The influence of depressive symptoms and school-going status on risky behaviors: a pooled analysis among adolescents in six sub-Saharan African countries
BackgroundEvidence from sub-Saharan Africa (SSA) regarding risky behaviors among adolescents remains scarce, despite the large population (approximately 249 million out of 1.2 billion globally in 2019) of adolescents in the region. We aimed to examine the potential influence of depressive symptoms a...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-07-01
|
| Series: | Frontiers in Psychiatry |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1171231/full |
| _version_ | 1797773571248881664 |
|---|---|
| author | Uttara Partap Nega Assefa Yemane Berhane Ali Sie David Guwatudde Japhet Killewo Ayoade Oduola Mary M. Sando Said Vuai Richard Adanu Till Bärnighausen Till Bärnighausen Wafaie W. Fawzi Wafaie W. Fawzi Wafaie W. Fawzi |
| author_facet | Uttara Partap Nega Assefa Yemane Berhane Ali Sie David Guwatudde Japhet Killewo Ayoade Oduola Mary M. Sando Said Vuai Richard Adanu Till Bärnighausen Till Bärnighausen Wafaie W. Fawzi Wafaie W. Fawzi Wafaie W. Fawzi |
| author_sort | Uttara Partap |
| collection | DOAJ |
| description | BackgroundEvidence from sub-Saharan Africa (SSA) regarding risky behaviors among adolescents remains scarce, despite the large population (approximately 249 million out of 1.2 billion globally in 2019) of adolescents in the region. We aimed to examine the potential influence of depressive symptoms and school-going status on risky behaviors among adolescents in six SSA countries.MethodsWe used individual cross-sectional data from adolescents aged 10–19 based in eight communities across six SSA countries, participating in the ARISE Network Adolescent Health Study (N = 7,661). Outcomes of interest were cigarette or tobacco use, alcohol use, other substance use, getting into a physical fight, no condom use during last sexual intercourse, and suicidal behavior. We examined the proportion of adolescents reporting these behaviors, and examined potential effects of depressive symptoms [tertiles of 6-item Kutcher Adolescent Depression Scale (KADS-6) score] and school-going status on these behaviors using mixed-effects Poisson regression models. We also assessed effect modification of associations by sex, age, and school-going status.ResultsThe proportion of adolescents reporting risky behaviors was varied, from 2.2% for suicidal behaviors to 26.2% for getting into a physical fight. Being in the higher tertiles of KADS-6 score was associated with increased risk of almost all risky behaviors [adjusted risk ratio (RR) for highest KADS-6 tertile for alcohol use: 1.70, 95% confidence interval (95% CI): 1.48–1.95, p < 0.001; for physical fight: 1.52, 95% CI: 1.36–1.70, p < 0.001; for suicidal behavior: 7.07, 95% CI: 2.69–18.57, p < 0.001]. Being in school was associated with reduced risk of substance use (RR for alcohol use: 0.73, 95% CI: 0.53–1.00, p = 0.047), and not using a condom (RR: 0.81, 95% CI: 0.66–0.99, p = 0.040). There was evidence of modification of the effect of school-going status on risky behaviors by age and sex.ConclusionOur findings reinforce the need for a greater focus on risky behaviors among adolescents in SSA. Addressing depressive symptoms among adolescents, facilitating school attendance and using schools as platforms to improve health may help reduce risky behaviors in this population. Further research is also required to better assess the potential bidirectionality of associations. |
| first_indexed | 2024-03-12T22:08:24Z |
| format | Article |
| id | doaj.art-c5295e0998bb4a5194b6acec277dcf0e |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-03-12T22:08:24Z |
| publishDate | 2023-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj.art-c5295e0998bb4a5194b6acec277dcf0e2023-07-24T09:51:14ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402023-07-011410.3389/fpsyt.2023.11712311171231The influence of depressive symptoms and school-going status on risky behaviors: a pooled analysis among adolescents in six sub-Saharan African countriesUttara Partap0Nega Assefa1Yemane Berhane2Ali Sie3David Guwatudde4Japhet Killewo5Ayoade Oduola6Mary M. Sando7Said Vuai8Richard Adanu9Till Bärnighausen10Till Bärnighausen11Wafaie W. Fawzi12Wafaie W. Fawzi13Wafaie W. Fawzi14Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, United StatesSchool of Public Health, College of Health and Medical Sciences, Haramaya University, Dire Dawa, EthiopiaAddis Continental Institute of Public Health, Addis Ababa, EthiopiaNouna Health Research Center, Nouna, Burkina FasoDepartment of Epidemiology and Biostatistics, Makerere University School of Public Health, Kampala, UgandaDepartment of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, TanzaniaUniversity of Ibadan Research Foundation, University of Ibadan, Ibadan, NigeriaAfrica Academy for Public Health, Dar es Salaam, TanzaniaCollege of Natural and Mathematical Sciences, University of Dodoma, Dodoma, Tanzania0Department of Population, Family and Reproductive Health, University of Ghana School of Public Health, Accra, Ghana1Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany2Africa Health Research Institute, KwaZulu-Natal, South AfricaDepartment of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, United States3Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States4Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United StatesBackgroundEvidence from sub-Saharan Africa (SSA) regarding risky behaviors among adolescents remains scarce, despite the large population (approximately 249 million out of 1.2 billion globally in 2019) of adolescents in the region. We aimed to examine the potential influence of depressive symptoms and school-going status on risky behaviors among adolescents in six SSA countries.MethodsWe used individual cross-sectional data from adolescents aged 10–19 based in eight communities across six SSA countries, participating in the ARISE Network Adolescent Health Study (N = 7,661). Outcomes of interest were cigarette or tobacco use, alcohol use, other substance use, getting into a physical fight, no condom use during last sexual intercourse, and suicidal behavior. We examined the proportion of adolescents reporting these behaviors, and examined potential effects of depressive symptoms [tertiles of 6-item Kutcher Adolescent Depression Scale (KADS-6) score] and school-going status on these behaviors using mixed-effects Poisson regression models. We also assessed effect modification of associations by sex, age, and school-going status.ResultsThe proportion of adolescents reporting risky behaviors was varied, from 2.2% for suicidal behaviors to 26.2% for getting into a physical fight. Being in the higher tertiles of KADS-6 score was associated with increased risk of almost all risky behaviors [adjusted risk ratio (RR) for highest KADS-6 tertile for alcohol use: 1.70, 95% confidence interval (95% CI): 1.48–1.95, p < 0.001; for physical fight: 1.52, 95% CI: 1.36–1.70, p < 0.001; for suicidal behavior: 7.07, 95% CI: 2.69–18.57, p < 0.001]. Being in school was associated with reduced risk of substance use (RR for alcohol use: 0.73, 95% CI: 0.53–1.00, p = 0.047), and not using a condom (RR: 0.81, 95% CI: 0.66–0.99, p = 0.040). There was evidence of modification of the effect of school-going status on risky behaviors by age and sex.ConclusionOur findings reinforce the need for a greater focus on risky behaviors among adolescents in SSA. Addressing depressive symptoms among adolescents, facilitating school attendance and using schools as platforms to improve health may help reduce risky behaviors in this population. Further research is also required to better assess the potential bidirectionality of associations.https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1171231/fullsub-Saharan Africaadolescentsrisky behaviordepressive symptomsschools |
| spellingShingle | Uttara Partap Nega Assefa Yemane Berhane Ali Sie David Guwatudde Japhet Killewo Ayoade Oduola Mary M. Sando Said Vuai Richard Adanu Till Bärnighausen Till Bärnighausen Wafaie W. Fawzi Wafaie W. Fawzi Wafaie W. Fawzi The influence of depressive symptoms and school-going status on risky behaviors: a pooled analysis among adolescents in six sub-Saharan African countries Frontiers in Psychiatry sub-Saharan Africa adolescents risky behavior depressive symptoms schools |
| title | The influence of depressive symptoms and school-going status on risky behaviors: a pooled analysis among adolescents in six sub-Saharan African countries |
| title_full | The influence of depressive symptoms and school-going status on risky behaviors: a pooled analysis among adolescents in six sub-Saharan African countries |
| title_fullStr | The influence of depressive symptoms and school-going status on risky behaviors: a pooled analysis among adolescents in six sub-Saharan African countries |
| title_full_unstemmed | The influence of depressive symptoms and school-going status on risky behaviors: a pooled analysis among adolescents in six sub-Saharan African countries |
| title_short | The influence of depressive symptoms and school-going status on risky behaviors: a pooled analysis among adolescents in six sub-Saharan African countries |
| title_sort | influence of depressive symptoms and school going status on risky behaviors a pooled analysis among adolescents in six sub saharan african countries |
| topic | sub-Saharan Africa adolescents risky behavior depressive symptoms schools |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1171231/full |
| work_keys_str_mv | AT uttarapartap theinfluenceofdepressivesymptomsandschoolgoingstatusonriskybehaviorsapooledanalysisamongadolescentsinsixsubsaharanafricancountries AT negaassefa theinfluenceofdepressivesymptomsandschoolgoingstatusonriskybehaviorsapooledanalysisamongadolescentsinsixsubsaharanafricancountries AT yemaneberhane theinfluenceofdepressivesymptomsandschoolgoingstatusonriskybehaviorsapooledanalysisamongadolescentsinsixsubsaharanafricancountries AT alisie theinfluenceofdepressivesymptomsandschoolgoingstatusonriskybehaviorsapooledanalysisamongadolescentsinsixsubsaharanafricancountries AT davidguwatudde theinfluenceofdepressivesymptomsandschoolgoingstatusonriskybehaviorsapooledanalysisamongadolescentsinsixsubsaharanafricancountries AT japhetkillewo theinfluenceofdepressivesymptomsandschoolgoingstatusonriskybehaviorsapooledanalysisamongadolescentsinsixsubsaharanafricancountries AT ayoadeoduola theinfluenceofdepressivesymptomsandschoolgoingstatusonriskybehaviorsapooledanalysisamongadolescentsinsixsubsaharanafricancountries AT marymsando theinfluenceofdepressivesymptomsandschoolgoingstatusonriskybehaviorsapooledanalysisamongadolescentsinsixsubsaharanafricancountries AT saidvuai theinfluenceofdepressivesymptomsandschoolgoingstatusonriskybehaviorsapooledanalysisamongadolescentsinsixsubsaharanafricancountries AT richardadanu theinfluenceofdepressivesymptomsandschoolgoingstatusonriskybehaviorsapooledanalysisamongadolescentsinsixsubsaharanafricancountries AT tillbarnighausen theinfluenceofdepressivesymptomsandschoolgoingstatusonriskybehaviorsapooledanalysisamongadolescentsinsixsubsaharanafricancountries AT tillbarnighausen theinfluenceofdepressivesymptomsandschoolgoingstatusonriskybehaviorsapooledanalysisamongadolescentsinsixsubsaharanafricancountries AT wafaiewfawzi theinfluenceofdepressivesymptomsandschoolgoingstatusonriskybehaviorsapooledanalysisamongadolescentsinsixsubsaharanafricancountries AT wafaiewfawzi theinfluenceofdepressivesymptomsandschoolgoingstatusonriskybehaviorsapooledanalysisamongadolescentsinsixsubsaharanafricancountries AT wafaiewfawzi theinfluenceofdepressivesymptomsandschoolgoingstatusonriskybehaviorsapooledanalysisamongadolescentsinsixsubsaharanafricancountries AT uttarapartap influenceofdepressivesymptomsandschoolgoingstatusonriskybehaviorsapooledanalysisamongadolescentsinsixsubsaharanafricancountries AT negaassefa influenceofdepressivesymptomsandschoolgoingstatusonriskybehaviorsapooledanalysisamongadolescentsinsixsubsaharanafricancountries AT yemaneberhane influenceofdepressivesymptomsandschoolgoingstatusonriskybehaviorsapooledanalysisamongadolescentsinsixsubsaharanafricancountries AT alisie influenceofdepressivesymptomsandschoolgoingstatusonriskybehaviorsapooledanalysisamongadolescentsinsixsubsaharanafricancountries AT davidguwatudde influenceofdepressivesymptomsandschoolgoingstatusonriskybehaviorsapooledanalysisamongadolescentsinsixsubsaharanafricancountries AT japhetkillewo influenceofdepressivesymptomsandschoolgoingstatusonriskybehaviorsapooledanalysisamongadolescentsinsixsubsaharanafricancountries AT ayoadeoduola influenceofdepressivesymptomsandschoolgoingstatusonriskybehaviorsapooledanalysisamongadolescentsinsixsubsaharanafricancountries AT marymsando influenceofdepressivesymptomsandschoolgoingstatusonriskybehaviorsapooledanalysisamongadolescentsinsixsubsaharanafricancountries AT saidvuai influenceofdepressivesymptomsandschoolgoingstatusonriskybehaviorsapooledanalysisamongadolescentsinsixsubsaharanafricancountries AT richardadanu influenceofdepressivesymptomsandschoolgoingstatusonriskybehaviorsapooledanalysisamongadolescentsinsixsubsaharanafricancountries AT tillbarnighausen influenceofdepressivesymptomsandschoolgoingstatusonriskybehaviorsapooledanalysisamongadolescentsinsixsubsaharanafricancountries AT tillbarnighausen influenceofdepressivesymptomsandschoolgoingstatusonriskybehaviorsapooledanalysisamongadolescentsinsixsubsaharanafricancountries AT wafaiewfawzi influenceofdepressivesymptomsandschoolgoingstatusonriskybehaviorsapooledanalysisamongadolescentsinsixsubsaharanafricancountries AT wafaiewfawzi influenceofdepressivesymptomsandschoolgoingstatusonriskybehaviorsapooledanalysisamongadolescentsinsixsubsaharanafricancountries AT wafaiewfawzi influenceofdepressivesymptomsandschoolgoingstatusonriskybehaviorsapooledanalysisamongadolescentsinsixsubsaharanafricancountries |