title: Investigating the psychosocial determinants of child health in Africa: The Drakenstein Child Health Study.
abstract: BACKGROUND
  Early life psychobiological and psychosocial factors play a key role in influencing child health outcomes. Longitudinal studies may help elucidate the relevant risk and resilience profiles, and the underlying mechanisms that impact on child health, but there is a paucity of birth cohort data from low and middle-income countries (LMIC). We describe the rationale for and present baseline findings from the psychosocial component of the Drakenstein Child Health Study (DCHS).
  
  
  METHODS
  We review the psychosocial measures used in the DCHS, a multidisciplinary birth cohort study in a peri-urban area in South Africa, and provide initial data on psychological distress, depression, substance use, and exposure to traumatic stressors and intimate partner violence (IPV). These and other measures will be assessed longitudinally in mothers in order to investigate associations with child neurodevelopmental and health outcomes.
  
  
  RESULTS
  Baseline psychosocial data is presented for mothers (n=634) and fathers (n=75) who have completed antenatal assessments to date. The sample of pregnant mothers is characterized by multiple psychosocial risk factors, including a high prevalence of psychological distress and depression, high levels of substance use, and high exposure to traumatic stressors and IPV.
  
  
  CONCLUSIONS
  These data are consistent with prior South African studies which have documented a high prevalence of a multitude of risk factors during pregnancy. Further longitudinal assessment of mothers and children may clarify the underlying psychobiological and psychosocial mechanisms which impact on child health, and so inform clinical and public health interventions appropriate to the South African and other LMIC contexts.
authors: Department of Psychiatry and Mental Health, University of Cape Town, South Africa; Medical Research Council (MRC), Unit on Anxiety & Stress Disorders, South Africa. Electronic address: dan.stein@uct.ac.za.
authors: D J
authors: DJ
authors: Stein
authors: Department of Psychiatry and Mental Health, University of Cape Town, South Africa; Medical Research Council (MRC), Unit on Anxiety & Stress Disorders, South Africa.
authors: N
authors: N
authors: Koen
authors: Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and Medical Research Council Unit on Child & Adolescent Health, University of Cape Town, South Africa.
authors: K A
authors: KA
authors: Donald
authors: Department of Psychiatry and Mental Health, University of Cape Town, South Africa.
authors: C M
authors: CM
authors: Adnams
authors: Department of Psychiatry and Mental Health, University of Cape Town, South Africa.
authors: S
authors: S
authors: Koopowitz
authors: Department of Psychiatry and Mental Health, University of Cape Town, South Africa.
authors: C
authors: C
authors: Lund
authors: Department of Psychiatry and Mental Health, University of Cape Town, South Africa.
authors: A
authors: A
authors: Marais
authors: Department of Psychiatry and Mental Health, University of Cape Town, South Africa; Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, South Africa.
authors: B
authors: B
authors: Myers
authors: Medical Research Council (MRC), Unit on Anxiety & Stress Disorders, South Africa; Department of Psychiatry, Stellenbosch University, South Africa.
authors: A
authors: A
authors: Roos
authors: Department of Psychiatry and Mental Health, University of Cape Town, South Africa.
authors: K
authors: K
authors: Sorsdahl
authors: Department of Psychiatry and Mental Health, University of Cape Town, South Africa.
authors: M
authors: M
authors: Stern
authors: Department of Psychology, Stellenbosch University, South Africa.
authors: M
authors: M
authors: Tomlinson
authors: Department of Psychiatry and Mental Health, University of Cape Town, South Africa.
authors: C
authors: C
authors: van der Westhuizen
authors: Department of Psychiatry and Mental Health, University of Cape Town, South Africa.
authors: B
authors: B
authors: Vythilingum
authors: School of Public Health and Family Medicine, University of Cape Town, South Africa.
authors: L
authors: L
authors: Myer
authors: Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and Medical Research Council Unit on Child & Adolescent Health, University of Cape Town, South Africa.
authors: W
authors: W
authors: Barnett
authors: Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and Medical Research Council Unit on Child & Adolescent Health, University of Cape Town, South Africa.
authors: K
authors: K
authors: Brittain
authors: Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and Medical Research Council Unit on Child & Adolescent Health, University of Cape Town, South Africa.
authors: H J
authors: HJ
authors: Zar
mesh_terms: D002648:Child; D002649:Child Abuse / Q000523:psychology*; D000067576:Child Health; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D009034:Mother-Child Relations; D011014:Pneumonia / Q000453:epidemiology / Q000209:etiology; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data; D012307:Risk Factors; D012959:Socioeconomic Factors; D013019:South Africa / Q000453:epidemiology; D013315:Stress, Psychological / Q000453:epidemiology*
keywords: Birth cohort; Child health; Depression; Intimate partner violence; South Africa; Substance use