The Institute for Global Health and Development
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Item Current tobacco use and susceptibility to using tobacco among non-users of tobacco: A cross-sectional study among school-going adolescents in Sierra Leone.(2023-01-30) James, Peter B; Kabba, John A; Bah, Abdulai Jawo; Idriss, Ayesha; Kitchen, Chenai; Conteh, Eugene B; Lahai, Michael; Dalinjong, Philip ATobacco use is a global health threat associated with a high disease burden and death. Current tobacco use and susceptibility to using tobacco products among adolescents who are potential adult tobacco users have not been explored in Sierra Leone. Thus, we aimed to estimate the prevalence and correlates of current tobacco use and tobacco non-users susceptibility to using tobacco amongst high school students in Sierra Leone. We used data obtained from the 2017 Sierra Leone Global Youth Tobacco Survey (GYTS), which presented information collected from 6680 students aged 11-17 years nationwide. Gender-based correlates of current use and susceptibility to using tobacco among non-tobacco users were determined by complex sample logistic regression analyses. Adjusted odds ratios (AOR) and respective 95% confidence intervals (CIs) are reported. A p<0.05 was considered significant. The prevalence of current tobacco use among high school adolescents in Sierra Leone was 24.6%, higher in males (27.9%) than in females (18.6%). Male (AOR=1.50; 95% CI: 1.18-1.91), parental smoking (AOR=1.73; 95% CI: 1.32-2.26) exposure to household secondhand smoke (AOR=1.82; 95% CI: 1.27-2.62), having peers who smoke (AOR=2.24; 95% CI: 1.51-3.31) were more likely to be currently using tobacco. The overall tobacco non-users susceptibility to using tobacco among adolescents in Sierra Leone was 18.2% (males 18.0%, females 18.5%). Exposure to tobacco promotion (AOR=1.50; 95% CI: 1.06-2.10) and non-exposure to anti-smoking education (AOR=1.39; 95% CI: 1.05-1.86) were significantly associated with tobacco non-users' susceptibility to using tobacco. Our study suggests that one in four school-going adolescents currently uses tobacco, with nearly one in five non-users susceptible to using tobacco. Given the high prevalence of tobacco product use among adults in Sierra Leone, our findings highlight the need for policies and interventions to prevent tobacco use behavior among adolescents, aimed at averting tobacco use in adulthood. [Abstract copyright: © 2023 James P.B. et al.]Item Sexual risk behaviour among school-going adolescents in Sierra Leone and Liberia: a secondary analysis of the 2017 Global school-based student health surveys(BioMed Central, 2022-12-24) James, Peter Bai; Osborne, Augustus; Bah, Abdulai Jawo; Margao, Emmanuel Kamanda; Conteh-Barrat, MohamedBackground: Sierra Leone and Liberia have experienced civil wars and, recently, Ebola outbreaks that led to profound economic hardship, psychopathologies and family disruptions. These factors are associated with sexual risk behaviours among youths. However, there is very little information on sexual risk behaviour among Sierra Leonean and Liberian school-going adolescents. The present study assessed the prevalence and determinants of sexual risk behaviours among school-going adolescents (10–19 years) in Sierra Leone and Liberia. Method: We used publicly available nationally representative cross-sectional datasets of the 2017 Sierra Leone and Liberia Global school health survey. The sample consisted of 2798 and 2744 school-going adolescents from Sierra Leone and Liberia, respectively. Complex sample descriptive and regression analysis was used to analyse our data. Results: The majority of adolescents in the two countries were involved in multiple sexual risk behaviour (80.2%), with a higher prevalence observed in Sierra Leone (85.2%) than in Liberia (75.3%). Liberian adolescents showed lesser odds of indulging in multiple sexual risk behaviours than their Sierra Leonean counterparts (AOR = 0.572; 95%CI: 0.345–0.946). Male, compared to females, were more likely to engage in multiple sexual risk behaviour (AOR = 2.310;95%CI:1.543–3.458), with a similar pattern observed in both countries. Alcohol use was associated with multiple sexual risk behaviour (AOR = 3.064; 95%CI: 2.137–4.392). Also, in Sierra Leone and Liberia, adolescents with one and two or more forms of psychological distress were more likely to have ever had sex than those who did not show any form of psychological distress. Missing class/school was associated with multiple sexual risk behaviour (AOR = 1.655; 95%CI:1.133–2.418). Peer support was only found to be a protective factor against no condom use among Liberian adolescents (AOR = 0.608; 95%CI: 0.435–0.850). Less parental support was only associated with ever had sex among adolescents in Sierra Leone (AOR = 2.027; 95%CI: 1.322–3.107) but not in Liberia (AOR = 1.034; 95%CI: 0.650–1.644). Conclusion: Our study found a high sexual risk behaviour among school-going adolescents in Sierra Leone and Liberia. Our finding highlights the need to strengthen sexual and reproductive health education in schools and communities that incorporate mental health promotion activities tailored to this group.Item The use of condoms and other birth control methods among sexually active school-going adolescents in nine sub-Saharan African countries(BioMed Central, 2022-12-16) James, Peter Bai; Osborne, Augustus; Babawo, Lawrence Sao; Bah, Abdulai Jawo; Margao, Emmanuel KamandaBackground: Adolescents in sub-Saharan Africa still face sexual and reproductive health challenges. Contraceptives have been used to address these challenges. Despite efforts at national and global levels, contraceptive uptake among young people in Africa remains a challenge due to personal, societal, and health systems-based barriers. We estimated the prevalence and correlates of condom use and other birth control methods among sexually active school-going adolescents in nine sub-Saharan African (SSA) countries. Methods: We conducted a secondary analysis of the Global School-based Student Health Surveys (GSHS) datasets pooled from nine SSA countries. We included a sample of 27,504 school-going adolescents 11 years and younger and 18 years and older. We employed meta-analysis using a random-effects model to estimate the total prevalence of the use of condoms, other birth control methods other than a condom and any birth control method at last sexual intercourse. We conducted complex sample descriptive and logistic regression analyses to determine the characteristics and determinants of not using condoms and other birth control methods among sexually active school-going adolescents in nine sub-Saharan African countries, respectively. Results: More than half [n = 4430, 53.8% (43.9–63.8)], two-fifth [n = 3242, 39.5% (33.2–45.9) and two-thirds of adolescents [n = 4838, 65.6% (57.5–73.7)] of sexually active in school adolescents across the nine sub-Saharan African countries used condom, other birth control methods and any form birth control method during their last sexual intercourse, respectively. The non-use of condoms at last sex was associated with being younger (less than 16 years) [AOR = 1.48;95%CI: 1.12–1.94], early sexual debut [AOR = 1.81(1.47–2.22)], having two or more sexual partners [AOR = 1.30(1.06–1.58)] and no/minimal parental support [AOR = 1.54(1.17–2.03)]. The non-use of other birth control methods at last sex was associated with being male [AOR = 1.37 (1.09–1.73)], early sexual debut [AOR = 1.83(1.48–2.27) and having no parental support [AOR = 1.64(1.34–2.00)]. Conclusion: Contraceptive need among sexually active school adolescents in the nine sub-Saharan African countries is high. Such a need calls for the development of country-specific and or the review of existing school-based sexual health education and youth-friendly sexual and reproductive health interventions that target risky adolescents and promote adolescent-parent effective communication, connectedness and support.Item Prevalence and correlates of current tobacco use and non-user susceptibility to using tobacco products among school-going adolescents in 22 African countries: A secondary analysis of the 2013-2018 global youth tobacco surveys(BMC, 2022-04-14) James, Peter Bai; Bah, Abdulai Jawo; Kabba, John Alimamy; Kassim, Said Abasse; Dalinjong, Philip AyizemBackground: Our study examined the prevalence and associated factors of tobacco product use and non-users’ susceptibility to using tobacco products among school-going adolescents in 22 African countries. Methods: We analyzed the cross-sectional 2013-2018 Global Youth Tobacco Survey (GYTS) data from 22 African countries. We conducted complex sampling descriptive and logistic regression analyses. Results: The overall prevalence of current use of any tobacco product among adolescents was 19.1%, with more males (23.7%) than females (13.7%) being current users. Zimbabwe and Morocco were the highest (47.1%) and least (12.6%) reported prevalence, respectively. Being male (AOR = 1.93;95%CI:1.61-2.32), being 16 and older(AOR = 1.37;95%CI:1.01-1.86), exposure to secondhand smoke within (AOR = 1.98;95%CI:1.69-2.32) and outside (AOR = 1.37;95%CI:1.13-1.65) the home, not knowledgeable about the harmful effect of secondhand smoke (AOR = 1.44;95%CI:1.20-1.74), exposure to tobacco industry promotion (AOR = 3.05;95%CI:2.68-3.47) and not in favour of banning smoking in enclosed places (AOR = 1.32;95%CI:1.08-1.60) were associated with current use of any tobacco product. The prevalence of the susceptibility to using tobacco products among never users of tobacco products was 12.2%, with no significant gender difference. Mozambique (24.6%) and Algeria (4.5%) had the highest and least prevalence of susceptibility to using tobacco products among never users, respectively. Exposure to tobacco industry promotion (AOR = 1.54;95%CI:1.31-1.82), those not in favour of banning smoking in enclosed places (AOR = 1.29;95%CI:1.14-1.45) and those not exposed to anti-smoking school education (AOR = 1.24;95%CI:1.06-1.46) were associated with susceptibility to using any tobacco product among never users of tobacco products. Conclusion: Our study reports that tobacco use and non-user susceptibility to using tobacco products among school-going adolescents in the 22 African countries is high. As part of public health efforts, governments and other stakeholders need to fully implement anti-tobacco use campaigns, enforce a complete ban on tobacco promotion and advertising, institute educational programs for families, and anti-tobacco use education for the general public and in schools in line with WHO Framework Convention on Tobacco Control guidelines.