Long term stress and impairment in children and youth after an acute infectious disease outbreak: A longitudinal study of the social, familial and individual effects of Ebola viral disease (EVD)

项目摘要。史无前例的2013-2016年埃博拉病毒病(EVD)疫情 导致的感染和死亡比过去40年历史上所有疫情都要多 这种病毒加在一起。在超过2.8万名埃博拉病毒感染者中 大约21%是16岁以下的儿童，超过1.6万名儿童走失 在疫情爆发期间，父母中的一人或双方。慢性传染病的前期研究 例如艾滋病毒，已经显示出持久的健康、社会和心理社会后果。然而， 关于EVD的长期并发症，或者更广泛地说，精神疾病，人们知之甚少。 与急性传染病暴发有关的健康和心理社会并发症。我们的 目标是了解身体和生态对身体健康的影响，认知 和情绪发展；并告知有助于发展的干预措施 受埃博拉病毒影响的个人充分发挥其健康和富有成效的生活的潜力。 本研究以三个具体目标为指导：目标1：确定生态因素 埃博拉病毒感染者、感染者和非感染者风险和复原力的影响过程 孩子们。7-17岁的儿童和青年将从一个既定的队列中进行研究 塞拉利昂感染埃博拉病毒儿童(n=350)、埃博拉病毒感染儿童(n=350)和对照儿童(n=350) 里昂。我们将评估两个领域：(A)家庭和社区的接受度，以及 埃博拉病毒感染者或感染者遭受疾病耻辱的经历；和(B)心理社会 通过检查心理健康和适应态度对儿童和照顾者的适应 和行为。目标2：确定在身体健康和功能方面的差异 随着时间的推移，感染埃博拉病毒的儿童、感染埃博拉病毒的和未感染埃博拉病毒的儿童。我们将利用经过验证的 发展评估工具，用于识别感染、受影响和 控制儿童长期应激的指标：(A)认知健康和发育；(B) 身体健康；和(C)压力陈述，包括收集生物标记物样本。 目标3：加强关键组织开展持续研究的能力 弱势儿童和家庭的心理社会福祉和身体健康。我们会 与支持卫生系统和凯内马政府医院合作，加强 它们在两个领域的能力：(A)确定有临床意义的症状学和 建立适当的服务转介途径；和(B)改善诊断和 通过研究方法培训提高分析能力，并引入 急需的诊断设备及其使用方面的培训。

Project Abstract. The unprecedented 2013-2016 Ebola virus disease (EVD) epidemic resulted in more infections and deaths than all prior outbreaks in the 40-year history of this virus combined. Among the more than 28,000 people infected with EVD approximately 21% were children under the age of 16, and more than 16,000 children lost one or both parents during the outbreak. Prior research on chronic infectious diseases such as HIV has demonstrated lasting health, social and psychosocial outcomes. Yet, little is known about the long-term complications of EVD, or more generally, mental health and psychosocial complications related to acute infectious disease outbreaks. Our goals are to understand the physical and ecological effects on physical health, cognitive and emotional development; and to inform development of interventions that will help EVD-affected individuals achieve their full potential for healthy and productive lives. This study is guided by three Specific Aims: AIM 1: Identify ecological factors influencing processes of risk and resilience among EVD-infected, affected and unaffected children. Children and youth, aged 7-17 years, will be studied from an established cohort of EVD-infected (n=350), EVD–affected (n=350), and control (n=350) children in Sierra Leone. We will evaluate two areas: (a) Family and community acceptance, and the experience of disease stigma for those infected or affected by EVD; and (b) Psychosocial adjustment of children and caregivers by examining mental health and adaptive attitudes and behaviors. AIM 2: Identify differences in the physical health and functioning of EVD-infected, affected and unaffected children over time. We will utilize validated developmental assessment tools to identify differences among infected, affected, and control children in markers of long-term stress: (a) cognitive health and development; (b) physical health; and (c) stress presentation including collection of biomarker samples. AIM 3: Strengthen the capacity of key organizations to conduct ongoing research on vulnerable children and families' psychosocial well-being and physical health. We will partner with Sustaining Health Systems and Kenema Government Hospital to strengthen their capacities in two areas: (a) Identifying clinically significant symptomatology and creating appropriate referral pathways to services; and (b) Improving diagnostic and analytic capacity through training in research methodologies, and introduction of critically needed diagnostic equipment and training in its use.