Gutema Befikadu Tariku, Tariku Eshetu Zerihun, Melketsedik Zeleke Aschalew, Levecke Bruno, De Henauw Stefaan, Abubakar Amina, Abbeddou Souheila
School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.
Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
PLOS Glob Public Health. 2024 Mar 21;4(3):e0002978. doi: 10.1371/journal.pgph.0002978. eCollection 2024.
Ethiopian schools were closed for nearly 40 weeks as a measure to control the COVID-19 pandemic. The objective of the study was to evaluate the role of COVID-19 pandemic's restrictive measures on cognition and behavioral difficulties of schoolchildren in Arba Minch Health and Demographic Surveillance Site. Two cross-sectional surveys were conducted in November 2019 (pre-COVID-19-lockdown) and November 2020 (post-COVID-19 lockdown). Data were collected both at the school and homes of the children. Cognitive development of the children was assessed using digit span, Raven's coloured progressive matrices (RCPM) and Visual search using cancellation task. Behavioral difficulties score of the children was assessed using Strengths and Difficulties Questionnaire. Analysis of covariance (ANCOVA) was used to compare between the cognition outcomes and behavioral difficulties score pre- and post-COVID-19-lockdown. In a sub-group of children who provided data in both surveys, the difference in cognitive and behavioral outcomes was tested using a mixed effect model. Compared to the pre-COVID-19-lockdown, schoolchildren post-COVID-19-lockdown scored lower in the standardized performance index for the visual search task, which measures attention (0.27 SD, 95% confidence intervals (95%CI): -0.40, -0.13). However, they scored higher by 0.26 SD (95%CI: 0.13, 0.40) and 0.36 SD (95%CI: 0.22, 0.49) in digit span and RCPM, respectively, measuring working memory and non-verbal intelligence. There was no significant difference in total difficulties score between pre- and post-COVID-19-lockdown (0.01 SD, 95%CI: -0.12, 0.15). The subgroup analysis showed a significant increase in digit span among children post-COVID-19-lockdown while the other domains did not show a significant change. Factors contributing to the improvement of children's cognitive domains while away from the school environment should be explored and utilized to enhance child development. This study was registered at clinicaltrials.gov as NCT04137354 on October 14, 2019.
作为控制新冠疫情的一项措施，埃塞俄比亚的学校停课近40周。本研究的目的是评估新冠疫情限制措施对阿尔巴米琴健康与人口监测点学童认知和行为困难的影响。在2019年11月（新冠疫情封锁前）和2020年11月（新冠疫情封锁后）进行了两项横断面调查。在学校和孩子们家中收集数据。使用数字广度、瑞文彩色渐进矩阵（RCPM）和使用消去任务的视觉搜索来评估儿童的认知发展。使用优势与困难问卷评估儿童的行为困难得分。采用协方差分析（ANCOVA）比较新冠疫情封锁前后的认知结果和行为困难得分。在两项调查中均提供数据的儿童亚组中，使用混合效应模型测试认知和行为结果的差异。与新冠疫情封锁前相比，新冠疫情封锁后的学童在视觉搜索任务的标准化表现指数上得分较低，该任务衡量注意力（0.27标准差，95%置信区间（95%CI）：-0.40，-0.13）。然而，他们在数字广度和RCPM上分别高出0.26标准差（95%CI：0.13，0.40）和0.36标准差（95%CI：0.22，0.49），分别衡量工作记忆和非言语智力。新冠疫情封锁前后的总困难得分没有显著差异（0.01标准差，95%CI：-0.12，0.15）。亚组分析显示新冠疫情封锁后儿童的数字广度显著增加，而其他领域没有显著变化。应该探索并利用有助于儿童在远离学校环境时认知领域改善的因素，以促进儿童发展。本研究于2019年10月14日在clinicaltrials.gov注册，注册号为NCT04137354。
