Africa Knowledge Hub for Children

Peer-reviewed articleEurope PMC1 Sept 2026

'Let's Just Hope for the Best': A Photovoice Study Exploring the Impact of Covid-19 Restrictions on Children With Intellectual Disabilities in the UK.

Background To date, little research has explored children with intellectual disabilities' own experience of the Covid-19 pandemic. The current study used photovoice to explore the impact of Covid-19 on children with intellectual disabilities. Method Sessions were carried out with (n = 13) children aged 8-16 years across five sessions with five small groups (either face-to-face or video calls) between November 2021-March 2022. Results Three main themes (1) "Nobody likes the lockdown"; (2) "You don't want the Covid [to] get you"; (3) Everything is Different Now were connected to an overarching theme of (Im)Permanence. Conclusions Children with intellectual disabilities were anxious during the Covid-19 pandemic and employed numerous coping strategies (such as distracting themselves with sensory-based activities). Despite looking forward to seeing family/friends, children reported worries and hesitancy about returning to 'normal', indicating potential lasting effects of the lockdown.

Mair APA, Khawam G, Christie H et al.

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Peer-reviewed articleEurope PMC8 Jun 2026

Social connectedness in mobile gaming: how family dynamics shape children's virtual interactions.

Background Mobile gaming is important for children's social interaction, but its impact on real-life social connectedness depends heavily on family dynamics. How family patterns shape children's emotional and social experiences around gaming remains underexplored, particularly qualitatively. This study examined how family dynamics influence children's belonging, emotion regulation, and virtual interactions in mobile gaming. Methods Using a phenomenological design, we conducted semi-structured interviews with 20 participants from 10 families across urban, suburban, and rural China. Participants included children (n=10, aged 10-12), parents (n=8, all mothers), and siblings (n=2). All children had played mobile games for ≥6 months. Data were analyzed via thematic analysis (Braun & Clarke). Family patterns were identified based on parental mediation, emotional communication, and children's sense of connectedness. Results Three family patterns emerged. Restrictive-Control Families (4/8) showed high monitoring and low trust, linked to concealment, tension, and social shift to virtual peers. Supportive Co-Play Families (3/8) exhibited shared play, emotional communication, and digital-offline continuity, with children reporting greater resilience and belonging. Sibling-Mediated Families (3 families) featured siblings as companions and emotional buffers, helping manage frustration without direct parental involvement. No severe conflicts or distress were directly caused by gaming in any pattern. Conclusions Children's mobile gaming outcomes are shaped by relational context, not just time. This study identifies three family-level regulatory mechanisms: suppression (restrictive-control), cognitive reappraisal (supportive co-play), and co-regulation (sibling-mediated). These findings extend Social Connectedness Theory, showing how family patterns shape children's emotion regulation. Supportive co-play and sibling mediation facilitate adaptive regulation and connectedness, while restrictive-control may drive children to virtual spaces. Family-based interventions targeting emotion regulation, not just screen reduction, are recommended. Shifting from "anti-addiction" to "developmental enhancement" offers a safe, practical strategy for integrating gaming into family life.

Pang L, Mustafa SE, Gong J et al.

CNRead at source

Peer-reviewed articlePubMed Central (PMC)1 Dec 2020

DIPG-84. COMPLEMENTARY AND ALTERNATIVE MEDICINE IN DIFFUSE INTRINSIC PONTINE GLIOMA

Abstract INTRODUCTION Diffuse intrinsic pontine glioma (DIPG) is a rare and aggressive childhood brainstem malignancy with a two-year survival rate of ≤10%. In this international survey study we aim to evaluate the use of complementary and alternative medicine (CAM) in this patient population. METHODS Parents of-, and physicians treating DIPG patients were asked to participate in a retrospective online survey with questions regarding CAM use during time of illness. RESULTS 120 parents and 75 physicians contributed to the online survey between January and May 2020. Physicians estimated that <50% of their patients used CAM, whereas 69% of the parents reported to have used CAM to treat their child during time of illness. Cannabis was the most widely used form of CAM, followed by vitamins and minerals, melatonin, curcumin and boswellic acid. CAM was mainly used to actively treat the tumor. Other motivations were to treat side effects of chemotherapy, or to comfort the child. Children diagnosed ≥2016 were more likely to use CAM (χ2=6.08, p=0.014). No significant difference was found between CAM users and non-users based on ethnicity (χ2=4.18, p=0.382) and country of residence (χ2=9.37, p=0.154). Almost 50% of the physicians do not frequently ask their patients about possible CAM use. CONCLUSION This survey demonstrates that worldwide a considerable number of DIPG patients use CAM. Physicians should be more aware of potential CAM use and more actively discuss the topic. More research is needed to gain knowledge about possible anticancer effects of CAM and their interactions with conventional therapies.

El-Khouly F, Adil S, Hendrikse H et al.

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Peer-reviewed articleEurope PMC24 Jul 2026

Heavy metal contamination in pharmaceuticals: A narrative review of prevalence, health risks, and regulatory gaps in Nigeria.

Pharmaceutical quality and safety are critical to public health, yet low- and middle-income countries such as Nigeria remain vulnerable to medicine safety challenges due to weak regulatory enforcement and limited market surveillance. A major concern is contamination of pharmaceutical products with toxic heavy metals, including lead, cadmium, mercury, arsenic, nickel, and chromium. These metals can bioaccumulate and cause adverse health effects even at low concentrations, such as neurodevelopmental impairment, renal and hepatic dysfunction, reproductive toxicity, and cardiovascular complications. This narrative review synthesised evidence on the prevalence of heavy metal contamination in pharmaceuticals marketed in Nigeria, associated health risks, and the adequacy of existing regulatory frameworks.Relevant literature published between 2005 and 2025 was identified through a comprehensive literature search of major databases such as PubMed, Google Scholar, African Journals Online, and Scopus, supplemented with reports from the National Agency for Food and Drug Administration and Control, the World Health Organisation, and grey literature. Studies assessing industrially manufactured or over-the-counter medicines for heavy metal contamination in Nigeria were included.The findings reveal recurrent contamination across several pharmaceutical categories, particularly syrups, locally manufactured analgesics, and herbal preparations. Lead and cadmium were the most frequently reported contaminants, with some products containing multiple metals and exceeding pharmacopeial limits. Heavy metal exposure induces oxidative stress and cellular damage, contributing to kidney injury, neurotoxicity, haematological effects, and endocrine disruption. Children, pregnant women, individuals with renal impairment, and frequent users of herbal medicines were identified as particularly vulnerable. Overall, heavy metal contamination remains a significant medicine safety concern in Nigeria, highlighting the need for stronger regulation, improved analytical capacity, and risk-based surveillance.

Ogungbe BA, Atanda DO, Bepo JA et al.

NGRead at source

Peer-reviewed articlePubMed Central (PMC)18 Jun 2021

Child parent psychotherapy in the treatment of severe trauma in a 4-year-old child with co-occurring autism spectrum disorder

Aims This poster describes Child Parent Psychotherapy (CPP) in the treatment of severe trauma in a 4-year-old child with co-occurring Autism Spectrum Disorder (ASD). Background The London Infant and Family Team (LIFT) implements the New Orleans Intervention Model. It targets the mental health needs of under 5 year olds, providing evidence based assessments and interventions for infants, their parents and foster carers within the framework of the Family Court in England. The majority of children seen by LIFT have suffered severe trauma. LIFT delivers a range of interventions including CPP - a relational treatment for young children who have experienced trauma. CPP seeks to intervene in a number of ways: provides developmental guidance, demonstrates that the child's behaviour has meaning and can be linked to past traumas, enables the child to have space to play and talk about what has happened, helps to name and contain emotions - supporting emotional regulation, and helps the dyad to understand each other. The dyadic relationship is key to the intervention - helping to establish safety for the child and strengthen the caregiver-child relationship, enabling the child to make sense of past experiences and learn new ways to express feelings. Exploration of trauma takes place through a combination of play and interpretations made by the clinician, who supports and holds in mind the experiences and history of both child and carer. There is evidence that CPP helps young traumatised children to become less anxious, more secure in their attachment relationships and more able to cue their needs. There is less evidence of the efficacy of CPP in the context of young children with a co-occurring diagnosis of ASD. Method The poster describes the assessment of a 4-year-old child of normal intelligence with a two year history of severe neglect, and physical and emotional abuse, who presented significant behavioural and emotional disturbance. Tools used to assess the child's behaviour, trauma symptoms and ASD are outlined. The process of CPP with the child and foster carer dyad is described. Outcome measures and symptom resolution are reported. Conclusion Co-occurrence of ASD did not prevent this child accessing trauma therapy. He engaged in symbolic play, made use of CPP interpretations, and achieved significant improvement in his symptoms. The differential diagnoses of trauma symptoms and ASD presenting in young children are discussed, alongside the importance of understanding and treating trauma in this context.

Lamb C, O'Sullivan B

ProtectionRead at source

Peer-reviewed articlePubMed Central (PMC)13 Aug 2021

Bridging the treatment gap in India: Online training of psychologists in basic mental health services

Introduction The National Mental Health Survey of India 2015-16 (Gururaj et al., 2016) indicated a large treatment gap of 70-92% for mental disorders and a paucity of mental health specialists in the country. In order to address this treatment gap and develop human resources, the National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India, with impetus from the Ministry of Health and Family Welfare, Govt. of India, launched the online course of Diploma in Community Mental Health for Psychologists. Objectives The course was designed with the objective of training individuals with a Master’s Degree in Psychology, in providing first-level psychological care in the community. Methods The course is a 3-month online programme comprising of approximately 25 hours of self-paced e-learning and 11 hours of live real-time interactive discussion via video conference. The course comprises of 6 modules, with an assessment at the completion of each module. Pre- and Post-Assessment is conducted to evaluate competencies achieved. Results On successful completion of the course, trainees are expected to have achieved competencies to: Screen for and identify mental health problems in adults and children, and understand factors influencing them; Understand management options; Conduct interview-based functional developmental assessment for intellectual deficits; Conduct first-level brief psychosocial interventions; Make appropriate referrals to Mental Health Professionals and other health professionals. Conclusions This digitally-driven online course is a viable option for development of human resources on a large scale, in a resource-scarce (i.e. of mental health specialists) country such as India. Disclosure No significant relationships.

Kapanee A, Sudhir P, Suman L

INRead at source

Peer-reviewed articleEurope PMC28 Aug 2026

Rapid review of gender-affirming healthcare for children and adolescents: Evidence synthesis (2021-2025) and recommendations for South Africa.

Background Since the publication of the Southern African HIV Clinicians Society Gender-Affirming Healthcare (GAHC) Guideline in 2021, global evidence on care for transgender and gender-diverse (TGD) youth has expanded. An updated, locally grounded, evidence-informed assessment of health outcomes can support South African stakeholders, particularly as both adolescents and TGD persons are populations of relevance to HIV prevention, sexual health, and integrated healthcare programmes in South Africa. Objectives To synthesise global empirical evidence (2021-2025) across psychosocial, endocrine, surgical, policy, and non-medical gender-affirming interventions for TGD youth under 18, with attention to South Africa's social, legal, and health-system, and HIV-service delivery context. Method A rapid review was conducted across 12 databases, supplemented by targeted searches for recent systematic reviews. Eligible sources comprised peer-reviewed empirical studies (N ≥ 5) reporting psychosocial or physical health outcomes of relevant interventions for TGD youth under 18 (or their families), and systematic or grey-literature reviews with reproducible methods. Findings were synthesised narratively by intervention domain. Results The review included 200 primary studies, 29 academic systematic reviews, and four grey-literature reviews. Affirming psychosocial interventions were associated with reduced distress, anxiety and suicidality, and improved functioning and belonging. Puberty blockers and hormone therapy produced expected physiological outcomes under specialist care, with generally mild adverse events and stable or improved mental health. Restrictive policies were linked to poorer mental health, while protective policies improved outcomes. Most studies were small, observational, and Global North-focused. Conclusion Evidence supports the safety and effectiveness of GAHC for TGD youth. Strengthening affirming care, timely clinical access, and protective policies in South Africa may improve healthcare engagement and support the delivery of integrated adolescent, sexual health, and HIV-related services for TGD youth.

Lynch I, Dunkle KL, McLachlan C et al.

ZARead at source

Peer-reviewed articlePubMed Central (PMC)1 May 2021

711 Changes in Healthcare Visits and Sleep Medication Use in Sleep Medicine Patients during the COVID-19 Pandemic

Abstract Introduction Patients may be experiencing increased stress and sleep disturbance due to healthcare changes during the COVID-19 pandemic. Healthcare changes may include telemedicine visits, delayed or canceled appointments and sleep studies. The purpose of this study was to assess the association between changes in healthcare and sleep medication use on sleep disturbance and insomnia severity. Methods Between June-November 2020, 81 sleep medicine clinic patients (54.8 ± 15.9 y, 44% male, 69% Caucasian) completed an online survey that included questions about COVID-19 (tested for coronavirus, test results, willingness to be vaccinated for COVID-19, changes in health care visits and sleep medications during the pandemic), PROMIS measures (Sleep Disturbance, Sleep-Related Impairments), and Insomnia Severity Index (ISI). Stepwise linear regression was performed using SAS to determine if changes in healthcare and sleep medications predicted poorer sleep. Results Among participants, 32% were tested for coronavirus, out of those 8% tested positive for COVID-19. 74% were willing to get vaccinated and 65% were willing to get their children vaccinated. 35% changed their healthcare office appointments to telephone visits, 54% changed to video visits; whereas 26% cancelled and 32% rescheduled their healthcare appointments. Changes in health care visits during the pandemic had a significant increase on ISI score (3.98 ± 1.66, p=0.019). Changes in sleep medication during the pandemic had significant effect on Sleep Disturbance (7.15 ± 2.51, p=0.005), Sleep-Related Impairments (8.69 ± 2.68, p=0.001) and ISI (6.04 ± 1.66, p=0.001) measures. Conclusion Sleep medicine patients who reported changes in sleep medication reported higher insomnia severity, sleep disturbance, and sleep-related impairments. Patients who reported changes in healthcare visits during the pandemic reported higher insomnia severity. Assessing sleep medication changes and preference for healthcare visit format is advised when treating sleep medicine patients during the pandemic. Support (if any) This work is supported by National Institutes of Health (NIH) Grant # R01NR018342 (PI: Nowakowski) and by the Department of Veteran Affairs, Veterans Health Administration, Office of Research and Development, and the Center for Innovations in Quality, Effectiveness and Safety (CIN 13–413).

Debian A, Arentson-Lantz E, Kokanda M et al.

SurvivalRead at source

Peer-reviewed articleEurope PMC18 Feb 2026

A systematic review of school-based interventions to promote digital resilience in children.

This systematic review investigates the novel concept of digital resilience, how school-based interventions address this and the extent to which they are effective. Four databases were searched and 15 interventions meeting the inclusion criteria were identified. Quality was assessed using the Mixed Methods Appraisal Tool, study data were extracted, and behaviour change techniques were coded. Recognition of online risks was taught effectively across most interventions and management of online risks had some coverage which was mostly effective. However, few interventions included the teaching of recovery from online risks, and this was rarely assessed as an outcome measure. Therefore, future interventions and curricula should aim to have a greater focus on digital resilience in its entirety in which children can recognize and manage online risks and go on to recover following exposure to online risks.

Halliwell GC, Rose SE, Cooke R et al.

DevelopmentRead at source

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