Global,regional and national burdens of bipolar disorders in adolescents and young adults:a trend analysis from 1990 to 2019

Background Bipolar disorder is identified as a cause of severe damage to the physical,psychological and social functioning of adolescents and young adults.Aims The aim of this study is to ascertain the trends in the burden of bipolar disorder among individuals aged 10-24 years at global,regional and national levels from 1990 to 2019.Methods The data analysed in this study were from the Global Burden of Diseases 2019.The numbers,rates per 100000 population,average annual percentage changes(AAPCs)of incidence,prevalence and years lived with disability(YLDs)of bipolar disorder are reported at the global,regional and national levels among individuals aged 10-24 years.Global trends by age,sex and Social Development Index(SDI)were further analysed.Results Globally,the incidence of bipolar disorder among adolescents and young adults increased from 79.21 per 100000 population(95%uncertainty interval(Ul):58.13 to 105.15)in 1990 to 84.97 per 100000 population(95%Ul:61.73 to 113.46)in 2019,AAPC 0.24(95%confidence interval(Cl):0.22 to 0.26).In the past three decades,there has been an increase in incidence,prevalence and YLDs in both males and females.The largest increase in incidence between 1990 and 2019 was observed in those aged 20-24 years old from 51.76 per 100000 population(95%Ul:26.81 to 87.20)in 1990 to 58.37 per 100000 population(95%UI:30.39 to 98.55)in 2019;AAPC 0.42(95%Cl:0.38 to 0.47).By the SDI quintile,the largest increase in incidence was observed in the middle SDl;however,the high SDI countries had the highest incidence.Regionally,the largest increase in incidence was observed in southern Latin America.At the national level,the most pronounced increase in the incidence was in Greenland.Conclusions The global increase in incidence among adolescents and young adults between 1990 and 2019 indicates that strategies to improve their mental health still need to be emphasised.

Shifting the Paradigm:A Fresh Look at Physical Activity Frequency and Its Impact on Mental Health,Life Satisfaction,and Self-Rated Health in Adolescents

As adolescent mental health problems are becoming a more serious issue globally,this paper explores the relationship of physical activity in adolescents and its frequency on mental health as well as examines the mediating effects of life satisfaction and self-rated health in order to provide a reference for the promotion of mental health in adolescents.A sample of 3578 Chinese high school students completed questionnaires assessing their mental health,physical activity frequency,life satisfaction,and self-rated health.The mean SCL-90 value for adolescents was found to be 1.629%,and 24.73%of adolescents had varying degrees of mental health issue.Increased physical activity frequency is positively associated with improved mental health(p<0.001).Additionally,life satisfaction and self-rated health were found to play significant mediating roles in the relationship between physical activity frequency and mental health.Specifically,low-frequency physical activity had the most pronounced mediating effect on mental health through life satisfaction,while high-frequency physical activity exerted the most significant mediating effect on mental health through self-rated health.These findings underscore the importance of promoting physical activity among adolescents and highlight the distinct pathways through which physical activity frequency can influence mental health outcomes.Further research is needed to explore these relationships in diverse populations and settings,as well as to develop targeted intervention.

Parental Educational Expectations,Academic Pressure,and Adolescent Mental Health:An Empirical Study Based on CEPS Survey Data

Background:This study aimed to investigate the relationship between parental educational expectations and adolescent mental health problems,with academic pressure as a moderating variable.Methods:This study was based on the baseline data of the China Education Panel Survey,which was collected within one school year during 2013–2014.It included 19,958 samples from seventh and ninth graders,who ranged from 11 to 18 years old.After removing missing values and conducting relevant data processing,the effective sample size for analysis was 16344.The OLS(Ordinary Least Squares)multiple linear regression analysis was used to examine the relationship between parental educational expectations,academic pressure,and adolescents’mental health problems.In addition,we established an interaction term between parents’educational expectations and academic pressure to investigate the moderating effect of academic stress.Results:The study found that adolescents whose parents had high educational expectations reported less mental health problems.(β=−0.195;p<0.001).Additionally,adolescents who had high academic pressure reported more mental health problems.(β=0.649;p<0.001).Furthermore,the study found that academic pressure had a significant moderating effect on the relationship between parental educational expectations and adolescents’mental health problems(β=0.082;p<0.001).Conclusion:Parental educational expectations had a close relationship with adolescents’mental health problems,and academic pressure moderated this relationship.For those adolescents with high levels of academic pressure,the association between high parental educational expectations and mental health problems became stronger.On the contrary,for those adolescents with low levels of academic pressure,the association between high parental educational expectations and mental health problems became weaker.These findings shed new light on how parental educational expectations affected adolescent mental health problems and had significant implications for their healthy development.

Adolescent suicide risk factors and the integration of socialemotional skills in school-based prevention programs

Adolescents are considered one of the most vulnerable groups affected by suicide.Rapid changes in adolescents’physical and mental states,as well as in their lives,significantly and undeniably increase the risk of suicide.Psychological,social,family,individual,and environmental factors are important risk factors for suicidal behavior among teenagers and may contribute to suicide risk through various direct,indirect,or combined pathways.Social-emotional learning is considered a powerful intervention measure for addressing the crisis of adolescent suicide.When deliberately cultivated,fostered,and enhanced,selfawareness,self-management,social awareness,interpersonal skills,and responsible decision-making,as the five core competencies of social-emotional learning,can be used to effectively target various risk factors for adolescent suicide and provide necessary mental and interpersonal support.Among numerous suicide intervention methods,school-based interventions based on social-emotional competence have shown great potential in preventing and addressing suicide risk factors in adolescents.The characteristics of school-based interventions based on social-emotional competence,including their appropriateness,necessity,cost-effectiveness,comprehensiveness,and effectiveness,make these interventions an important means of addressing the crisis of adolescent suicide.To further determine the potential of school-based interventions based on social-emotional competence and better address the issue of adolescent suicide,additional financial support should be provided,the combination of socialemotional learning and other suicide prevention programs within schools should be fully leveraged,and cooperation between schools and families,society,and other environments should be maximized.These efforts should be considered future research directions.

Nutrition Awareness and Knowledge and Body Mass Index in Adolescents in Public Junior Secondary Schools

Background: Non-communicable diseases are increasing among adolescents. The decision about diet is the foundation of eating habits that could persist to adulthood. Dietary decisions, which usually are hard to change later in life, make nutrition education at school paramount to prevent obesity and NCDs, and promote healthy eating. Objectives: To assess level of nutrition awareness and knowledge of healthy eating and food intake behaviors and association with Body Mass Index (BMI) and age. Methods: A cross sectional study that included measures such as age, gender, socioeconomic status, BMI, and nutrition knowledge was conducted in 264 respondents from 18th June 2015 to 9th July 2015. The nutrition knowledge questionnaire was composed of 24 questions divided into food nutrients, food contents, healthiest foods, and energy expenditure and nutrition benefits. CDC BMI chart for 2-20-year-olds was used to plot respondent’s weight and height. Results: The mean age of the respondents was 14.3 years (SD 0.79). Most of the respondents (153/252, 53.6%) had a low socio-economic status as categorized by the present study. The mean (SD) BMI was 20.08 (3.90). Most respondents (56.3%, 142/252) failed the knowledge test and scored below 50% and only two respondents (0.8%) had excellent nutrition knowledge. The mean percentage achieved was 46.1% (SD 15.91) ranging from 8.3% to 87.5%. There was a significant correlation between nutrition knowledge and BMI (p = 0.001). Conclusion: The study shows that adolescents do not have adequate nutrition knowledge, placing them at risk for developing non-communicable diseases later in life. Nutrition education programs are urgently needed for teachers, parents, and children.

The COVID-19 Pandemic: Present or Gone, Where Do Adolescents Stand?

Introduction: The initial global response to the SARS-CoV-2 pandemic focused on adults as adolescents mainly had subclinical infections. Adolescents, however, could transmit the virus and hence be a risk to the elderly, young children and immunocompromised. Adolescents are also at risk of long-term complications. This study sought to determine the prevalence of antibodies to SARS-CoV-2 among adolescents in Southern Nigeria, and to determine the association between SARS-CoV-2 seropositivity and age, gender, socioeconomic class, school type and nutritional status. Methods: This descriptive cross-sectional study was carried out in Edo state of southern Nigeria. We recruited 270 in-school adolescents aged 10 - 19 years. A WHO-adapted, pre-tested questionnaire was used to obtain data on participant history and risk factors. The questionnaire was interviewer-administered. Adolescents whose parents gave consent were recruited through a multi-stage randomized sampling method. Capillary blood for the assay was collected and analysed using a lateral-flow immunoassay device. The primary outcome was serostatus of the study. The positive predictors of serostatus were finally determined using a multiple logistics regression model. Statistical significance was set at p Results: The seroprevalence of SARS-CoV-2 was 45.9%. IgM antibodies were found in 5.6% of participants. Older adolescents had higher seropositivity rates than younger adolescents (2 = 8.101, p = 0.017). There was no association between gender and seropositivity. Adolescents in public schools were more likely to be seropositive than those in private schools (2 = 25.242, p = 0.001). A higher seroprevalence was noticed among study participants in the lower socioeconomic class (x2 = 6.928, p = 0.031), and those in overcrowded classes. (2 = 79.303, p = 0.001). Conclusion: This study showed a high seroprevalence of SARS-CoV-2 among in-school adolescents. Behavioural change communication on SARS-CoV-2, vaccination of adolescents, and standardization of classrooms are recommended.

Network analysis of suicide ideation and depression-anxiety symptoms among Chinese adolescents

Background The co-occurrence of depression and anxiety among adolescents is typically associated with suicide ideation.Aims The study aimed to investigate the symptom-level relationship between suicide ideation and the comorbidity of depression and anxiety.Methods 1501 adolescents aged 12-19 years were assessed using the Patient Health Questionnaire(PHQ-9)and the Generalized Anxiety Disorder Scale,and 716 adolescents who scored≥5 on both scales were selected as participants.Network analysis was used to identify the network structure of depressive symptoms and anxiety symptoms.Participants were categorised into either the suicide ideation or non-suicide ideation groups based on their scoring on the suicide-related item in PHQ-9.A comparison was made between the depression-anxiety symptom networks of the two groups.Results‘Restlessness’,‘sad mood’and‘trouble relaxing’were the most prominent central symptoms in the depression-anxiety symptom network,and‘restlessness’,‘nervousness’and‘reduced movement’were the bridge symptoms in this network.‘Sad mood’was found to be directly related to‘suicide ideation’with the highest variance.The network structure was significantly different in properties between the suicide ideation group and the non-suicide ideation group,with‘restlessness’and‘sad mood’exhibiting significantly higher influence in the network of the suicide ideation group than that in the non-suicide ideation group.Conclusion Restlessness and sad mood could be targeted for the intervention of depression-anxiety symptoms among adolescents with suicide ideation.

Thirty-year trends of anxiety disorders among adolescents based on the 2019 Global Burden of Disease Study

Background Anxiety disorders are the most common psychiatric problems,affecting approximately 1 in 12 children and 1 in 4 adolescents.Understanding the incidence,burden and correlated risks of anxiety disorders among children and adolescents can help identify areas of success,stagnation and emerging threats,thereby facilitating effective improvement strategies.Aims To estimate the incidence and burden trends of anxiety disorders in children and adolescents from 1990 to 2019 in 204 countries and compare the incidence and disease burden in different countries.To examine the association between anxiety disorders and social indicators(healthcare access and quality of life).Methods Data were obtained from the Global Burden of Disease Study 2019.The age-standardised incidence rates(ASIRs)and disability-adjusted life years(DALYs)were reported to assess the burden of anxiety disorders,and the estimated annual percentage change was calculated to quantify the temporal trends.Pearson’s correlation was used to investigate country-level risk factors for incidence and DALYs.Results Globally,there were 932 million incident cases of anxiety disorders in children and adolescents,739.29 per 100000 ASIRs and 380.62 million DALYs in 2019.From 1990 to 2019,the estimated annual percentage change of incidence of anxiety disorders decreased by 2.2%.Significant variations were observed in the age-standardised burden rate and the changing trend of anxiety disorders among countries.Portugal reported the highest ASIR of anxiety disorders,while Mexico had the largest increase rate of ASIR.In 2019,Portugal reported the highest number of DALYs(1001.71 million),and India(212.09 million)reported the lowest number of DALYs.The burden of anxiety disorders was positively correlated with the average number of psychiatrists,psychologists and nurses in the mental health sector(per 100000),and quality of life and the correlation coefficients were 0.58,0.67,0.43 and 0.53,respectively.Conclusions The incidence and global burden of anxiety disorders in adolescents have continued to decrease over the past 30 years.However,the incidence and disease burden in developed countries are still increasing steadily.Policymakers should design and implement mental health strategies for adolescents based on their specific developmental status,as well as the cultural and regional characteristics of each country.

Mediating effect of resilience on the relationship between rumination and suicide attempts in Chinese adolescents with mood disorders

To the editor:Mood disorders(MD)are serious mental illnesses that commonly affect adolescents,leading to a high incidence of suicidal behaviour.1 In China,the suicide attempt(SA)rate for adolescents with MD is 51.96%,2 and over 500000 adolescent SA are reported annually in the USA due to depression.3 Risk factors for SA include gender,hormone levels,family conflict and,particularly,negative cognitive styles such as rumination.

Audits of Death in HIV-Infected Children and Adolescents Followed up in the Pediatric Department of the Regional Teaching Hospital of Borgou/Alibori from 2005 to 2020

Introduction: Human immunodeficiency virus (HIV) is a major public health problem with high morbidity and mortality among children. The objective of this work was to audit the deaths of children and adolescents with HIV infection followed up in the pediatric department of the Regional Teaching Hospital of Borgou/Alibori (CHUDB/A) the from 2005 to 2020. Patients and Method: This was a retrospective and descriptive study conducted in the pediatric department of CHUD/B-A in Parakou. All children with HIV infection who died from January 1, 2005 to August 31, 2020 were included. Data collection was carried out in three stages: a phase of medical records processing, a phase of community survey and a phase of death audits. The variables studied were sociodemographic, clinical, biological, therapeutic and evolutionary. Results: Over the study period, the data of 464 infected children were recorded, including 92 deaths, representing a case fatality rate of 19.83%. Severe acute malnutrition (69.23%), gastro-intestinal tract infections (43.58%) and serious opportunistic pulmonary infections (24.36% pulmonary tuberculosis and 19.23% pneumocystis) were the main causes of death. The main dysfunctions found were: the delayed diagnosis of HIV infection (79.35%), the absence or delay in consultation when the child’s clinical condition deteriorates (32.61% and 47.83%), delayed initiation of antiretroviral treatment (42.39%) and non-adherence to treatment (38.04%). Non-adherence to treatment was predominant in adolescents (90.49%). Conclusion: Specific interventions for early detection, adequate nutritional care, psychosocial support for adolescents and mothers of children are necessary to reduce mortality due to HIV among children and adolescents.

Prevalence and risk factors associated with long COVID symptoms in children and adolescents in a southern province of Vietnam

Objective:To investigate the prevalence and risk factors associated with long COVID symptoms among children and adolescents who have recovered from COVID-19.Methods:This study applied a cross-sectional approach within community settings in a southern province of Vietnam.A structured questionnaire featuring socio-demographic information and common long COVID symptoms was employed.Phi correlation coefficients assessed associations among pairs of long COVID symptoms.Additionally,multivariable logistic regression models were performed to investigate the risk factors of long COVID in recovered COVID-19 children and adolescents.Results:Among 422 participants,39.3%reported long COVID symptoms,with a prevalence of 45.2%(SD=0.5)in children and 22.2%(SD=0.4)in adolescents.Common symptoms reported were cough 34.6%(SD=0.5),fatigue 20.6%(SD=0.4),shortness of breath 10.9%(SD=0.3),and lack of appetite 6.6%(SD=0.3).Concerning risk factors of long COVID,a higher risk was observed among demographic groups,including girls(OR 1.25,95%CI 1.15-1.37;P<0.001,reference:boys),children compared to adolescents(OR 1.24,95%CI 1.12-1.37;P<0.001),overweight individuals(OR 1.14,95%CI 1.02-1.27;P=0.018,reference:healthy weight),and participants without any COVID-19 vaccination(OR 1.36,95%CI 1.20-1.54;P<0.001),or have received only one single dose(OR 1.35,95%CI 1.10-1.64;P=0.004)compared to those who have received two doses.Besides,patients with a COVID-19 treatment duration exceeding two weeks also had a higher risk of long COVID(OR 1.32,95%CI 1.09-1.60;P=0.003)than those who recovered less than seven days.Conclusions:The insights from this study provide crucial guidance for predicting the factors associated with the occurrence of long COVID in pediatric patients,contributing to strategic interventions aimed at mitigating the long COVID risks among children and adolescents in Vietnam.

Acceptance and Experience of HIV-Infected Adolescents in Two Hospitals in Yaoundé

Introduction: Access to antiretroviral drugs has improved the survival of children infected with the Human Immunodeficiency Virus (HIV). As they reach adolescence, they are confronted with various constraints related to the infection and its treatment, in addition to those of the growth period they are going through. The main aim of the study was to assess the acceptance and describe the experience of HIV infection by infected adolescents but also to investigate the factors associated with good acceptance and a positive experience. Methodology: The cross-sectional analytic study concerned HIV-infected adolescents aged 15 to 19 followed up at the Chantal Biya Foundation-Mother and Child Centre (CME-FCB) and the Yaoundé University Hospital Centre (CHUY) between February 2020 and June 2020. The study saw participants complete a questionnaire containing socio-demographic data and assessing acceptance and experience with the infection. Data analysis was accomplished using Epi info software version 7.2.2.6. Results: One hundred and thirteen HIV-infected adolescents were included in the study. The sex ratio was 0.68 and the mean age was 17 years. More than half of the adolescents had a good acceptance and positive experience with the infection. Related factors were the adolescent’s perception of good health and participation in an association with other infected adolescents. Conclusion: Emphasizing the psychological and educational follow-up of infected adolescents and encouraging their participation in associations for adolescents living with HIV could reduce the consequences of poor acceptance and ensure a better transition to adulthood. .

Determinants of Sexual Activity among HIV-Infected Adolescents in Cameroon

Introduction: Adolescence is a period of transition to adulthood, including for HIV-infected adolescents (HIA), when sexual problems emerge. Few studies have been carried out on the sexuality of HIA. This study aimed to assess the sexual behavior of HIV-infected adolescents in Cameroon. Methodology: A cross-sectional study was conducted in three hospitals in the cities of Yaoundé and Douala, from November 2019 to June 2020. All HIA aged 13 to 19 years followed in the study who knew their HIV status were included in the study after obtaining their assent and their parent’s consent. Socio-demographic and clinical characteristics were collected, as well as sexual practices and the determinants of their sexual activity. A multivariate analysis was performed to explore the relationship between the different variables studied and the sexual activity of these adolescents. Results: Of 204 HIA enrolled in the study, 64 (31.7%) were sexually active, the mean age at first sexual intercourse was 15.6 ± 2.8 years and the sex ratio was 0.94. Of the adolescents in the study, 75.7% of girls and 61.2% of boys had regular sexual activity, while 21.3% of girls and 35.4% of boys had multiple sexual relationships in the six months preceding the study. Nearly 16 (25.0%) of the sexually active HIA had more than 2 sexual encounters per month, 6 (9.3%) of these encounters had been paid for and 9 (27.2%) of the girls had already had at least one pregnancy. More than 7 out of 10 HIA (79.6%) had used a condom the last time they had sex. Age less than 18 years [OR = 11.1 (95% CI: 3.1 - 39.4), p = 0.001], lack of remuneration [OR = 9.8 (95% CI: 2.0 - 47.4), p = 0.001] and self-care were significantly associated with sexual activity in HIA, while school attendance was a protective factor. Self-funded HIAs were 21 times more likely to be sexually active [OR = 21.6 (95% CI: 2.3 - 179), p = 0.004]. Conclusion: More than a third of HIV-infected adolescents were sexually active and risky sexual practices were not negligible.

Actors of Psychoactive Drug Initiation among Adolescents in Yaoundé-Cameroon

Introduction: Actors of psychoactive drug initiation refer to those who introduce others to psychoactive drug use (initiators) and those who are introduced to psychoactive drugs (users). By identifying their features, better prevention and intervention programs can be developed to reduce psychoactive drug use among adolescents. This article describes the role of actors of psychoactive drug initiation among teenagers in secondary schools in Yaoundé (Cameroon). Methodology: A cross sectional study was carried out in twelve secondary schools in Yaoundé from October 2022 to May 2023. Adolescents from Form four to upper sixth, who assented to participate in the study and received parental consent were included. Data were collected in a structured self-reported questionnaire and analyzed using SPSS 23. Quantitative variables were expressed using means, standard deviations, median and interquartile ranges depending on the distribution of data. Qualitative variables were expressed in the form of frequency and percentages. Results: Drug use was more prevalent among male adolescents (55.3%) from nuclear families (91.4%) who received relatively high pocket money. The main sources of drug exposure were non-family members (49.7%), especially friends outside school. The most frequent place of initiation was snack bars (33.1%). Conclusion: The study revealed the importance of the family, friends and leisure places in the initiation process of drug use in teenagers. Based on these results, parents and school authorities should work together to create a safe and supportive environment that fosters communication, education to prevent drug abuse among adolescents in Yaoundé.

The Obstetric and Perinatal Outcomes of Adolescent Pregnancies in a Developed Cosmopolitan Middle Eastern Country: A Retrospective Pearl-Peristat Registry

Background: Early marriage is prevalent in Middle Eastern culture. The objective of this study was to investigate the pregnancy outcomes of married pregnant adolescents in a prosperous and highly developed Middle Eastern society, when they receive sufficient prenatal care and social assistance. Methods: A retrospective analysis was performed on the Peristat-based Maternal-Newborn registry utilizing hospital data acquired from four main governmental hospitals in Qatar. The study analyzed the pregnancy outcomes of young adults [ages 20 - 24) who experienced their first pregnancy and compared them to the pregnancy outcomes of adolescents aged 15 to 19 years old. Results: The study comprised a cohort of 3152 pregnant married women. This cohort included 2674 women between the ages of 20 and 24, as well as 478 adolescents aged 15 to 19 years old. In comparison to the young adult group, the non-Qatari population in the adolescent group was significantly higher (78.6% (376/478) vs. 71.5% (1914/2674), p-value = 0.003). Other Arab nationalities accounted for more than half of the adolescent population. All the mothers were married, did not use alcohol, and were nonsmokers. There were no documented mothers under the age of 15. Attending antenatal clinics was significantly higher in the adolescent group (p < 0.001). There was no significant difference in the mean gestational age at birth between adolescents and young adults (38.5 ± 2.3 weeks vs. 38.7 ± 2.1 weeks, p = 0.06). Furthermore, adolescent mothers had a higher rate of low birth weight (13.6% vs. 10.4%, p < 0.001) than young mothers. There was a non-statistically significant rise in pre-eclampsia incidence. Other unfavorable pregnancy outcomes were less common among them, such as diabetes, operative vaginal delivery, caesarean section, stillbirth, NICU hospitalization, and an Apgar score of less than 7 at five minutes. There were no maternal deaths;however, there was a comparable rate of neonatal in-hospital mortality. Conclusion: Pregnancy during adolescence may not relate to significant problems in a well-tolerant culture that ensures dedicated antenatal and social support.

Interaction between adolescent sleep rhythms and gender in an obese population

BACKGROUND The obesity rate of adolescents is gradually increasing,which seriously affects their mental health,and sleep plays an important role in adolescent obesity.AIM To investigate the relationship between sleep rhythm and obesity among adolescents and further explores the interactive effect of sleep rhythm and gender on adolescent obesity,providing a theoretical basis for developing interventions for adolescent obesity.METHODS Research data source Tianjin Mental Health Promotion Program for Students.From April to June 2022,this study selected 14201 students from 13 middle schools in a certain district of Tianjin as the research subject using the convenient cluster sampling method.Among these students,13374 accepted and completed the survey,with an effective rate of 94.2%.The demographic data and basic information of adolescents,such as height and weight,were collected through a general situation questionnaire.The sleep rhythm of adolescents was evaluated using the reduced version of the morningness-eveningness questionnaire.RESULTS A total of 13374 participants(6629 females,accounting for 49.56%;the average age is 15.21±1.433 years)were analyzed.Among them,the survey showed that 2942 adolescent were obesity,accounting for 22%and 2104 adolescent were overweight,accounting for 15.7%.Among them,1692 male adolescents are obese,with an obesity rate of 25.1%,higher than 18.9%of female adolescents.There is a statistically significant difference between the three groups(χ2=231.522,P<0.000).The obesity group has the smallest age(14.94±1.442 years),and there is a statistical difference in age among the three groups(F=69.996,P<0.000).Obesity rates are higher among individuals who are not-only-child,have residential experience within six months,have family economic poverty,and have evening-type sleep(P<0.05).Logistic regression analysis shows a correlation between sleep rhythm and adolescent obesity.Evening-type sleep rhythm can increase the risk of obesity in male adolescents[1.250(1.067-1.468)],but the effect on female obesity is not remarkable.Further logistic regression analysis in the overall population demonstrates that the interaction between evening-type sleep rhythm and the male gender poses a risk of adolescent obesity[1.122(1.043-1.208)].CONCLUSION Among adolescents,the incidence of obesity in males is higher than in females.Evening-type sleep rhythm plays an important role in male obesity but has no significant effect on female obesity.Progressive analysis suggests an interactive effect of sleep rhythm and gender on adolescent obesity,and the combination of evening-type sleep and the male gender promotes the development of adolescent obesity.In formulating precautions against adolescent obesity,obesity in male adolescents with evening-type sleep should be a critical concern.

Associated Factors with Early Sexual Intercourse among In-School Adolescents in Brazzaville

Background: Early sexual intercourse (ESI) is a global public health problem. In Congo, associated factors with ESI have been under-studied. Objective: To analyse factors associated with early sexual intercourse among in-school adolescents in Brazzaville. Method: A cross-sectional analytic study with three-stage random sampling was carried out from March 2 to June 2, 2022 in Brazzaville secondary and high schools. Adolescents in the selected schools were interviewed about their sexual and social behaviour, and their family and school environment. Multivariate analysis using logistic regression was used to identify factors associated with ESI. The significance level of the p-value was set at 5% and the confidence interval at 95%. Results: Of a total of 1100 adolescents surveyed, 800 (72.7%) had ESI, 98% of them were female. The main reason for early initiation of sexual intercourse was curiosity (81.8%). Non-use of condoms and multiple sexual partnerships were noted respectively in 98.7% and 68.7% of adolescents who had experienced ESI. Female gender (p Conclusion: The prevalence of ESI is high, and the factors identified in this study may help to reduce it.

Sexual and Reproductive Health Knowledge and Behaviour among Adolescents in Rural Burkina Faso

Background: Adolescents in developing countries have limited knowledge about the prevention of STIs and unwanted pregnancies. In several African countries, risky sexual behaviour persists, including early sexual debut, multiple sexual partners, economic and sexual exchange, and low condom and contraceptive use. The purpose of this study is to assess the sexual and reproductive health knowledge and behaviour of adolescents in rural Burkina Faso in order to improve their sexual and reproductive health. Method: This was a descriptive cross-sectional study with prospective data collection conducted from 07 March to 04 April 2022 in the area of the Demographic and Health Surveillance System of the Nouna Research Centre. A questionnaire was administered to a randomly selected sample of 1202 adolescents. Results: The mean age of the adolescents was 14.1 years and 56.6% were male. Only 58.2% of the adolescents had ever heard of HIV/AIDS. Of these, 95.7% did not know their HIV status. In addition, 15.8% had ever had sexual intercourse and 2.4% had been sexually active at an early age. Almost 45% had not used any contraceptive method the last time they had sex. Condoms were the most frequently used contraceptive method (47.4%). Among teenagers, 27.6% had been pregnant at least once, 7.3% were married and the average age at marriage was 18.45 years. Almost 7% (6.9%) of teenagers had more than one sexual partner. Conclusion: Adolescents have limited knowledge about reproductive health. Risky sexual behaviour persists. Awareness campaigns need to be intensified to improve their sexual and reproductive health.

A Cross-Sectional Study on the Impact of Operation Triple Zero (OTZ) Program on Viral Load Suppression amongst Members of the Adolescent Club in 68 Nigerian Army Reference Hospital Yaba Lagos, Nigeria

Background: In Nigeria, adolescents and young people (AYP) aged 10 - 24, comprise 22.3% of the population and with HIV prevalence of 3.5%. The AYP living with HIV enrolled at the 68 NARHY, Lagos reflects the national challenges with poor viral suppression. The OTZ program aligns with the UNAIDS 95-95-95 goals. It seeks to empower AYPLHIV to be in charge of their treatment and commit to triple zero outcomeszero missed appointments, zero missed drugs, and zero viral loads. The purpose of the study was to assess the impact of the OTZ program on viral load suppression among members of the adolescent club in 68 NARHY, Lagos. Method: A cross-sectional retrospective study to evaluate the impact of the OTZ program on the viral load of 53 AYP enrolled in the OTZ program between March 2019 to December 2019 was analyzed. The Percentage of viral load suppression before enrollment compared with 6 and 12 months after enrollment into the OTZ program. The AYP is grouped into 10 - 14, 15 - 19, and 20 - 24 years. Activities conducted were peer driven monthly meetings with the AYP during which the adolescents interacted on issues relating to improving their treatment outcomes, healthcare workers reviewed their clinical status, viral load result, provider peer counseling, and caregivers engagement to support adherence to medication and ARV refills. Results: Before OTZ, 81% aged 10 - 14 years, 75% aged 15 - 19 years, and 25% aged 20 - 24 years were virally suppressed (VL less than 1000 copies/ml). Six months after enrollment, 94% were virally suppressed95% aged 10 - 14 years, 96% aged 15 - 19 years, and 66% aged 20-24 years. Twelve months after enrollment, 96% of AYP were virally suppressed100% aged 10-14 years, 93% aged 15 - 19 years, and 100% aged 20 - 24 years. Males viral load (VL) suppression improved from 79% to 96% and 92%, while females VL suppression improved from 69% to 93% and 100% at 6 and 12 months respectively. Conclusion: The OTZ activities contributed to improved viral load suppression in the AYP of the facility.

The effects of exercise interventions on brain-derived neurotrophic factor levels in children and adolescents:a meta-analysis

Brain-derived neurotrophic factor is a crucial neurotrophic factor that plays a significant role in brain health. Although the vast majority of meta-analyses have confirmed that exercise interventions can increase brain-derived neurotrophic factor levels in children and adolescents, the effects of specific types of exercise on brain-derived neurotrophic factor levels are still controversial. To address this issue, we used meta-analytic methods to quantitatively evaluate, analyze, and integrate relevant studies. Our goals were to formulate general conclusions regarding the use of exercise interventions, explore the physiological mechanisms by which exercise improves brain health and cognitive ability in children and adolescents, and provide a reliable foundation for follow-up research. We used the Pub Med, Web of Science, Science Direct, Springer, Wiley Online Library, Weipu, Wanfang, and China National Knowledge Infrastructure databases to search for randomized controlled trials examining the influences of exercise interventions on brain-derived neurotrophic factor levels in children and adolescents. The extracted data were analyzed using Review Manager 5.3. According to the inclusion criteria, we assessed randomized controlled trials in which the samples were mainly children and adolescents, and the outcome indicators were measured before and after the intervention. We excluded animal experiments, studies that lacked a control group, and those that did not report quantitative results. The mean difference(MD;before versus after intervention) was used to evaluate the effect of exercise on brain-derived neurotrophic factor levels in children and adolescents. Overall, 531 participants(60 children and 471 adolescents, 10.9–16.1 years) were included from 13 randomized controlled trials. Heterogeneity was evaluated using the Q statistic and I^(2) test provided by Review Manager software. The meta-analysis showed that there was no heterogeneity among the studies(P = 0.67, I^(2) = 0.00%). The combined effect of the interventions was significant(MD = 2.88, 95% CI: 1.53–4.22, P < 0.0001), indicating that the brain-derived neurotrophic factor levels of the children and adolescents in the exercise group were significantly higher than those in the control group. In conclusion, different types of exercise interventions significantly increased brain-derived neurotrophic factor levels in children and adolescents. However, because of the small sample size of this meta-analysis, more high-quality research is needed to verify our conclusions. This metaanalysis was registered at PROSPERO(registration ID: CRD42023439408).