title: Polyvictimization Among Children and Adolescents in Low- and Lower-Middle-Income Countries: A Systematic Review and Meta-Analysis.
abstract: Most of the world's children and adolescents live in low- and lower-middle-income countries (LALMIC), but there is limited evidence about polyvictimization (experiences of multiple forms of victimization) among them. The aims of this article were to systematically review the evidence from LALMIC about the overall prevalence of polyvictimization and to identify the associations between polyvictimization and health and well-being among children and adolescents.
  
  
  
  A systematic search of the English-language peer-reviewed literature to identify empirical, quantitative studies conducted in LALMIC between 2005 and 2015, assessing at least four forms of victimization among young people aged up to 19 years. Where prevalence of any victimization and of polyvictimization were reported, meta-analyses were performed.
  
  
  
  A total of 30/8,496 articles were included in the review. Evidence was available from 16/84 LALMIC and methodology and quality varied. Pooled prevalence of experiences of any victimization was 76.8% (95% confidence interval (CI) [64.8%, 88.9%]). Prevalence of polyvictimization ranged from 0.3% to 74.7% with an overall estimate of 38.1% (95% CI [18.3%, 57.8%]). None of the studies examined the associations between polyvictimization and physical or reproductive health or quality of life. Polyvictimization was associated with increased likelihood of mental health problems and involvement in health risk behaviors.
  
  
  
  Experiences of polyvictimization among children and adolescents in LALMIC are more prevalent than in high- and upper-middle-income countries and contribute to the burden of poor health among children and adolescents. Most LALMIC lack local data, and research is required to address this knowledge gap.
authors.affiliation: 1 Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, Victoria, Australia.
authors.forename: Minh T H
authors.initials: MTH
authors.lastname: Le
authors.affiliation: 1 Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, Victoria, Australia.
authors.forename: Sara
authors.initials: S
authors.lastname: Holton
authors.affiliation: 2 The Ian Potter Library, the Alfred Hospital, Melbourne, Victoria, Australia.
authors.forename: Lorena
authors.initials: L
authors.lastname: Romero
authors.affiliation: 1 Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, Victoria, Australia.
authors.forename: Jane
authors.initials: J
authors.lastname: Fisher
mesh_terms: D000293:Adolescent; D002648:Child; D002650:Child Abuse, Sexual / Q000523:psychology*; D019548:Crime Victims / Q000523:psychology* / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D003906:Developing Countries / Q000706:statistics & numerical data; D000069581:Exposure to Violence / Q000523:psychology*; D006801:Humans; D011203:Poverty
keywords: adolescents; child abuse; cultural contexts; mental health and violence; sexual harassment; vicarious trauma