*Faculty of Health Sciences (ETDs)
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Browsing *Faculty of Health Sciences (ETDs) by SDG "SDG-10: Reduced inequalities"
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Item Correlation of maternal age to their children born with orofacial cleft treated at Wits Oral Health Centre(2024) Ravat, NaseebaObjectives: Orofacial Clefts (OFC) are the most common congenital malformations of the craniofacial complex. OFC affects 1/700 live births globally with extensive variability across geographic origin, racial and ethnic populations. In South Africa the prevalence of OFC is 0.3 per 1000 live births. Advanced maternal age has been associated with cell division errors, that can predispose to the occurrence of OFC. This study evaluated the correlation of advanced maternal age with the occurrence of OFC and the types of OFC. Methods: A retrospective cross-sectional study was conducted to review records of 105 children with OFC from 1 January 2013 to 31 December 2019. The clinical information reviewed included the child’s sex, race and type and laterality of OFC. The mother’s demographic information including the age at birth to the child with OFC, race, marital status, education level, number of children that the mother gave birth to as well as the familial history of OFC was documented. Stata version 17.0 was used to analyse the data and statistical tests were conducted at a 5% significance level. Results: The mean maternal age at the birth of a child with OFC was 26 years, with a range of 17-46 years. The majority of the mothers were Black (64.76%) followed by White (14.29%), Indian (11.43%) and Coloured (9.52%). There were more female children with OFC (51.43%) compared to male children (48.57%). Most of the children were Black (63.81%) followed by White (12.38%), Indian (11.43%) and Coloured (10.48%). The predominant type of OFC was the unilateral cleft lip and palate (CLP) occurring on the left side of the face (39.05%) compared to the right side (23.81%). Bilateral CLP was observed in 28.67% of children, and 0.57% of children had a cleft palate only. Mothers who gave birth to children with right CLP were older (over 30 years old) compared to those who gave birth to children with left CLP (under 25 years old). No statistical significance was found between maternal age and OFC. Conclusions- The clinical appearance of OFC highlighted the maternal age differences to type of OFC in our study sample. Children with right CLP were born to older mothers whilst the youngest mothers had children with CP. The majority of the mothers were unemployed, single parents with low level of education. This signified the burden of care these single parents have in caring for their children with OFC.Item The relationship between violence across the life course, protective factors and mental disorders among adult women living in a slum setting in Ibadan, Nigeria(2024) Sekoni, Olutoyin OlubunmiResearch suggests that adult women in Nigeria have experienced traumatic events (TE) across their life course. Violence is a TE that can occur within intimate relationships as well as other spheres of life. TE and adverse life events can increase risk of a mental disorder such as: depression, anxiety and Post Traumatic Stress Disorder (PTSD). Despite experience of TE or adverse life events, some women do not experience the onset of a mental disorder which may be due to protective factors such as resilience and social support. The links between lifecourse TE and the development of common mental disorders have not been well researched on the African continent particularly in slum settings. This thesis aimed to investigate the relationships between adult women’s childhood trauma, experiences of Intimate Partner Violence (IPV) and adverse life events and common mental disorders among adult women living in a slum setting in Ibadan, Nigeria. The thesis also sought to examine the presence of protective factors in these relationships. Methods -A community-based cross-sectional household survey utilizing multistage sampling was carried out among 550 women. Childhood trauma was measured using the short form of the Childhood Trauma Questionnaire. IPV was measured using the WHO Multi-country Study on Women's Health and Domestic Violence Questionnaire. Common mental disorders were measured using the short version of the Depression, Anxiety and Stress Scale (DASS-21) while the Harvard Trauma Questionnaire was used to measure PTSD. Recent stressors were measured using the Life Events Questionnaire. The protective factors of resilience, social support, social connectedness and self- esteem were measured using the Wagnild and Young resilience scale, the Multidimensional Scale of Perceived Social Support, the Social Connectedness Scale (Revised) and the Rosenberg self-esteem scale respectively. Bivariate and multivariate analysis were conducted to identify any associations and net effect of the key independent variables on the primary outcomes of interest while controlling for socio demographic characteristics. Results The prevalence of lifetime and past year experience of IPV were 31.5% and 14.8% respectively. The prevalence of the TE during childhood ranged from 8.9% (sexual abuse), 50.4% physical abuse and 70.4% emotional abuse, while 30.8%, 41.6% and 5.8% had experienced one, two and three forms of childhood trauma respectively. Women who had experienced all three forms of childhood trauma had five times the odds of reporting a lifetime experience of IPV compared to those who had not had any experience of childhood trauma (OR= 5.21; CI= 2.30-11.76). Common mental disorders were reported by 14.0% of the respondents, with PTSD reported by 4.18%. Resilience and social support were found to be protective against reporting symptoms of common mental disorders. Women who reported higher levels of social support and resilience were less likely to report common mental disorders (OR:0.96, 95% CI 0.93, 0.98) and (OR:0.95, 95% CI 0.91, 0.99) respectively. Women who were 65 years and older were also less likely to report the occurrence of common mental disorders (OR:0.38, 95% CI 0.15, 0.98) compared to those aged 18–34 years. Conclusion- The findings from this study show that trauma over the life course is prevalent among the women in these slums as a result of childhood trauma, IPV and recent stressors. The findings also show that even though many of the women were exposed to trauma, most of them did not develop mental disorders. Resilience and social support appeared to play an important role in mitigating the effects of adversity among this population of women even in the light of their extant circumstances within the slum setting. Addressing the use of both child protection programs and IPV reduction as well as fostering resilience and social support among women would be of benefit in reducing the burden of common mental disorders.