Impact of COVID-19 lockdowns on adolescent pregnancy and school dropout among secondary schoolgirls in Kenya.
Impact of COVID-19 lockdowns on adolescent pregnancy and school dropout among secondary schoolgirls in Kenya.
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COVID-19锁定对肯尼亚中学女生青少年怀孕和学校辍学的影响。
DOI：
10.1136/bmjgh-2021-007666
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发表时间：
2022-01
影响因子：
8.1
通讯作者：
Phillips-Howard PA
中科院分区：
文献类型：
--
作者：
Zulaika G;Bulbarelli M;Nyothach E;van Eijk A;Mason L;Fwaya E;Obor D;Kwaro D;Wang D;Mehta SD;Phillips-Howard PA
旨在限制COVID-19感染和死亡人数的中学关闭可能扩大了弱势少女的性健康和生殖健康（SRH）以及学业成果的负面影响。这项研究的目的是衡量流行病对肯尼亚在校女童少女怀孕和辍学的影响。我们报告的纵向调查结果910名女孩在他们的最后2年的中学。该研究于2018年至2021年在肯尼亚西部农村的12所中学进行。我们采用因果比较设计，比较了403名在2019年11月疫情前完成期末学校考试后毕业的女孩与507名因COVID-19而中断学业并在2021年3月参加考试的女孩的性健康和生殖健康及学业成果。使用未经调整和经调整的广义线性混合模型来调查COVID-19相关学校关闭和限制对所有关注结果和意外怀孕的影响。在研究开始时，COVID-19前队列中女孩的平均年龄为17.2岁（IQR：16.4-17.9），COVID-19队列中女孩的平均年龄为17.5岁（IQR：16.5-18.4）。经历COVID-19遏制措施的女孩在完成中学教育之前怀孕的风险增加了一倍，调整了年龄，家庭财富和家庭状况（调整后的风险比（aRR）=2.11; 95% CI：1.13至3.95，p=0.019）;辍学风险是（aRR=3.03; 95%CI：1.55至5.95，p=0.001），考试前转学的风险是COVID-19前学生的3.4倍（aRR=3.39; 95%CI：1.70至6.77，p=0.001）。COVID-19队列中的女孩更有可能性活跃（aRR=1.28; 95% CI：1.09至1.51，p=0.002），并且不太可能按照要求报告其第一次性行为（aRR=0.49; 95% CI：0.37至0.65，p<0.001）。这些女孩报告了与学校无关的工作时间增加（每天3.32小时，而COVID-19前队列每天2.63小时，aRR=1.92; 95%CI：1.92至2.99，p=0.004）。在COVID-19队列中，80. 5%的人报告家庭经济状况恶化，COVID-19相关压力很常见。2019冠状病毒病疫情严重影响了女童的性健康和生殖健康，并加剧了转学和辍学。有必要制定适当的方案和干预措施，帮助缓解人口一级的紧急情况对在校青少年的影响。NCT 03051789。
Secondary school closures aimed at limiting the number of infections and deaths due to COVID-19 may have amplified the negative sexual and reproductive health (SRH) and schooling outcomes of vulnerable adolescent girls. This study aimed to measure pandemic-related effects on adolescent pregnancy and school dropout among school-going girls in Kenya. We report longitudinal findings of 910 girls in their last 2 years of secondary school. The study took place in 12 secondary day schools in rural western Kenya between 2018 and 2021. Using a causal-comparative design, we compared SRH and schooling outcomes among 403 girls who graduated after completion of their final school examinations in November 2019 pre-pandemic with 507 girls who experienced disrupted schooling due to COVID-19 and sat examinations in March 2021. Unadjusted and adjusted generalised linear mixed models were used to investigate the effect of COVID-19-related school closures and restrictions on all outcomes of interest and on incident pregnancy. At study initiation, the mean age of participants was 17.2 (IQR: 16.4–17.9) for girls in the pre-COVID-19 cohort and 17.5 (IQR: 16.5–18.4) for girls in the COVID-19 cohort. Girls experiencing COVID-19 containment measures had twice the risk of falling pregnant prior to completing secondary school after adjustment for age, household wealth and orphanhood status (adjusted risk ratio (aRR)=2.11; 95% CI:1.13 to 3.95, p=0.019); three times the risk of school dropout (aRR=3.03; 95% CI: 1.55 to 5.95, p=0.001) and 3.4 times the risk of school transfer prior to examinations (aRR=3.39; 95% CI: 1.70 to 6.77, p=0.001) relative to pre-COVID-19 learners. Girls in the COVID-19 cohort were more likely to be sexually active (aRR=1.28; 95% CI: 1.09 to 1.51, p=0.002) and less likely to report their first sex as desired (aRR=0.49; 95% CI: 0.37 to 0.65, p<0.001). These girls reported increased hours of non-school-related work (3.32 hours per day vs 2.63 hours per day in the pre-COVID-19 cohort, aRR=1.92; 95% CI: 1.92 to 2.99, p=0.004). In the COVID-19 cohort, 80.5% reported worsening household economic status and COVID-19-related stress was common. The COVID-19 pandemic deleteriously affected the SRH of girls and amplified school transfer and dropout. Appropriate programmes and interventions that help buffer the effects of population-level emergencies on school-going adolescents are warranted. NCT03051789.
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影响因子：
9.8
作者：
Baron, E. Jason;Goldstein, Ezra G.;Wallace, Cullen T.
通讯作者：
Wallace, Cullen T.
影响因子：
3.7
作者：
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影响因子：
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作者：
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通讯作者：
Anthuber, S
DOI：
10.1007/978-3-319-97637-2_8
发表时间：
2019-01-01
期刊：
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影响因子：
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作者：
Onyango, Monica Adhiambo;Resnick, Kirsten;Shah, Rupal Ramesh
通讯作者：
Shah, Rupal Ramesh
DOI：
10.1073/pnas.2022376118
发表时间：
2021-04-27
影响因子：
11.1
作者：
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通讯作者：
Verhagen MD