ABSTRACT
BACKGROUND: There is a lack of comparative data on the prevalence and effects of exposure to violence in African youth. AIMS: We assessed trauma exposure, post-traumatic stress symptoms and gender differences in adolescents from two African countries. METHOD: A sample of 2041 boys and girls from 18 schools in CapeTown and Nairobi completed anonymous self-report questionnaires. RESULTS: More than 80% reported exposure to severe trauma, either as victims or witnesses. Kenyan adolescents, compared with South African, had significantly higher rates of exposure to witnessing violence (69% v. 58%), physical assault by a family member (27% v. 14%) and sexual assault (18% v. 14%). But rates of current full-symptom post-traumatic stress disorder (PTSD) (22.2% v. 5%) and current partial-symptom PTSD (12% v. 8%) were significantly higher in the South African sample. Boys were as likely as girls to meet PTSD symptom criteria. CONCLUSIONS: Although the lifetime exposure to trauma was comparable across both settings, Kenyan adolescents had much lower rates of PTSD. This difference may be attributable to cultural and other trauma-related variables. High rates of sexual assault and PTSD, traditionally documented in girls, may also occur in boys and warrant further study.
Subject(s)
Stress Disorders, Post-Traumatic/epidemiology , Violence , Adolescent , Child Abuse, Sexual , Depressive Disorder/epidemiology , Depressive Disorder/etiology , Female , Health Surveys , Humans , Kenya/epidemiology , Kenya/ethnology , Male , Prevalence , Regression Analysis , Self-Assessment , Sex Distribution , South Africa/epidemiology , South Africa/ethnology , Stress Disorders, Post-Traumatic/ethnology , Stress Disorders, Post-Traumatic/psychology , Substance-Related Disorders/epidemiology , Substance-Related Disorders/etiology , Surveys and Questionnaires , Time FactorsABSTRACT
BACKGROUND: On 7th August 1998, a terrorist bomb destroyed the American Embassy in Nairobi, killing and injuring thousands of people. OBJECTIVES: To describe the media component of the (larger) mental health response, and evaluate the impact of the intervention. DESIGN: Descriptive cross sectional study. SETTING: Nairobi, three months after the explosion. SUBJECTS: Residents of Nairobi and outlying areas, exposed to the bomb blast and who received Radio and TV coverage about the explosion. INTERVENTIONS: Radio and TV broadcasts, starting hours after the explosion and continuing for two weeks thereafter. RESULTS: Of a sample of 400 respondents interviewed, 172 reported they were affected by the bomb blast, either directly or through friends and relatives. TV and radio had the highest reach, (89% and 85%) respectively. Seventy per cent felt the programmes gave victims hope and 90% felt the programmes should continue, as they were helpful to the needy. CONCLUSION: The media is a controversial, sometimes overused and at times underused resource in Disaster Management. Judicious use of the media was shown to be helpful in this study. Literature supports media interventions in disaster. Doctors working in disaster areas need to understand the media and to prepare for its use as it compliments other interventions.
Subject(s)
Communications Media/statistics & numerical data , Health Knowledge, Attitudes, Practice , Mental Health Services/statistics & numerical data , Terrorism/psychology , Terrorism/statistics & numerical data , Adult , Cross-Sectional Studies , Female , Health Surveys , Humans , Kenya/epidemiology , Male , Mental Health/statistics & numerical data , Middle Aged , Program Evaluation , Surveys and Questionnaires , United States/epidemiologyABSTRACT
Following exposure to a major traumatic event like the August seventh 1998 Nairobi bomb blast various reactions occur, some of which result in stress-related psychiatric disorders. We have described one such case, and used it to illustrate the salient features of post-traumatic stress disorder. We have outlined the diagnostic categories of the post-traumatic disorders and discussed the different treatment modalities applicable.
