Acharya Shneha, Bhatta Dharma Nanda, Assannangkornchai Sawitri
1Epidemiology Unit, Faculty of Medicine,Prince of Songkla University,Hat-yai,Thailand.
2Department of Public Health and Community Medicine, People's Dental College,Tribhuwan University,Kathmandu,Nepal.
Disaster Med Public Health Prep. 2018 Aug;12(4):486-492. doi: 10.1017/dmp.2017.100. Epub 2017 Aug 23.
The 2015 earthquake in Nepal affected the country in terms of economy, and by causing damage and stress reactions. This study aimed to estimate the prevalence and determine individual child- and family-level predictors of post-traumatic stress disorder (PTSD) symptoms.
A community-based cross-sectional study was carried out in Kathmandu district 15 months after the earthquake. Multistage cluster sampling was adopted to collect 800 earthquake-affected children aged 7-16 years and a face-to-face interview was conducted. Trauma exposure questionnaire and Child PTSD Symptoms Scale were used for assessment of the level of exposure and PTSD symptoms. Multilevel generalized linear regression analysis was used to explore individual and family-level predictors.
Among the children, 51% had moderate-to-severe PTSD symptoms. Children of school age (adjusted odds ratio=2.83 [1.45-5.49]), those attending lower-secondary school (2.26 [1.21-4.21]), those having a higher exposure to the severity of the earthquake, and those with low psychosocial acuity [1.70 (1.10-2.60)] were more likely to have more severe PTSD symptoms compared with those who were adolescents and in higher-secondary school, whereas children from a family living in an urban (0.33 [0.19-0.59]) setting and following Hindu religion (0.31 [0.16-0.60]) were less likely to have PTSD symptoms compared with children from suburban areas and those following Buddhist religion.
PTSD symptoms were prevalent among children of Nepal more than a year following the earthquake. Family-level indicators cannot be excluded when studying children's trauma reactions. (Disaster Med Public Health Preparedness. 2018;12:486-492).
2015年尼泊尔地震在经济方面对该国造成了影响，并引发了破坏和应激反应。本研究旨在估计创伤后应激障碍（PTSD）症状的患病率，并确定个体儿童及家庭层面的预测因素。
在地震发生15个月后，于加德满都区开展了一项基于社区的横断面研究。采用多阶段整群抽样方法收集了800名7至16岁受地震影响的儿童，并进行了面对面访谈。使用创伤暴露问卷和儿童PTSD症状量表评估暴露水平和PTSD症状。采用多水平广义线性回归分析来探索个体和家庭层面的预测因素。
在这些儿童中，51%有中度至重度PTSD症状。与青少年及高中阶段的儿童相比，学龄儿童（调整比值比=2.83[1.45 - 5.49]）、初中阶段儿童（2.26[1.21 - 4.21]）、地震严重程度暴露较高的儿童以及心理社会敏锐度较低的儿童（1.70[1.10 - 2.60]）更有可能出现更严重的PTSD症状；而与来自郊区及信奉佛教的儿童相比，居住在城市环境（0.33[0.19 - 0.59]）且信奉印度教的家庭中的儿童出现PTSD症状的可能性较小。
地震发生一年多后，PTSD症状在尼泊尔儿童中普遍存在。在研究儿童创伤反应时，不能排除家庭层面的指标。（《灾难医学与公共卫生防范》。2018年；12:486 - 492）
