Background Child maltreatment poses high risks to the mental health and cognitive functioning of children not only in childhood but also in later life. However, it remains unclear whether child maltreatment is directly associated with impaired cognitive functioning or whether this link is mediated by mental health problems. Our study aimed at examining this research question among children and adolescents in Uganda. Methods A sample of 232 school-going children and adolescents with a mean age of 14.03 (SD = 3.25) was assessed on multiple forms of maltreatment using the Maltreatment and Abuse Chronology Exposure—Pediatric Version (pediMACE). Executive functions were assessed by the Tower of London task and working memory by the Corsi Block Tapping task, while mental health problems were assessed using the Child PTSD Symptom Scale for PTSD and the Center for Epidemiological Studies Depression Scale for Children (CES-DC). Results In total, 232 (100%) of the participant reported to have experienced at least one type of maltreatment in their lifetime including emotional, physical, and sexual violence as well as neglect. We found a negative association between child maltreatment and executive functions (β = − 0.487, p < 0.001) and working memory (β = − 0.242, p = 0.001). Mental health problems did not mediate this relationship. Conclusions Child maltreatment seems to be related to lower working memory and executive functioning of affected children and adolescents even after controlling for potential cofounders. Our study indicates that child maltreatment the affects children’s cognitive functionality beyond health and well-being.

Background Severe acute malnutrition (SAM) affects about 13 million under-five children (U5), with an estimated one million dying every year. In this study we aimed at determining the in hospital mortality and its associated factors among U5s admitted with SAM. Methods This was a prospective cohort study of children 6 months to 5 years with SAM admitted at Mbarara Regional Referral Hospital (MRRH) between June and August 2015. Caretakers were interviewed to collect socio-demographic and clinical information. Children underwent physical examination and had blood drawn for HIV, serum glucose, malaria, full blood count, culture and serum electrolytes investigation. Children were managed according to WHO treatment guidelines for SAM. All participants were followed up for a maximum period of 30 days. The proportion of U5 deaths within the first 48 hours and during the entire admission period was calculated. Using Poisson regression analysis, predictors of in-hospital mortality were analyzed with STATA/IC 11.0. Results We enrolled 122 children, median age of 15 months [IQR:11-24], 58.2% males, 90% immunized, 81% ill for more than 2 weeks before admission, 71% from lower health facilities and majority with unknown HIV status(76%). Overall, 13 (10.7%) children died in hospital. Seven (5.7%) died within the first 48 hours. Intravenous (IV) fluid administration significantly predicted in-hospital mortality (adjusted IRR: 7.2, 95%CI: 2.14-24.08, p = 0.001). Conclusion The in-hospital mortality in U5s with SAM was lower than that previously reported in central Uganda. Intravenous fluid administration significantly predicted overall in-hospital mortality. While Administration of intravenous fluids is still the main stay of managing severely

Background: Child maltreatment poses high risks to the mental health and cognitive functioning of children not only in childhood but also in later life. However, it remains unclear whether child maltreatment is directly associated with impaired cognitive functioning or whether this link is mediated by mental health problems. Our study aimed at examining this research question among children and adolescents in Uganda. Methods: A sample of 232 school-going children and adolescents with a mean age of 14.03 (SD = 3.25) was assessed on multiple forms of maltreatment using the Maltreatment and Abuse Chronology Exposure – Pediatric Version (pediMACE). Executive functions were assessed by the Tower of London task and working memory by the Corsi Block Tapping task, while mental health problems were assessed using the Child PTSD Symptom Scale for PTSD and the Center for Epidemiological Studies Depression Scale for Children (CES-DC).Results: In total, 232(100%) of the participant reported to have experienced at least one type of maltreatment in their lifetime ranging from having been intentionally pushed by an authority figure (89.7%, n = 208) to entering an object in the participant’s body (2.6%, n =6). We found a negative association between child maltreatment and executive functions (β = -0.487, p < .001) and working memory (β = -0.242, p = .001). Mental health problems did not mediate this relationship.Conclusions: Child maltreatment seems to be related to lower working memory and executive functioning of affected children and adolescents even after controlling for potential cofounders. Our study indicates that child maltreatment affects children’s cognitive functionality beyond health and well-being.

Background Worldwide, more than 95 million children are sexually abused each year with children in sub-Saharan Africa experiencing sexual assault at higher rates than those in more developed areas. In Uganda, 20% of young people indicated that their sexual debut was non-consensual. The risk for transmission of HIV to children through Child Sexual Abuse is high because of greater mucosal tissue damage and the often repetitive nature of abuse. This contributes significantly to the burden of HIV in Uganda. Despite these risks, studies have shown gaps in active parental involvement in child sexual abuse prevention despite their being the primary protectors of children. Against this background we sought to explore parental understanding of childhood sexual abuse and prevention as a measure for HIV prevention in Rwampara District, South Western Uganda. Methods A phenomenological study was carried out in four health centers that serve the communities of Rwampara district. A total of 25 (n = 25) parents or guardians of children aged 9–14 years were purposively selected to participate in the study. The participants were subjected to in-depth semi-structured interviews which were recorded, transcribed, and translated for thematic analysis. Results Parents’ understanding of child sexual abuse was limited to penetrative sex between a man and a child. Three of the parents interviewed reported to have had children who had been sexually abused while one of the parents had been abused when she was young. The children reported to have been abused were female and were between 3-14years. We also identified gaps in the sensitization of parents regarding home-based prevention of child sexual abuse and psychological support for the victims of abuse. Conclusion Our study shows that child sexual abuse exists in rural western Uganda. There remains a significant gap in the awareness of parents regarding the extent of sexual abuse, signs of sexual abuse, case handling, and psychological support for victims of sexual abuse. This significantly affects the capacity of parents as the primary protectors of children to identify and protect the children against the multiple forms of child sexual abuse.

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