Uptake of HIV voluntary counseling and testing and associated factors among students in the Higher Institutions of Learning in Kigali, Rwanda: A cross-sectional study

Background HIV/AIDS remains a significant global public health challenge with youth bearing the brunt of the burden. One essential method for preventing and accessing AIDS care is through Voluntary Counselling and Testing (VCT). Regardless of this, youth population continues to have low utilization of VCT services. Objective To assess the uptake of HIV VCT services and associated factors among university students in Kigali. Methods A cross-sectional study among 374 students recruited using stratified sampling was conducted. A structured questionnaire was used to gather information. A multivariable logistic regression analysis was used to assess the independent factors associated with VCT uptake. Results The prevalence of VCT uptake was 59.9%. The logistic regression revealed that being Catholic (AOR = 11.99, 95%CI: 5.44-26.41) and Moslem (AOR = 37.34, 95%CI: 2.67-128.36) compared to Protestant, as well as availability of VCT services (AOR = 5.15, 95%CI: 3.11 - 8.541) favored the use VCT. On the other hand, being aged 20 to 24 years (AOR = 0.112, 95%CI: 0.04 - 0.29) had low likelihood of using VCT than those more than 24 years of age. Conclusion VCT uptake was significantly positively associated with religion and VCT services availability, and negatively associated with age 20-24 years in the campus. Therefore, targeted actions of disseminating information on benefits of VCT and enhancing accessibility of VCT services among students are necessary for the increased VCT uptake to be attained.

Environmental and nutritional determinants of diarrhoea disease among children under five years in Rwanda: A secondary data analysis of the Rwanda demographic and health survey 2014-15

Background Diarrhoea remains one of the leading of causes of deaths in children under five years old globally. Children under five years are more vulnerable to diarrhea especially those from low and middle countries. The aim of this study was to explore the environmental and nuttitional factors associated with diarrhea among children underfive years in Rwanda. Methods A secondary data analysis of the Rwanda Demographic and Heralth Survey 2014-2015 (RDHS 2014-2015) was used. A total sample of 7,558 children under five years old was included. The data were analysed using Stata 13. Bivariate with Chi-square test and multivariable logistic regression analysis were performed to assess the relashionship of factors associsted with diarreha. A 95% confidence interval and a significance level of 0.05 were set. Results Two environmental factors (Source of drinking water and shared toilets facilities with other households) were associated with child diarrhea. Pvalues: 0.029, OR:1.79, CI [1.06-3.01]; 0.019, OR:1.26, CI: [1.04-1.53] respectively. None of the selected nutritional factors was associated with childhood diarrhea. Conclusion Based on the findings, drinking borehole water and shared toilet facilities were associated with diarrhea. The study therefore recommends the provision of potable water and supporting/enabling the households to own toilets.

Childhood emotional and behavior problems and their associations with cesarean delivery

Objective: To determine the prevalence of childhood emotional and behavioral problems and examine their associations with cesarean delivery. Methods: Our sample consisted of 8,900 preschoolers from 35 kindergartens in four cities in East China. Parents completed the Strengths and Difficulties Questionnaire (SDQ) and provided other information. Children's emotional and behavioral problems were assessed using five subscales of the SDQ. Mode of delivery was classified as vaginal or cesarean section (CS); in sub-analyses, we divided CS into elective or emergency delivery. Logistic regression was used to examine associations. Results: A total of 1,209 (13.6%) children had a total SDQ score within abnormal range; 25.5% had peer problems within abnormal range, 9.0% had abnormal emotional symptoms, 13.9% had abnormal conduct problems, 18.9% had abnormal hyperactivity problems, and 16.2% were rated abnormal in pro-social behavior. Overall, 67.3% of the children who participated were delivered by CS. In fully adjusted analysis, CS was significantly associated with abnormal total SDQ score (OR = 1.27; 95%CI 1.10-1.46; p < 0.05) and pro-social behavior (OR = 1.27; 95%CI 1.12-1.45; p < 0.0001). No significant association was found between CS and risk of having conduct problems (OR 1.13; 95%CI 0.98-1.29), peer problems (OR 1.11; 95%CI 0.99-1.24), hyperactivity (OR 1.02; 95%CI 0.91-1.15), or emotional problems (OR 1.06; 95%CI 0.90-1.24). Conclusion: In this sample, CS was associated with risk of behavioral problems, but not with emotional problems. Further research is needed to better understand these associations.

Emotional and behavioral problems associated with sleep problems in preschool aged children / 中华流行病学杂志

Objective To examine whether sleep problems are related to both emotional and behavioral problems in children aged 3-6 years.Methods A large cross-sectional study was conducted in Anqing,Wuhu,Tongling and Yangzhou from March to June 2015.A total of 8 900 preschool aged children were included.Sleep problems were obtained by using adapted BISQ completed by the parents or the people who took care of children.Emotional and behavioral problems of the children were accessed by using Strengths and Difficulties Questionnaire (SDQ),and multivariate logistic regression model was used for statistical analyses.Results The detected rates of emotional symptoms,conduct problems,hyperactivity problems,peer problems,total difficulties and prosocial behavior in preschool aged children were 9.0％,13.9％,18.9％,25.5％,13.6％ and 16.2％ respectively.All the detected rates were higher in boys than in girls except the higher rate of emotional symptoms.The proportions of children with high sleep quality,moderate sleep quality and poor or worse sleep quality were 3.9％,52.9％ and 43.2％ respectively.After controlling the confounding factors of demographic variables,including gender,age,delivery mode,birth weight,birth height and patent' s educational level,multinomial logistic regression analysis showed that the risk of emotional symptoms,conduct problems,hyperactivity problems,peer problems,total difficulties and prosocial behavior in children with longer sleep duration was lower than that in children with shorter sleep duration,the ORs were 0.86 (95％CI:0.77-0.95),0.85 (95％CI:0.78-0.93),0.85 (95％CI:0.79-0.92),0.87(95％CI:0.81-0.93),0.83 (95％CI:0.76-0.91) and 0.82 (95％CI:0.76-0.89) respectively.Compared with the children with good sleep quality,the risk of emotional symptoms,conduct problems,hyperactivity problems,peer problems,total difficulties and prosocial behavior were higher in children with poor or worse sleep quality,the ORs were 3.26 (95％CI:2.40-4.42),2.86 (95％CI:2.16-3.78),2.60 (95％ CI:2.00-3.38),1.96 (95％ CI:1.52-2.54),4.02 (95％ CI:3.06-5.27) and 2.56 (95％ CI:1.96-3.35) respectively.Conclusion There was a negative impact of shorter sleep and poor or worse sleep on emotional and behavioral problems of preschool aged children.

Emotional and behavioral problems associated with sleep problems in preschool aged children / 中华流行病学杂志

Objective To examine whether sleep problems are related to both emotional and behavioral problems in children aged 3-6 years.Methods A large cross-sectional study was conducted in Anqing,Wuhu,Tongling and Yangzhou from March to June 2015.A total of 8 900 preschool aged children were included.Sleep problems were obtained by using adapted BISQ completed by the parents or the people who took care of children.Emotional and behavioral problems of the children were accessed by using Strengths and Difficulties Questionnaire (SDQ),and multivariate logistic regression model was used for statistical analyses.Results The detected rates of emotional symptoms,conduct problems,hyperactivity problems,peer problems,total difficulties and prosocial behavior in preschool aged children were 9.0％,13.9％,18.9％,25.5％,13.6％ and 16.2％ respectively.All the detected rates were higher in boys than in girls except the higher rate of emotional symptoms.The proportions of children with high sleep quality,moderate sleep quality and poor or worse sleep quality were 3.9％,52.9％ and 43.2％ respectively.After controlling the confounding factors of demographic variables,including gender,age,delivery mode,birth weight,birth height and patent' s educational level,multinomial logistic regression analysis showed that the risk of emotional symptoms,conduct problems,hyperactivity problems,peer problems,total difficulties and prosocial behavior in children with longer sleep duration was lower than that in children with shorter sleep duration,the ORs were 0.86 (95％CI:0.77-0.95),0.85 (95％CI:0.78-0.93),0.85 (95％CI:0.79-0.92),0.87(95％CI:0.81-0.93),0.83 (95％CI:0.76-0.91) and 0.82 (95％CI:0.76-0.89) respectively.Compared with the children with good sleep quality,the risk of emotional symptoms,conduct problems,hyperactivity problems,peer problems,total difficulties and prosocial behavior were higher in children with poor or worse sleep quality,the ORs were 3.26 (95％CI:2.40-4.42),2.86 (95％CI:2.16-3.78),2.60 (95％ CI:2.00-3.38),1.96 (95％ CI:1.52-2.54),4.02 (95％ CI:3.06-5.27) and 2.56 (95％ CI:1.96-3.35) respectively.Conclusion There was a negative impact of shorter sleep and poor or worse sleep on emotional and behavioral problems of preschool aged children.