Manyema Mercy, Richter Linda M
DST-NRF Centre of Excellence in Human Development, University of the Witwatersrand School of Public Health Building, Wits Education Campus, 7 York Road, Parktown, Johannesburg, South Africa.
MRC/Wits Developmental Pathways for Health Research Unit, Second Floor School of Public Health Building, University of the Witwatersrand (Education Campus), 7 York Road, Parktown, South Africa.
Heliyon. 2019 Dec 12;5(12):e03003. doi: 10.1016/j.heliyon.2019.e03003. eCollection 2019 Dec.
While adverse childhood experiences (ACEs), as described by the CDC-Kaiser Permanente Study, are reportedly common in both high and low-income settings, evidence on the epidemiology of ACEs in low-income settings is scarce. This study aimed to determine the prevalence of ACEs reported in young adulthood and assess their association with childhood maternal, household and community factors. We used data from the 22-23 year wave of the Birth to Twenty Plus (Bt20+) study in South Africa, the largest and longest running birth cohort in Africa. With ACEs as the main outcome measure, their association with childhood factors was assessed using regression models. As demonstrated in high-income settings, ACEs are highly prevalent in this young adult population in a middle income country. Both household and community socio-economic status in childhood was associated with the experience of ACEs and the likelihood of experiencing multiple ACEs. The attenuation of significance in adjusted models suggested that individual ACEs are correlated and may exert their effects through other ACEs. Interventions for the prevention of ACEs need to be directed not only at individuals but households as well as communities.
据美国疾病控制与预防中心-凯撒医疗集团的研究描述，童年不良经历（ACEs）在高收入和低收入环境中似乎都很常见，但关于低收入环境中ACEs流行病学的证据却很少。本研究旨在确定青年期报告的ACEs患病率，并评估其与童年时期母亲、家庭和社区因素的关联。我们使用了南非“从出生到二十多岁（Bt20+）”研究中22至23岁年龄段的数据，该研究是非洲规模最大、持续时间最长的出生队列研究。以ACEs作为主要结局指标，使用回归模型评估其与童年因素的关联。正如在高收入环境中所表明的那样，ACEs在这个中等收入国家的年轻成年人群中非常普遍。童年时期的家庭和社区社会经济地位都与ACEs经历以及经历多种ACEs的可能性相关。调整模型中显著性的减弱表明，个体ACEs之间存在相关性，并且可能通过其他ACEs发挥作用。预防ACEs的干预措施不仅需要针对个体，还需要针对家庭和社区。
