{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T14:56:00Z","timestamp":1793199360930,"version":"4.5.0"},"reference-count":42,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,1,20]],"date-time":"2022-01-20T00:00:00Z","timestamp":1642636800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"publisher","award":["R01 TW011228"],"award-info":[{"award-number":["R01 TW011228"]}],"id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R01 DA043657"],"award-info":[{"award-number":["R01 DA043657"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Child"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Adverse childhood events (ACEs) are associated with negative health effects in adulthood. Despite knowledge of these later impacts, little is known about the earlier effect of ACEs on later child behaviour in low\u2010 and middle\u2010income countries (LMIC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The population\u2010based Asenze cohort study was implemented in a peri\u2010rural area of KwaZulu\u2010Natal, South Africa, comprising five Zulu tribal areas. Two waves of data were examined: family information and ACEs exposure when children were on average 5\u00a0years old and child behaviour problems (Strengths and Difficulties Questionnaire [SDQ]) approximately 2\u2009years later (average age 7\u00a0years). Logistic regression analysis was used to examine unadjusted and adjusted relationships between cumulative ACEs experienced and the SDQ total scores (dichotomized as top 10% vs. the rest) as well as selected SDQ subscales.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A significant relationship between increased ACE exposure and SDQ total score was observed. The same relationship was also seen for the SDQ emotional symptoms and conduct problem subscales, but not for hyperactivity. The results of a sensitivity analysis excluding intimate partner violence from the ACEs measure demonstrated similar results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There is an association between exposure to ACEs and later child behaviour problems within this LMIC population demonstrating an early negative impact for ACEs. While previous research has focused on the effects of ACEs on adult health, this study provided evidence for an earlier relationship between ACEs and child behaviour problems that may be a part of the mechanism through which later health effects arise.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cch.12950","type":"journal-article","created":{"date-parts":[[2021,12,16]],"date-time":"2021-12-16T02:03:15Z","timestamp":1639620195000},"page":"494-502","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Adverse childhood experiences (ACEs) and child behaviour problems in KwaZulu\u2010Natal, South Africa"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1380-8116","authenticated-orcid":false,"given":"Meaghan L.","family":"Nazareth","sequence":"first","affiliation":[{"name":"Department of Epidemiology Columbia University Mailman School of Public Health  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5519-3741","authenticated-orcid":false,"given":"Jane D.","family":"Kvalsvig","sequence":"additional","affiliation":[{"name":"School of Nursing and Public Health University of Kwa\u2010Zulu Natal  Durban South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claude A.","family":"Mellins","sequence":"additional","affiliation":[{"name":"HIV Center for Clinical and Behavioral Studies at Columbia University and New York State Psychiatric Institute  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Desmond","sequence":"additional","affiliation":[{"name":"School of Nursing and Public Health University of Kwa\u2010Zulu Natal  Durban South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuaib","family":"Kauchali","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Nelson Mandela University  Port Elizabeth South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie L.","family":"Davidson","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Columbia University Mailman School of Public Health  New York New York USA"},{"name":"Department of Pediatrics, College of Physicians &amp; 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