Intestinal parasitosis (IP) is a public health problem in developing countries affecting one fourth of the global population. IP are common studied in children, neglecting the adults that are also at high risk and source of transmission. A screening study was performed with a convenience sample in three Colombian regions: Guachené (Cauca), Quibdó (Chocó), and Urabá (Antioquia). Feces samples from 284 volunteers (older than 18 years old) were tested by microscopy to identify parasite ova and cysts. The IP frequency was 14.5%, and 52.1% were males. 63.2% of the parasitized patients exhibited diarrhea, and/or abdominal pain with significant association. 39.5% had single parasitic infection and 60.5% had multiple parasites: Blastocystis hominis (63.9%), Entamoeba hystolitica/dispar (39.4%), Endolimax nana (33.3%), Ascaris lumbricoides (22.2%), Giardia lamblia (19.4%), Entamoeba coli (13.9%), Trichuris trichiura (11.1%), hookworm species (11.1%), Strongyloides stercolaris (5.6%), and Iodamoeba butschlii (2.8%). A multivariate approach was used to determine predictor factors for IP: male gender, rainwater as drinking source, and feces disposal different to toilet, latrine or septic tank were positively associated with infection. This study evidences that adult population, not only children from vulnerable areas of Colombia, must have to include as a risk for intestinal parasitism.
Background: Adolescent depression and anxiety symptoms are prevalent in Sub-Saharan African countries, yet treatment options are scarce, and stigma limits help-seeking. Brief, computerized single-session interventions (SSIs) that contain empirically supported stigma-reducing elements may help expand access to treatment. We developed and evaluated such an intervention for Kenyan adolescents. Method: High school students (N=103, age 13-18) were randomized to a digital SSI Shamiri-Digital (Shamiri means “thrive” in Kiswahili) or a study-skills control intervention. Shamiri-Digital consisted of reading and writing activities about three concepts: growth mindset, gratitude, and value affirmation. Both Shamiri-Digital and the study-skills control condition were delivered electronically in schools. Results: Compared to the control, Shamiri-Digital produced greater reduction in adolescent depression symptoms in both the full sample (p = 0.028, d = 0.50) and a sub-sample of youths with moderate-to-severe depression symptoms (p = 0.010, d = 0.83) from baseline to two-week follow-up. The effects exceed the mean effects reported in meta-analyses of full-length, face-to-face psychotherapy for youth depression. There were no significant effects on anxiety symptoms, well-being, or happiness. Conclusion: This is the first report that a brief, computerized SSI may reduce depressive symptoms in adolescents in Sub-Saharan Africa. Replication trials with extended follow-ups will help gauge the strength and durability of these effects. Trial Registration Number: (registration number masked). Pan African Clinical Trials Registry (PACTR). Public Health Significance: This study provides evidence that a brief single-session positive-psychology intervention may help reduce depressive symptoms of adolescents living in Sub Saharan Africa, where there are few mental health professionals, and stigma limits help-seeking
Background: Developing low-cost yet scalable interventions for youth depression and anxiety symptoms in low-income regions such as countries in Sub Saharan Africa is a global mental health priority. We developed and intend to evaluate one such intervention for adolescent depression and anxiety in Kenya. The intervention, named Shamiri (a Swahili word for ‘thrive’), draws upon evidence-based components of brief interventions that involve nonclinical principles rather than treatment of psychopathology (e.g. growth mindset, gratitude and virtues).Methods: Between 400 and 500 high-symptom Kenyan adolescents (ages 13-18) will be randomized to either the four-week Shamiri group intervention or a group study-skills control intervention of equal duration and dosage. Participating adolescents will meet in groups of 8-15, led by a high-school graduate trained to deliver Shamiri as a lay-provider. Adolescents will self-report primary outcome measures (depression and anxiety symptoms) and secondary outcome measures (e.g., perceived social support, perceived academic control, self-reported optimism, etc.) at the 2-week intervention midpoint, 4-week post-intervention endpoint, and 2-week post-intervention follow-up. We predict that adolescents in the Shamiri group, when compared to the study-skills control group, will show greater improvements in primary outcomes and secondary outcomes. Discussion: Results may suggest that a brief, lay-provider delivered, school-based intervention may reduce internalizing symptoms, improve academic outcomes and other psychosocial outcomes in high-symptom adolescents in Sub-Saharan Africa.Trial Registration: Pan African Clinical Trials Registry. Trial ID: PACTR201906525818462. Registered 12th June 2019. Keywords: Adolescents, Sub Saharan Africa, Global Mental Health, Depression, Anxiety, Shamiri.
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