David W. Brown

To examine associations between exposure to physical violence (PV) or sexual violence (SV) and adverse health behaviours among a sample of children in five African countries. In a cross-sectional analysis of data from Namibia, Swaziland, Uganda, Zambia and Zimbabwe – countries that participated in the Global School-based Student Health Survey in 2003 or 2004 – we compared the relative frequency of several adverse health behaviours among children (primarily students 13–15 years of age) who did and who did not report exposure to PV or SV. We estimated odds ratios (ORs) for such behaviours and their 95% confidence intervals (CIs) after adjusting for age and sex. Exposure to PV during the 12 months preceding the survey was reported by 27–50% (average: 42%) of the children studied in the five countries, and lifetime exposure to SV was reported by 9–33% (average: 23%). Moderate to strong associations were observed between exposure to PV or SV and measures of mental health, suicidal ideation, current cigarette use, current alcohol use, lifetime drug use, multiple sex partners and a history of sexually transmitted infection (P ≤ 0.05 for all associations). For example, the odds of being a current cigarette smoker were higher in children involved in one fight (OR: 2.20; 95% CI: 1.77–2.75), 2–5 fights (OR: 3.43; 95% CI: 2.54–4.63), or 6 fights or more (OR: 5.95; 95% CI: 4.37–8.11) (P for trend < 0.001) during the 12 months preceding the survey than in children unexposed to PV. Childhood exposure to PV and SV is common among African children in some countries and is associated with multiple adverse health behaviours. In developing countries, increased awareness of the frequency of exposure to violence among children and its potential health consequences may lead to heightened attention to the need for health promotion and preventive programmes that address the problem.

Violence is an important public health challenge with substantial economic consequences for the affected individuals, families, and communities. Using data from the World Health Organization (WHO) and the World Bank, the economic value of disability-adjusted life years (DALYs) lost due to violence in 2002 was estimated for WHO Member States and presented as a percentage of gross domestic product (GDP). Results indicated an estimated 48.4 million DALYs were lost as a result of 1.6 million deaths due to violence in 2002, for a total estimated economic value of US$ 151 billion (in constant US$ for the year 2000). Expressed as a percentage of GDP, the economic value of DALYs lost due to violence ranged from 0.04% to 5.1% across the 193 Member States. Much more is needed in terms of quantifying the economic burden of violence globally, particularly in low- and middle-income countries, where the burden of violence is greatest.

Background and Purpose: Stroke occurs infrequently in young adults. While a familial basis for older onset stroke is well established, the extent of familial clustering in young-onset stroke is unknown. To address this issue, we compared the frequency of stroke in relatives of stroke cases to that in relatives of controls across different ages and by stroke subtype. Methods: Through a population-based case-control study of stroke, we identified 487 women aged 15–49 years with ischemic stroke and 615 women without stroke matched by age and geographic region. Family history of stroke was collected for 5,749 relatives (parents and siblings) of case and control probands by standardized interview. Results: Strokes were reported in 149 relatives of case patients and 119 relatives of controls. Siblings of stroke case patients had more than four times the risk of stroke compared to siblings of controls (OR, 4.17; 95% CI, 1.9–8.8) and mothers of stroke case patients had twice the risk of stroke compared to mothers of control subjects (OR, 2.02; 95% CI, 1.4–3.0). The association between stroke in probands and family history of stroke was strongest among women aged 15–24 years (OR, 2.5; 95% CI, 0.4–15.1), and diminished with increasing proband age (OR, 1.6; 95% CI, 0.8–3.3 among women 25–34 years and OR, 1.5; 95% CI, 1.1–1.9 among women 35--49 years; PGenet. Epidemiol. 2006. Published 2006 Wiley-Liss, Inc.