Alcohol Use among School-Going Adolescents in Harare; Zimbabwe: Results from the 2003 Global School-Based Health Survey

Data from the Global School-Based Health Survey (2003) were analysed to estimate the proportions of relevant socio-demographic and behavioural characteristics. Of the 1997 students who participated in the survey; 15.6(17.1males and 14.0females) reported alcohol consumption. Factors associated with consumption of alcohol use were being worried; bullied; smoking cigarettes; truant; and lack of parental supervision. Students who were never worried were 49(AOR=0.51 [95CI (0.36; 0.72)]) less likely to consume alcohol compared to students who were most of the time or always worried. Similarly; students who were never bullied were 42(AOR=0.57 [95CI (0.42; 0.77)]) less likely to take alcohol compared to students who were bullied at least six times in the previous one month to the survey. Compared to students who smoked cigarettes; non-smokers were 71(AOR=0.29 [95CI (0.21; 0.41)]) less likely to consume alcohol. Compared to students who always received parental supervision; students who rarely received parental supervision were more likely (AOR=1.85 [95CI (1.19; 2.90)] to consume alcohol; and those students who sometimes received parental supervision were less likely (AOR=0.70 [95CI (0.50; 0.98)] to consume alcohol. There is a need to implement public health interventions with special attention to the determinants of alcohol consumption in this age group

Prevalence and correlates of current cigarette smoking among adolescents in East Timor-Leste.

OBJECTIVES: To determine the prevalence and correlates for current cigarette smoking. DESIGN: Secondary analysis of the East Timor-Leste Global Youth Tobacco Survey conducted in 2006. SETTING: Public and private schools registered with the Ministry of Education. PARTICIPANTS: A two-stage cluster sample of 1790 students in Grades 7 to 9. Schools were selected with probability proportional to enrolment size, and classes were randomly selected in each school. All students in selected classes were eligible to participate in the survey. The school and student response rates were 96.0% and 84.5%, respectively. MAIN OUTCOME MEASURE: Prevalence of current cigarette smoking. RESULTS: Out of 1790 adolescents, 52.1% were of ages less than 15 years, 51.8% were males, 42.8% reported having some pocket money in a month, and 72.7% had at least a parent who was a smoker. Prevalence of current cigarette smoking was 40.3%. Current smokers also reported having bought cigarettes from peddlers (32.4%), someone bought for them (16.7%), got from someone older (13.7%), borrowed (13.3%), and stole (3.4%). Males were more likely to be smokers than females (59.0% versus 19.3%). Factors positively associated with current smoking were: parental smoking; closest friend smoking; amount of pocket money; and exposure to anti-tobacco messages. CONCLUSIONS: East Timor has one of the highest prevalence of cigarette smoking among adolescents. The fact that exposure to anti-tobacco messages was associated with being a smoker may be evidence suggesting that anti-tobacco messages, especially from tobacco-related industry, may have unintended consequences.

Gender differences in university students' HIV/AIDS-related knowledge and sexual behaviours in Malawi: a pilot study

A cross-sectional study was conducted among first-year university students in Malawi to determine distributions of HIV/AIDSrelated knowledge; and sexual behaviours. A total of 314 (199 male and 115 female) students were eligible to participate; and of these 221 (70.4) participated in the survey. Generally; levels of HIV/AIDS-related knowledge were similar between sexes. Overall; 68.9of students of both sexes felt that they knew enough about HIV/AIDS. Altogether; 83.3of students reported that they knew where to access HIV testing on campus; but only 19.0reported that they knew their HIV status. Some 60.3of students who had never been tested intended to have an HIV test. A history of having ever been tested was not associated with sex. Most (68.4) students felt that they were not at risk of acquiring HIV infection. Overall; 66.8of students knew where to get a condom on campus; and 38.7stated that they knew exactly how to use it. About half (52.6) of the students used a condom at last vaginal sexual intercourse. Having multiple sex partners in the last 12 months was reported by 40.4of students

Socio-demographic Characteristics and Sexual Health Related Attitudes and Practices of Men Having Sex with Men in Central and Southern Malawi

An exploratory study of men having sex with men (MSM) was conducted in central and southern Malawi in order to understand their socio-demographic characteristics; sexual behaviours; and perceptions about confidentiality and stigma. A total of 97 men participated in the study of whom 84 (86.6) were in the age group 17-32 years. The majority; 73 (75.3) of MSM had never married; 26 (32.5) reported not always using condoms during sexual intercourse; and 23 (23.7) had ever received money or gifts in exchange of sex. Only 17 (17.5) of the participants reported being exposed to HIV prevention messages targeted at MSM. Fear of sexual orientation disclosure and discrimination were reported by 27 (30.7) of MSM. Many of the study participants reported that HIV intervention programmes are not accessible to them. In conclusion; HIV intervention programmes may not be reaching out to the majority of MSM. We suggest an exploration of the feasibility of HIV prevention interventions targeting MSM in this country where the practice is illegal

Prevalence and Correlates of Cigarette Smoking among Adolescents in Malawi: Results from the Global Youth Tobacco Survey 2005

The majority of adults who smoke cigarettes initiated the habit when they were adolescents or young adults. While rates of smoking and associated factors are known among 13-15 year olds in Malawi; correlates of cigarette smoking among adolescents in a national representative sample in Malawi have not been studied. We; therefore; carried out this study to estimate the prevalence of current smoking and determine its correlates in a nationally representative sample of in-school adolescents in Malawi. An analysis of the Malawi Global Youth Tobacco Survey (GYTS) 2005 was conducted. Using logistic regression analysis; we estimated the association between current cigarette smoking and potential explanatory variables. Overall; 2.5of adolescents (3.2among males; and 1.8among females) were current cigarette smokers. Smoking among parents was 9.6with no significant difference between males and females (10.3versus 10.1). Stronger associations with smoking were observed for friends smoking status (AOR=3.07; 95CI 2.99; 3.16); receiving pocket money (AOR=3.06; 95CI 2.98; 3.14); and perception that smoking increases body weight (AOR=2.98; 95CI 2.81; 3.16). Students who thought that cigarette smoking is harmful to health were 56(AOR=0.44; 95CI 0.43; 0.45) less likely to smoke than students who thought otherwise. Despite being the world's second leading grower of tobacco; the prevalence of cigarette smoking among adolescent is lower than has been reported elsewhere

Prevalence and Determinants of ever Smoked Cigarettes among School-Going Adolescents in Lusaka; Zambia

Background: Cigarette smoking is the single most important preventable cause of non-infectious diseases. There is limited data on adolescent smoking and its determinants in developing countries. Methods: Further analysis was done on data collected in the Global Youth Tobacco Survey conducted among school-going adolescents in Lusaka; Zambia in 2002. Weighted logistic regression analyses were performed to determine associations between selected explanatory factors and ever smoked cigarettes. Results: A total of 2175 students participated in the study out of which 40.1(95CI 39.5-40.7) had ever smoked cigarettes. The prevalence of ever smoked cigarettes was 43.4(95CI 42.6-44.2) among boys; and 35.6(95CI 34.8-36.4) among girls; (p0.001). Among both boys and girls; history of having ever smoked cigarettes was associated with having a parent or closest friend who smoked. Among girls only; exposure to pro-tobacco advertisement and positive perception towards smoking were associated with ever smoked cigarettes. Adolescent girls who doubted that smoking was harmful to their health were more likely to have ever smoked. Conclusions: Public health interventions aimed to prevent teenage adolescent smoking should incorporate a comprehensive understanding of the determinants of smoking

Lost investment returns from the migration of medical doctors from Malawi

Migration of medical doctors from African countries to developed nations compromises the delivery of health care on the continent. The full cost of producing a medical doctor was estimated in Malawi by adding the costs of education from primary school through undergraduate medical education. The cost in fees for one medical doctor produced was US$ 56;946.79. The amount of lost investment returns for a doctor who migrated out and served for 30 years in the receiving country ranged from about US$ 433;493 to US$46 million at interest rates 7and 25; respectively. Quantitative assessments of the estimated loss in investment allows for informed policy discussions and decisions

Prevalence and determinants of cigarette smoking among adolescents in Blantyre City; Malawi

Tobacco smoking is a major risk factor for non-communicable diseases such as ischaemic heart disease; stroke; chronic obstructive airways disease and several cancers. There is little data about the prevalence and determinants of smoking among adolescents in southern Africa. This study aimed to determine the prevalence and determinants of cigarette smoking among adolescents in Blantyre City; Malawi. Cross-sectional data were obtained from school-going adolescents in Blantyre in 2001 using the Global Youth Tobacco Survey data collection instrument. Data were analysed to determine prevalence of current and ever cigarette smoking; and predictors of smoking. The prevalence of urrent smoking and ever smoking were 3.0and 15.6; respectively. Predictors of current tobacco smoking included male gender; having friends or parents who smoked; having been exposed to advertisements about tobacco brands on television and having seen a lot of advertisements in newspapers and magazines. School programmes that included being taught about smoking in class and a class discussion on the dangers of tobacco were not associated with reduced current smoking. Intervention programmesaiming to curb tobacco smoking among adolescents should focus on dealing also with parental smoking; peer influence and pay special attention toward male gender. School-based programmes to prevent smoking should be evaluated as some may have little impact in influencing current smoking status

Ethics and programmatic issues on the 2003 SARS epidemic: are any lessons transferable to the HIV pandemic?

The HIV/AIDS pandemic continues to spread globally but much more so in the less industrialised countries of southern and eastern Africa. Despite the difference in aetiology and modes of spread of the Severe Acute Respiratory Syndrome (SARS); there are certainly some lessons that policy makers can reflect on regarding the global control of the SARS epidemic in 2003. The response to the SARS outbreak garnering the support of every stakeholder than could be mobilized is an example of how emerging infectious diseases could be dealt with. However; the programmatic and ethicsissues; although resulting in an effective response were nonetheless controversial in many ways; as the potentially compromised people's rights and autonomy. These issues require further reflection and an assessment as to whether they could be used in the fight against HIV and AIDS. Presented in this paper; are selected HIV and SARS prevention and control activities that can be assessed for potential effectiveness; ethics rating and programmatic challenges. In this article; the similarities in prevention and control are presented; so will the differences