Reintegrating Children Living at Landfills in Burundi Into Society by Means of a Comprehensive Family Program Addressing Maltreatment and Mental Health Symptoms

Reintegrating Children Living at Landfills in Burundi Into Society by Means of a Comprehensive Family Program Addressing Maltreatment and Trauma-related Mental Health Symptoms

Children living at the landfills of Bujumbura are often exposed to maltreatment, including emotional neglect and physical abuse, and traumatic experiences. Furthermore, they grow up in severe poverty. Addressing trauma-related mental health issues and aggressive behaviour by Narrative Exposure Therapy (FORNET), familial communication by family visits, interaction difficulties of children by a group intervention, poverty by financial support and economic training for mothers, medical problems by medical assistance, legal conflicts by legal advice, and providing access to school, we aimed at reintegrating those children within the Burundian school system and improving familial relationships.

The investigators want to provide evidence, that mental health interventions are an integral part of assisting children and families affected by poverty and violence.

Study Overview

• Status: Completed
• Conditions: Posttraumatic Stress Disorder; Aggressive Behaviour; Parental Maltreatment; Days Spent at the Landfill
• Intervention / Treatment: Behavioral: Comprehensive family intervention including individual sessions of FORNET

• Study Type: Interventional
• Enrollment (Actual): 96
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Burundi
  • Bujumbura Mairie
    • Bujumbura, Bujumbura Mairie, Burundi
      • vivo international & Psychologues sans Frontières mental health center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 7 years to 18 years (ADULT, CHILD)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Spending days at the landfills of Bujumbura

Exclusion Criteria:

• Psychotic symptoms

Study Plan

How is the study designed?

Design Details

• Primary Purpose: TREATMENT
• Allocation: NON_RANDOMIZED
• Interventional Model: PARALLEL
• Masking: NONE

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
EXPERIMENTAL: Intervention group; Children and adolescents in the intervention group received: A group intervention once a week for about 20 weeks, including psychoeducation on mental health and drug abuse, anger management, roles within families, developing plans for the future, communication skills, sex education.; Access to schools and school material; Family visits; Their parents received training regarding agriculture and microcredit projects, and financial assistance; FORNET if affected by trauma-related symptoms, and/or acting aggressive; If needed medical assistance is provided; If needed legal assistance is provided	Behavioral: Comprehensive family intervention including individual sessions of FORNET; A group intervention once a week for about 20 weeks, including psychoeducation on mental health and drug abuse, anger management, roles within families, developing plans for the future, communication skills, sex education.; Access to schools and school material; Family visits; Their parents received training regarding agriculture and microcredit projects, and financial assistance; FORNET if affected by trauma-related symptoms, and/or acting aggressive; If needed medical assistance /.) If needed, legal assistance
NO_INTERVENTION: Control group; The control group was invited to participate in three interviews getting small amounts of money (~2,5 €) as decompensation of their time.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change of load of traumatic symptoms measured via the University of California at Los Angeles Posttraumatic Stress Disorder Reaction Index (scale administered by Clinicians)	27 items assessing PTSD, 4 additional items assessing dissociation on a scale from 0 - 4. Due to scoring rules, total sum score ranges from 0 to 80; sub scale intrusion: 0 - 20; sub scale avoidance: 0 - 8; sub scale negative cognitions: 0 - 28; sub scale hyperarousal: 0 - 24; higher values indicate more severe PTSD symptoms; all items are summed up for the total score	baseline; 5 months follow-up; 9 months follow-up
Change of number of aggressive acts measured via an adaption of the Domestic and Community Violence Checklist	32 items; answer categories: yes or no; sum score ranges from 0 - 32	baseline; 5 months follow-up; 9 months follow-up
Change of experienced parental maltreatment measured via a shortened version of the Maltreatment and Abuse Chronology of Exposure (MACE)	total sum score ranges from 0 - 100; sum score of each sub scale ranges from 0 - 10	baseline; 5 months follow-up; 9 months follow-up
Change of number of days spent at the landfill	during the last 14 days; sum ranges from 0 - 14	baseline; 5 months follow-up; 9 months follow-up

Collaborators and Investigators

• Sponsor: University of Konstanz
• Collaborators: Vivo international e.V.; Psychologues sans Frontières Burundi; Université Lumière de Bujumbura

Study record dates

Study Major Dates

• Study Start (ACTUAL): March 1, 2018
• Primary Completion (ACTUAL): March 30, 2019
• Study Completion (ACTUAL): March 30, 2019

Study Registration Dates

• First Submitted: February 15, 2019
• First Submitted That Met QC Criteria: February 15, 2019
• First Posted (ACTUAL): February 19, 2019

Study Record Updates

• Last Update Posted (ACTUAL): April 25, 2019
• Last Update Submitted That Met QC Criteria: April 24, 2019
• Last Verified: April 1, 2019

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Behavioral Symptoms; Mental Disorders; Trauma and Stressor Related Disorders; Stress Disorders, Traumatic; Aggression; Stress Disorders, Post-Traumatic
• Other Study ID Numbers: UKCR18

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Currently there is no plan to share IPD with other researchers not related to the institutions conducting the study. If data is shared, the PI will supervise those analysing the date, e.g., students writing their theses

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No