Poster #65 - Shaking of Very Young Children in Ghana and Sierra Leone: Prevalence and Risk Factors

• In Event: Poster Session 15

Abstract

Shaking of infants and young children can result in head trauma and death. Little, however, is known about prevalence of, and risk factors for, this behavior outside of high-income countries, despite the vast majority of children living in low- and middle-income countries (LMICs). One exception is a recent study of a national household sample from Chad in which shaking was reported to have occurred in the preceding month among 32.3% of children between 12 and 23 months of age (Alatorre, MacMillan & McLennan, 2022). This same study found that shaking was associated with (i) exposure to other types of physical punishment, (ii) a belief in the need for physical punishment in child rearing, (iii) the child having been left alone, and (iv) non-average size at birth (both larger and smaller), but not with several socioeconomic and demographic variables. Whether these associations are unique to Chad or generalizable to other LMICs is unknown. This study aimed to examine the same set of hypothesized predictor variables in two other Sub-Saharan African countries, using national household survey datasets (Multiple Indicator Cluster Surveys), from Ghana (2017-8) and Sierra Leone (2017). As with the Chad study, this study examined self-reported shaking by caregivers in the preceding month of a randomly selected child between 12-23 months of age in the household. Of the 1,557 households in the Ghana sample with a 12–23-month-old, 22.9% (95% confidence interval [CI]: 20.0, 26.1%) [weighted] were reported as shaken in the last month. Only exposure to other types of physical punishments was independently associated with shaking in the final adjusted logistic regression model. In bivariate analysis, spanking was the most strongly associated variable with shaking among the “other” physical punishments. Of the 1,126 households with a 12-23-month-old in the Sierra Leone sample, 15.6% (95% CI: 13.0, 18.5%) [weighted] were reported as shaken in the last month. Similar to both Ghana and Chad, shaking was associated with exposure to other physical punishments (in particular spanking). Similar to Chad, the belief in physical punishment was also associated with shaking in Sierra Leone. What accounts for the marked prevalence variation in shaking across these countries is unknown. The commonality of association with other physical punishments across countries may show that the main contributors to use of physical punishment extend to shaking. The lack of association with socioeconomic and demographic factors across countries suggests a need to examine other factors, potentially more indepth examination of beliefs and attitudes to identify possible causal variables.

Authors

• Isabella Alatorre, University of Calgary

• Harriet L. MacMillan, McMaster University

• John Duncan McLennan, University of Calgary (U of C)
  Presenting Author