gender (in) differences in prevalence and incidence of traumatic experiences among orphaned and separated children living in five low- and middle-income countries

  • C. L. Gray (a1), B. W. Pence (a1) (a2), J. Ostermann (a2), R. A. Whetten (a2), K. O'Donnell (a2) (a3) (a4), N. M. Thielman (a2) (a5) and K. Whetten (a2) (a6)...
Abstract
Background.

Approximately 153 million children worldwide are orphaned and vulnerable to potentially traumatic events (PTEs). Gender differences in PTEs in low- and middle-income countries (LMIC) are not well-understood, although support services and prevention programs often primarily involve girls.

Methods.

The Positive Outcomes for Orphans study used a two-stage, cluster-randomized sampling design to identify 2837 orphaned and separated children (OSC) in five LMIC in sub-Saharan Africa and Asia. We examined self-reported prevalence and incidence of several PTE types, including physical and sexual abuse, among 2235 children who were ≥10 years at baseline or follow-up, with a focus on gender comparisons.

Results.

Lifetime prevalence by age 13 of any PTE other than loss of a parent was similar in both boys [91.7% (95% confidence interval (CI) (85.0–95.5)] and girls [90.3% CI (84.2–94.1)] in institutional-based care, and boys [92.0% (CI 89.0–94.2)] and girls [92.9% CI (89.8–95.1)] in family-based care; annual incidence was similarly comparable between institution dwelling boys [23.6% CI (19.1,−29.3)] and girls [23.6% CI (18.6,−30.0)], as well as between family-dwelling boys [30.7% CI (28.0,−33.6)] and girls [29.3% CI (26.8,−32.0)]. Physical and sexual abuse had the highest overall annual incidence of any trauma type for institution-based OSC [12.9% CI (9.6–17.4)] and family-based OSC [19.4% CI (14.5–26.1)], although estimates in each setting were no different between genders.

Conclusion.

Prevalence and annual incidence of PTEs were high among OSC in general, but gender-specific estimates were comparable. Although support services and prevention programs are essential for female OSC, programs for male OSC are equally important.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/3.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
* Address for correspondence: C. L. Gray, Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, CB #7435, Chapel Hill, NC 27599-7435, USA (Email: clgray@email.unc.edu)
References
Hide All
Alisic E, Jongmans MJ, van Wesel F, Kleber RJ (2011). Building child trauma theory from longitudinal studies: a meta-analysis. Clinical Psychology Review 31, 736–47.
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders 5th ed. Washington, DC.
Atwoli L, Ayuku D, Hogan J, Koech J, Vreeman RC, Ayaya S, Braitstein P (2014). Impact of domestic care environment on trauma and posttraumatic stress disorder among orphans in western Kenya. PLoS ONE 9, e89937.
Birdthistle IJ, Floyd S, Mwanasa S, Nyagadza A, Gwiza E, Glynn JR (2011). Child sexual abuse and links to HIV and orphanhood in urban Zimbabwe. Journal of Epidemiology and Community Health 65, 1075–82.
Blanchard EB, Jones-Alexander J, Buckley TC, Forneris CA (1996). Psychometric properties of the PTSD Checklist (PCL). Behavior Research Therapy 34, 669–73.
Buhmann CB (2014). Traumatized refugees: morbidity, treatment and predictors of outcome. Danish Medical Journal 61, B4871.
Bullock CM, Beckson M (2011). Male victims of sexual assault: phenomenology, psychology, physiology. Journal of the American Academy of Psychiatry and the Law 39, 197205.
Chaudhry S, Sangani B, Ojwang SB, Khan KS (1995). Retrospective study of alleged sexual assault at the Aga Khan Hospital, Nairobi. East African Medical Journal 72, 200–2.
Christian M, Safari O, Ramazani P, Burnham G, Glass N (2011). Sexual and gender based violence against men in the Democratic Republic of Congo: effects on survivors, their families and the community. Medicine, Conflict and Survival 27, 227–46.
Ekabua JE, Agan TU, Iklaki CU, Ekanem EI, Itam IH, Ogaji DS (2006). Trauma related to sexual assault in Calabar, south eastern Nigeria. Nigerian Journal of Medical 15, 72–4.
Escueta M, Whetten K, Ostermann J, O'donnell K (2014). Adverse childhood experiences, psychosocial well-being and cognitive development among orphans and abandoned children in five low income countries. BMC International Health & Human Rights 14, 6.
Elhai JD, Gray MJ, Kashdan TB, Franklin CL (2005). Which instruments are most commonly used to assess traumatic event exposure and posttraumatic effects?: A survey of traumatic stress professionals. Journal of Traumatic Stress 18, 541545.
Gray MJ, Litz BT, Hsu JL, Lombardo TW (2004). Psychometric properties of the life events checklist. Assessment 11, 330–41.
Holmes WC, Slap GB (1998). Sexual abuse of boys: definition, prevalence, correlates, sequelae, and management. Journal of the American Medical Association 280, 1855–62.
Ige O, Fawole OI (2012). Evaluating the medical care of child sexual abuse victims in a general hospital in Ibadan, Nigeria. Ghana Medical Journal 46, 22–6.
Kim JC, Askew I, Muvhango L, Dwane N, Abramsky T, Jan S, Ntlemo E, Chege J, Watts C (2009). Comprehensive care and HIV prophylaxis after sexual assault in rural South Africa: the Refentse intervention study. British Medical Journal 338, b515.
Koenig L, Doll L, O'leary A, Pequegnat W (eds.) (2004). From Child Sexual Abuse to Adult Sexual Risk: Trauma, Revictimization, and Intervention. American Psychological Association: Washington, DC.
Kounou KB, Bui E, Dassa KS, Hinton D, Fischer L, Djassoa G, Birmes P, Schmitt L (2013). Childhood trauma, personality disorders symptoms and current major depressive disorder in Togo. Social Psychiatry Psychiatric Epidemiology 48, 1095–103.
Li X, Barnett D, Fang X, Lin X, Zhao G, Zhao J, Hong Y, Zhang L, Naar-King S, Stanton B (2009). Lifetime incidences of traumatic events and mental health among children affected by HIV/AIDS in rural China. Journal of Clinical Child & Adolescent Psychology 38, 731–44.
Mugavero M, Ostermann J, Whetten K, Leserman J, Swartz M, Stangl D, Thielman N (2006). Barriers to antiretroviral adherence: the importance of depression, abuse, and other traumatic events. AIDS Patient Care STDS 20, 418–28.
Rajan DG, Shirey K, Ostermann J, Whetten R, O'Donnell K, Whetten K (2013). Child and caregiver concordance of potentially traumatic events experienced by orphaned and abandoned children. Vulnerable Children and Youth Studies: An International Interdisciplinary Journal for Research, Vulnerable Children and Youth Studies 9(3), 220233. doi: 10.1080/17450128.2013.855346.
Sarnquist C, Omondi B, Sinclair J, Gitau C, Paiva L, Mulinge M, Cornfield DN, Maldonado Y (2014). Rape prevention through empowerment of adolescent girls. Pediatrics 133(5), e1226–32.
Seaman SR, White IR (2013). Review of inverse probability weighting for dealing with missing data. Statistical Methods in Medical Research 22, 277–95.
Sommarin C, Kilbane T, Mercy JA, Moloney-Kitts M, Ligiero DP (2014). Preventing sexual violence and HIV in children. Journal of Acquired Immune Deficiency Syndromes 66(Suppl 2), S21723.
StataCorp. (2013). Stata Statistical Software: Release 13. StataCorp LP: College Station, TX.
United Nations (2006). Protection from sexual exploitation and abuse. http://www.unviolencestudy.org/. Accessed November 25, 2014.
United Nations (2010). Protection from sexual exploitation and abuse. http://www.un.org/en/pseataskforce/overview.shtml. Accessed November 25, 2014.
United States Government (2012). President's emergency plan for AIDS relief. http://www.pepfar.gov/documents/organization/195702.pdf. Accessed November 25, 2014.
UNICEF (2012). State of the World's Children. http://www.unicef.org/sowc2012/pdfs/SOWC%202012-Main%20Report_EN_13Mar2012.pdf. Accessed April 25, 2014.
Weathers FW, Litz BT, Herman DS, Huska JA, Keane TM (1991). The PTSD Checklist-Civilian Version (PCLC). National Center for PTSD, Boston Veteran's Affairs Medical Center: Boston, MA.
Weathers FW, Litz BT, Herman DS, Huska JA, Keane TM (1993). Reliability, validity, and diagnostic utility. Paper presented at the Trauma, Coping and Adaptation ISTSS: 9th Annual Meeting, San Antonio, TX.
Whetten K, Ostermann J, Whetten R, O'donnell K, Thielman N (2011). More than the loss of a parent: potentially traumatic events among orphaned and abandoned children. Journal of Trauma Stress 24, 174–82.
Whetten K, Ostermann J, Whetten RA, Pence BW, O'donnell K, Messer LC, Thielman NM (2009). A comparison of the wellbeing of orphans and abandoned children ages 6–12 in institutional and community-based care settings in 5 less wealthy nations. PLoS ONE 4, e8169.
Whetten K, Shirey K, Pence BW, Yao J, Thielman N, Whetten R, Adams J, Agala B, Ostermann J, O'donnell K, Hobbie A, Maro V, Itemba D, Reddy E (2013). Trauma history and depression predict incomplete adherence to antiretroviral therapies in a low income country. PLoS ONE 8, e74771.
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