Department of Community Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana.
Department of Psychiatry, Korle-Bu Teaching Hospital, Accra, Ghana.
Eur Child Adolesc Psychiatry. 2024 Feb;33(2):467-480. doi: 10.1007/s00787-023-02168-x. Epub 2023 Mar 2.
The study sought to assess the prevalence and factors associated with Food Insecurity (FI) and further quantify its impact on substance use and suicidal behaviours (ideation, planning, and repeated attempted suicide) among school-going adolescents in Africa. The study involved a secondary analysis of cross-sectional data from the Global School-Based Student Health Survey (GSHS) conducted in Africa. Substance use and suicidal behaviours were the main outcomes. We employed the Double Selection Least Absolute Shrinkage and Selection Operator Poisson regression (DSLASSOPM) model to assess risk factors associated with FI and further employed Coarsened Exact Matching involving DSLASSOPM to assess the influence of FI on the study outcomes. Meta-analysis was conducted to obtain between-country heterogeneity in the prevalence of FI and the prevalence ratio of substance use and suicidal behaviours. The study involved 34,912 school-going adolescents. The pooled 30-day prevalence estimate of FI was 11.1% (95% CI 9.1-18.6), ranging from 6.7% (95% CI 5.0-8.3) in Tanzania to 18.4% (95% CI 14.4-22.4) in Benin. The most common associated factors included the experience of insomnia and the number of times injured. The pooled prevalence ratio of substance use, suicidal ideation, suicidal planning, and repeated attempted suicide among adolescents experiencing food insecurity were 1.92(95% CI 1.69-2.16), 1.56(95% CI 1.46-1.66), 1.50 (95% CI 1.41-1.58), and 1.90 (95% CI 1.73-2.07) respectively. A considerable heterogeneity between the sub-regions prevalence ratio for suicidal ideation and planning was also observed (I = 0, p value > 0.05). The study observed a high prevalence of food insecurity in West Africa with negligible heterogeneity between the countries. A significant positive association between FI and the study outcomes (substance use and suicidal behaviours) was observed. The study recommends country-specific social and school-based health interventions to screen risk factors associated with food insecurity for early identification. Measures to achieve Sustainable Development Goal 2 (Zero Hunger) by 2030 are key in these African countries and is likely to yield demographic dividends through improvement in mental health among school-going adolescents.
本研究旨在评估食物不安全（FI）的流行率和相关因素，并进一步量化其对非洲在校青少年物质使用和自杀行为（意念、计划和重复尝试自杀）的影响。本研究是对在非洲进行的全球学校学生健康调查（GSHS）的横断面数据进行的二次分析。物质使用和自杀行为是主要结局。我们采用双重选择最小绝对收缩和选择算子泊松回归（DSLASSOPM）模型来评估与 FI 相关的风险因素，并采用涉及 DSLASSOPM 的粗化精确匹配来评估 FI 对研究结局的影响。Meta 分析用于获得 FI 流行率和物质使用及自杀行为的患病率比的国家间异质性。该研究涉及 34912 名在校青少年。FI 的 30 天总体流行率估计为 11.1%（95%CI 9.1-18.6），范围从坦桑尼亚的 6.7%（95%CI 5.0-8.3）到贝宁的 18.4%（95%CI 14.4-22.4）。最常见的相关因素包括失眠经历和受伤次数。经历食物不安全的青少年物质使用、自杀意念、自杀计划和重复尝试自杀的总体患病率比分别为 1.92（95%CI 1.69-2.16）、1.56（95%CI 1.46-1.66）、1.50（95%CI 1.41-1.58）和 1.90（95%CI 1.73-2.07）。还观察到自杀意念和计划的亚区域患病率比之间存在相当大的异质性（I=0，p 值>0.05）。研究观察到西非的食物不安全发生率较高，各国之间的异质性可以忽略不计。FI 与研究结局（物质使用和自杀行为）之间存在显著的正相关。研究建议针对特定国家的社会和学校为基础的健康干预措施，以筛查与食物不安全相关的风险因素，以便早期发现。实现 2030 年可持续发展目标 2（零饥饿）的措施是这些非洲国家的关键，这可能会通过改善在校青少年的心理健康带来人口红利。
