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Association of Major Disease Outbreaks With Adolescent and Youth Mental Health in Low- and Middle-Income CountriesA Systematic Scoping Review

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Key Points

Question  Are major disease outbreaks from 2009 to 2021 associated with the mental health of adolescents and youth in low- and middle-income countries?

Findings  In this systematic scoping review of 6 databases, a total of 57 studies of the influenza A (H1N1) and SARS-CoV-2 infections revealed that these outbreaks were associated with adolescent and youth mental health. Results suggest high rates of anxiety and depressive symptoms, in addition to posttraumatic stress disorder, general stress, and health-related anxiety among adolescents.

Meaning  Findings suggest that the H1N1 and SARS-CoV-2 outbreaks were associated with adolescent and youth mental health; future studies with improved measurement tools and the inclusion of a wider range of mental disorders and risk factors will help ascertain how epidemics affect adolescent mental health in low- and middle-income countries.

Abstract

Importance  Adolescents and young people have been historically understudied populations, and previous studies indicate that during epidemics, these populations, especially in low- and middle-income countries (LMICs), are at high risk of developing mental disturbances.

Objective  To identify the existing evidence regarding the association of mental health with outbreaks of the influenza A (H1N1), Zika, Ebola, and SARS-CoV-2 virus in exposed youth and adolescents in LMICs.

Evidence Review  Across 6 databases (Embase, Cochrane Library, PubMed, PsycINFO, Scopus, and Web of Science), the mental health outcomes of adolescents and youth (aged 10-24 years) associated with 4 major pandemic outbreaks from January 2009 to January 2021 in LMICs were reviewed. A group of 3 authors at each stage carried out the screening, selection, and quality assessment using Joanna Briggs Institute checklists. The social determinants of adolescent well-being framework was used as a guide to organizing the review.

Findings  A total of 57 studies fulfilled the search criteria, 55 related to the SARS-CoV-2 (COVID-19) pandemic and 2 covered the H1N1 influenza epidemics. There were no studies associated with Zika or Ebola outbreaks that met screening criteria. The studies reported high rates of anxiety and depressive symptoms among adolescents, including posttraumatic stress disorder, general stress, and health-related anxiety. Potential risk factors associated with poor mental health outcomes included female sex; home residence in areas with strict lockdown limitations on social and physical movement; reduced physical activity; poor parental, family, or social support; previous exposure to COVID-19 infection; or being part of an already vulnerable group (eg, previous psychiatric conditions, childhood trauma, or HIV infection).

Conclusions and Relevance  Results of this systematic scoping review suggest that the COVID-19 pandemic and H1N1 epidemic were associated with adverse mental health among adolescents and youth from LMICs. Vulnerable youth and adolescents may be at higher risk of developing mental health–related complications, requiring more responsive interventions and further research. Geographically localized disease outbreaks such as Ebola, Zika, and H1N1 influenza are highly understudied and warrant future investigation.

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Article Information

Accepted for Publication: August 9, 2022.

Published Online: October 12, 2022. doi:10.1001/jamapsychiatry.2022.3109

Corresponding Author: Manasi Kumar, PhD, Brain and Mind Institute, Aga Khan University, 3rd Parklands Ave, Nairobi, Kenya (manasi.kumar@aku.edu).

Author Contributions: Drs Kumar and Akbarialiabad had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Kumar, Akbarialiabad, Taghrir, R. Shidhaye.

Acquisition, analysis, or interpretation of data: Kumar, Akbarialiabad, Forjoud Kouhanjani, Kiburi, P. Shidhaye, Taghrir.

Drafting of the manuscript: Kumar, Akbarialiabad, Forjoud Kouhanjani, Kiburi, Taghrir.

Critical revision of the manuscript for important intellectual content: Kumar, Akbarialiabad, Kiburi, P. Shidhaye, Taghrir, R. Shidhaye.

Statistical analysis: Kumar, Akbarialiabad, Kiburi, Taghrir.

Obtained funding: Kumar.

Administrative, technical, or material support: Kumar, Akbarialiabad.

Supervision: Kumar, Akbarialiabad, R. Shidhaye.

Conflict of Interest Disclosures: Dr Shidhaye reported receiving grant support from DBT-Wellcome Trust India Alliance Fellowship in Clinical and Public Health Research. No other disclosures were reported.

Additional Contributions: We thank Muhammad Rahman, BSc (University of Washington) for providing assistance in the first draft of this article and Vincent Nyongesa, BSc (University of Nairobi) for help with amending referencing in the final version of the paper. No one was financially compensated for their contribution.

References
1.
Guessoum  SB , Lachal  J , Radjack  R ,  et al.  Adolescent psychiatric disorders during the COVID-19 pandemic and lockdown.   Psychiatry Res. 2020;291:113264. doi:10.1016/j.psychres.2020.113264 PubMedGoogle ScholarCrossref
2.
Vagenas  P , Lama  JR , Ludford  KT , Gonzales  P , Sanchez  J , Altice  FL .  A systematic review of alcohol use and sexual risk-taking in Latin America.   Rev Panam Salud Publica. 2013;34(4):267-274.PubMedGoogle Scholar
3.
Sales  JM , Brown  JL , Vissman  AT , DiClemente  RJ .  The association between alcohol use and sexual risk behaviors among African American women across 3 developmental periods: a review.   Curr Drug Abuse Rev. 2012;5(2):117-128. doi:10.2174/1874473711205020117 PubMedGoogle ScholarCrossref
4.
Singh  S , Roy  D , Sinha  K , Parveen  S , Sharma  G , Joshi  G .  Impact of COVID-19 and lockdown on mental health of children and adolescents: a narrative review with recommendations.   Psychiatry Res. 2020;293:113429. doi:10.1016/j.psychres.2020.113429 PubMedGoogle ScholarCrossref
5.
Wang  C , Pan  R , Wan  X ,  et al.  Immediate psychological responses and associated factors during the initial stage of the 2019 Coronavirus Disease (COVID-19) epidemic among the general population in China.   Int J Environ Res Public Health. 2020;17(5):1729. doi:10.3390/ijerph17051729 PubMedGoogle ScholarCrossref
6.
Sharp  C , Venta  A , Marais  L , Skinner  D , Lenka  M , Serekoane  J .  First evaluation of a population-based screen to detect emotional-behavior disorders in orphaned children in Sub-Saharan Africa.   AIDS Behav. 2014;18(6):1174-1185. doi:10.1007/s10461-014-0739-6 PubMedGoogle ScholarCrossref
7.
Kamara  S , Walder  A , Duncan  J , Kabbedijk  A , Hughes  P , Muana  A .  Mental health care during the Ebola virus disease outbreak in Sierra Leone.   Bull World Health Organ. 2017;95(12):842-847. doi:10.2471/BLT.16.190470 PubMedGoogle ScholarCrossref
8.
Mohammed  A , Sheikh  TL , Gidado  S ,  et al.  An evaluation of psychological distress and social support of survivors and contacts of Ebola virus disease infection and their relatives in Lagos, Nigeria: a cross sectional study–2014.   BMC Public Health. 2015;15(1):824. doi:10.1186/s12889-015-2167-6 PubMedGoogle ScholarCrossref
9.
US Centers for Disease Control and Prevention. Outbreak of swine origin influenza A (H1N1) virus infection—Mexico, March—April 2009. Accessed November 8, 2021. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5817a5.htm
10.
Newman  C , Friedrich  TC , O’Connor  DH .  Macaque monkeys in Zika virus research: 1947-present.   Curr Opin Virol. 2017;25:34-40. doi:10.1016/j.coviro.2017.06.011 PubMedGoogle ScholarCrossref
11.
Coltart  CEM , Lindsey  B , Ghinai  I , Johnson  AM , Heymann  DL .  The Ebola outbreak, 2013-2016: old lessons for new epidemics.   Philos Trans R Soc Lond B Biol Sci. 2017;372(1721):20160297. doi:10.1098/rstb.2016.0297 PubMedGoogle ScholarCrossref
12.
Tricco  AC , Lillie  E , Zarin  W ,  et al.  PRISMA Extension for Scoping Reviews (PRISMA-ScR): checklist and explanation.   Ann Intern Med. 2018;169(7):467-473. doi:10.7326/M18-0850 PubMedGoogle ScholarCrossref
13.
Ouzzani  M , Hammady  H , Fedorowicz  Z , Elmagarmid  A .  Rayyan-a web and mobile app for systematic reviews.   Syst Rev. 2016;5(1):210. doi:10.1186/s13643-016-0384-4 PubMedGoogle ScholarCrossref
14.
Askarian  M , Khakpour  M , Taghrir  MH , Akbarialiabad  H , Borazjani  R .  Investigating the epidemiology of methanol poisoning outbreaks: a scoping review protocol.   JBI Evid Synth. 2020;19(6):1388-1393. doi:10.11124/JBIES-20-00221 PubMedGoogle ScholarCrossref
15.
Piper  C .  System for the Unified Management, Assessment, and Review of Information (SUMARI).   J Med Libr Assoc. 2019;107(4):634-636. doi:10.5195/jmla.2019.790 Google ScholarCrossref
16.
Viner  RM , Ozer  EM , Denny  S ,  et al.  Adolescence and the social determinants of health.   Lancet. 2012;379(9826):1641-1652. doi:10.1016/S0140-6736(12)60149-4 PubMedGoogle ScholarCrossref
17.
Cao  Y , Huang  L , Si  T , Wang  NQ , Qu  M , Zhang  XY .  The role of only-child status in the psychological impact of COVID-19 on mental health of Chinese adolescents.   J Affect Disord. 2021;282:316-321. doi:10.1016/j.jad.2020.12.113 PubMedGoogle ScholarCrossref
18.
Chen  S , Cheng  Z , Wu  J .  Risk factors for adolescents’ mental health during the COVID-19 pandemic: a comparison between Wuhan and other urban areas in China.   Global Health. 2020;16(1):96. doi:10.1186/s12992-020-00627-7 PubMedGoogle ScholarCrossref
19.
Deng  C-H , Wang  J-Q , Zhu  L-M ,  et al.  Association of web-based physical education with mental health of college students in Wuhan during the COVID-19 outbreak: cross-sectional survey study.   J Med internet Res. 2020;22(10):e21301. doi:10.2196/21301 PubMedGoogle ScholarCrossref
20.
Dyer  J , Wilson  K , Badia  J ,  et al.  The psychosocial effects of the COVID-19 pandemic on youth living with HIV in Western Kenya.   AIDS Behav. 2021;25(1):68-72. doi:10.1007/s10461-020-03005-x PubMedGoogle ScholarCrossref
21.
Eweida  RS , Rashwan  ZI , Desoky  GM , Khonji  LM .  Mental strain and changes in psychological health hub among intern-nursing students at pediatric and medical-surgical units amid ambience of COVID-19 pandemic: A comprehensive survey.   Nurse Educ Pract. 2020;49:102915. doi:10.1016/j.nepr.2020.102915 PubMedGoogle ScholarCrossref
22.
Garcia de Avila  MA , Hamamoto Filho  PT , Jacob  FLDS ,  et al.  Children’s anxiety and factors related to the COVID-19 pandemic: an exploratory study using the Children’s Anxiety Questionnaire and the Numerical Rating Scale.   Int J Environ Res Public Health. 2020;17(16):5757. doi:10.3390/ijerph17165757 PubMedGoogle ScholarCrossref
23.
Gu  J , Zhong  Y , Hao  Y ,  et al.  Preventive behaviors and mental distress in response to H1N1 among university students in Guangzhou, China.   Asia Pac J Public Health. 2015;27(2):NP1867-NP1879. doi:10.1177/1010539512443699 PubMedGoogle ScholarCrossref
24.
Islam  MA , Barna  SD , Raihan  H , Khan  MNA , Hossain  MT .  Depression and anxiety among university students during the COVID-19 pandemic in Bangladesh: A web-based cross-sectional survey.   PLoS One. 2020;15(8):e0238162. doi:10.1371/journal.pone.0238162 PubMedGoogle ScholarCrossref
25.
Islam  MS , Sujan  MSH , Tasnim  R , Sikder  MT , Potenza  MN , van Os  J .  Psychological responses during the COVID-19 outbreak among university students in Bangladesh.   PLoS One. 2020;15(12):e0245083. doi:10.1371/journal.pone.0245083 PubMedGoogle ScholarCrossref
26.
Kalok  A , Sharip  S , Abdul Hafizz  AM , Zainuddin  ZM , Shafiee  MN .  The psychological impact of movement restriction during the COVID-19 outbreak on clinical undergraduates: a cross-sectional study.   Int J Environ Res Public Health. 2020;17(22):8522. doi:10.3390/ijerph17228522 PubMedGoogle ScholarCrossref
27.
Kang  S , Sun  Y , Zhang  X , Sun  F , Wang  B , Zhu  W .  Is physical activity associated with mental health among Chinese adolescents during isolation in COVID-19 pandemic?   J Epidemiol Glob Health. 2021;11(1):26-33. doi:10.2991/jegh.k.200908.001 PubMedGoogle ScholarCrossref
28.
Khan  AH , Sultana  MS , Hossain  S , Hasan  MT , Ahmed  HU , Sikder  MT .  The impact of COVID-19 pandemic on mental health & well-being among home-quarantined Bangladeshi students: a cross-sectional pilot study.   J Affect Disord. 2020;277:121-128. doi:10.1016/j.jad.2020.07.135 PubMedGoogle ScholarCrossref
29.
Kılınçel  Ş , Kılınçel  O , Muratdağı  G , Aydın  A , Usta  MB .  Factors affecting the anxiety levels of adolescents in home-quarantine during COVID-19 pandemic in Turkey.   Asia Pac Psychiatry. 2021;13(2):e12406. doi:10.1111/appy.12406 PubMedGoogle ScholarCrossref
30.
Li  X , Lv  Q , Tang  W ,  et al.  Psychological stresses among Chinese university students during the COVID-19 epidemic: the effect of early life adversity on emotional distress.   J Affect Disord. 2021;282:33-38. doi:10.1016/j.jad.2020.12.126 PubMedGoogle ScholarCrossref
31.
Li  Y , Zhao  J , Ma  Z ,  et al.  Mental health among college students during the COVID-19 pandemic in China: a 2-wave longitudinal survey.   J Affect Disord. 2021;281:597-604. doi:10.1016/j.jad.2020.11.109 PubMedGoogle ScholarCrossref
32.
Liang  L , Ren  H , Cao  R ,  et al.  The effect of COVID-19 on youth mental health.   Psychiatr Q. 2020;91(3):841-852. doi:10.1007/s11126-020-09744-3 PubMedGoogle ScholarCrossref
33.
Ma  Z , Zhao  J , Li  Y ,  et al.  Mental health problems and correlates among 746 217 college students during the coronavirus disease 2019 outbreak in China.   Epidemiol Psychiatr Sci. 2020;29:e181. doi:10.1017/S2045796020000931 PubMedGoogle ScholarCrossref
34.
Pinchoff  J , Santhya  KG , White  C , Rampal  S , Acharya  R , Ngo  TD .  Gender specific differences in COVID-19 knowledge, behavior and health effects among adolescents and young adults in Uttar Pradesh and Bihar, India.   PLoS One. 2020;15(12):e0244053. doi:10.1371/journal.pone.0244053 PubMedGoogle ScholarCrossref
35.
Qi  H , Liu  R , Chen  X ,  et al.  Prevalence of anxiety and associated factors for Chinese adolescents during the COVID-19 outbreak.   Psychiatry Clin Neurosci. 2020;74(10):555-557. doi:10.1111/pcn.13102 PubMedGoogle ScholarCrossref
36.
Sallam  M , Dababseh  D , Yaseen  A ,  et al.  Conspiracy beliefs are associated with lower knowledge and higher anxiety levels regarding COVID-19 among students at the University of Jordan.   Int J Environ Res Public Health. 2020;17(14):4915. doi:10.3390/ijerph17144915 PubMedGoogle ScholarCrossref
37.
Saurabh  K , Ranjan  S .  Compliance and psychological impact of quarantine in children and adolescents due to COVID-19 pandemic.   Indian J Pediatr. 2020;87(7):532-536. doi:10.1007/s12098-020-03347-3 PubMedGoogle ScholarCrossref
38.
Tang  W , Hu  T , Hu  B ,  et al.  Prevalence and correlates of PTSD and depressive symptoms one month after the outbreak of the COVID-19 epidemic in a sample of home-quarantined Chinese university students.   J Affect Disord. 2020;274:1-7. doi:10.1016/j.jad.2020.05.009 PubMedGoogle ScholarCrossref
39.
Torrente  F , Yoris  A , Low  DM ,  et al.  Sooner than you think: a very early affective reaction to the COVID-19 pandemic and quarantine in Argentina.   J Affect Disord. 2021;282:495-503. doi:10.1016/j.jad.2020.12.124 PubMedGoogle ScholarCrossref
40.
Wang  Y , Xu  B , Zhao  G , Cao  R , He  X , Fu  S .  Is quarantine related to immediate negative psychological consequences during the 2009 H1N1 epidemic?   Gen Hosp Psychiatry. 2011;33(1):75-77. doi:10.1016/j.genhosppsych.2010.11.001 PubMedGoogle ScholarCrossref
41.
Wiguna  T , Anindyajati  G , Kaligis  F ,  et al.  Brief research report on adolescent mental well-being and school closures during the COVID-19 pandemic in Indonesia.   Front Psychiatry. 2020;11:598756. doi:10.3389/fpsyt.2020.598756 PubMedGoogle ScholarCrossref
42.
Xiang  M , Yamamoto  S , Mizoue  T .  Depressive symptoms in students during school closure due to COVID-19 in Shanghai.   Psychiatry Clin Neurosci. 2020;74(12):664-666. doi:10.1111/pcn.13161 PubMedGoogle ScholarCrossref
43.
Xiao  H , Shu  W , Li  M ,  et al.  Social distancing among medical students during the 2019 coronavirus disease pandemic in China: disease awareness, anxiety disorder, depression, and behavioral activities.   Int J Environ Res Public Health. 2020;17(14):5047. doi:10.3390/ijerph17145047 PubMedGoogle ScholarCrossref
44.
Xiao  S , Yan  Z , Zhao  L .  Physical activity, screen time, and mood disturbance among Chinese adolescents during COVID-19.   J Psychosoc Nurs Ment Health Serv. 2021;59(4):14-20. doi:10.3928/02793695-20201104-04 PubMedGoogle ScholarCrossref
45.
Xie  X , Xue  Q , Zhou  Y ,  et al.  Mental health status among children in home confinement during the Coronavirus Disease 2019 outbreak in Hubei Province, China.   JAMA Pediatr. 2020;174(9):898-900. doi:10.1001/jamapediatrics.2020.1619 PubMedGoogle ScholarCrossref
46.
Yitayih  Y , Lemu  YK , Mekonen  S , Mecha  M , Ambelu  A .  Psychological impact of COVID-19 outbreak among Jimma University Medical Centere visitors in Southwestern Ethiopia: a cross-sectional study.   BMJ Open. 2021;11(1):e043185. doi:10.1136/bmjopen-2020-043185 PubMedGoogle ScholarCrossref
47.
Zhang  X , Zhu  W , Kang  S , Qiu  L , Lu  Z , Sun  Y .  Association between physical activity and mood states of children and adolescents in social isolation during the COVID-19 epidemic.   Int J Environ Res Public Health. 2020;17(20):7666. doi:10.3390/ijerph17207666 PubMedGoogle ScholarCrossref
48.
Zhou  J , Yuan  X , Qi  H ,  et al.  Prevalence of depression and its correlative factors among female adolescents in China during the coronavirus disease 2019 outbreak.   Global Health. 2020;16(1):69. doi:10.1186/s12992-020-00601-3 PubMedGoogle ScholarCrossref
49.
Zhou  S-J , Wang  L-L , Yang  R ,  et al.  Sleep problems among Chinese adolescents and young adults during the coronavirus-2019 pandemic.   Sleep Med. 2020;74:39-47. doi:10.1016/j.sleep.2020.06.001 PubMedGoogle ScholarCrossref
50.
Ademhan Tural  D , Emiralioglu  N , Tural Hesapcioglu  S ,  et al.  Psychiatric and general health effects of COVID-19 pandemic on children with chronic lung disease and parents’ coping styles.   Pediatr Pulmonol. 2020;55(12):3579-3586. doi:10.1002/ppul.25082PubMedGoogle ScholarCrossref
51.
Akkaya-Kalayci  T , Kothgassner  OD , Wenzel  T ,  et al.  The impact of the COVID-19 pandemic on mental health and psychological well-being of young people living in Austria and Turkey: a multicenter study.   Int J Environ Res Public Health. 2020;17(23):9111. doi:10.3390/ijerph17239111PubMedGoogle ScholarCrossref
52.
Arundhana  AI , Iqbal  M , Maharani  SA , Syam  A .  The emotional state and physical condition of Indonesian college students: an emerging situation during the coronavirus disease-19 crisis in Indonesia.   Open Access Maced J Med Sci. 2020;8(T1):261-267. doi:10.3889/oamjms.2020.5283Google ScholarCrossref
53.
Chang  J , Yuan  Y , Wang  D .  [Mental health status and its influencing factors among college students during the epidemic of COVID-19].   Nan Fang Yi Ke Da Xue Xue Bao. 2020;40(2):171-176. doi:10.12122/j.issn.1673-4254.2020.02.06PubMedGoogle Scholar
54.
Chen  F , Zheng  D , Liu  J , Gong  Y , Guan  Z , Lou  D .  Depression and anxiety among adolescents during COVID-19: A cross-sectional study.   Brain Behav Immun. 2020;88:36-38. doi:10.1016/j.bbi.2020.05.061PubMedGoogle ScholarCrossref
55.
Chen  RN , Liang  SW , Peng  Y ,  et al.  Mental health status and change in living rhythms among college students in China during the COVID-19 pandemic: A large-scale survey.   J Psychosom Res. 2020;137:110219. doi:10.1016/j.jpsychores.2020.110219PubMedGoogle ScholarCrossref
56.
Ding  X , Yao  J .  Peer education intervention on adolescents’ anxiety, depression, and sleep disorder during the COVID-19 pandemic.   Psychiatr Danub. 2020;32(3-4):527-535. doi:10.24869/psyd.2020.527PubMedGoogle ScholarCrossref
57.
Li  D .  Influence of the youth’s psychological capital on social Anxiety during the COVID-19 pandemic outbreak: the mediating role of coping style.   Iran J Public Health. 2020;49(11):2060-2068. doi:10.18502/ijph.v49i11.4721PubMedGoogle ScholarCrossref
58.
Duan  L , Shao  X , Wang  Y ,  et al.  An investigation of mental health status of children and adolescents in china during the outbreak of COVID-19.   J Affect Disord. 2020;275:112-118. doi:10.1016/j.jad.2020.06.029PubMedGoogle ScholarCrossref
59.
Guo  J , Fu  M , Liu  D , Zhang  B , Wang  X , van IJzendoorn  MH .  Is the psychological impact of exposure to COVID-19 stronger in adolescents with pre-pandemic maltreatment experiences? A survey of rural Chinese adolescents.   Child Abuse Negl. 2020;110(Pt 2):104667. doi:10.1016/j.chiabu.2020.104667PubMedGoogle ScholarCrossref
60.
Li  M , Liu  L , Yang  Y , Wang  Y , Yang  X , Wu  H .  Psychological impact of health risk communication and social media on college students during the COVID-19 pandemic: cross-sectional study.   J Med Internet Res. 2020;22(11):e20656. doi:10.2196/20656PubMedGoogle ScholarCrossref
61.
Li  X , Zhou  S .  Parental worry, family-based disaster education and children’s internalizing and externalizing problems during the COVID-19 pandemic.   Psychol Trauma. 2021;13(4):486-495. doi:10.1037/tra0000932PubMedGoogle ScholarCrossref
62.
Mallik  CI , Radwan  RB .  Impact of lockdown due to COVID-19 pandemic in changes of prevalence of predictive psychiatric disorders among children and adolescents in Bangladesh.   Asian J Psychiatr. 2021;56:102554. doi:10.1016/j.ajp.2021.102554PubMedGoogle ScholarCrossref
63.
Manjareeka  M , Pathak  M .  COVID-19 lockdown anxieties: is student a vulnerable group?   J Indian Assoc Child Adolesc Ment Health. 2021;17(1):72-80. doi:10.1177/0973134220210106Google ScholarCrossref
64.
Nihmath Nisha  S , Francis  YM , Balaji  K , Raghunath  G , Kumaresan  M .  A survey on anxiety and depression level among South Indian medical students during the COVID-19 pandemic.   Int J Res Pharm Sci; 2020:779-786. doi:10.26452/ijrps.v11iSPL1.3082Google ScholarCrossref
65.
Qi  M , Zhou  SJ , Guo  ZC ,  et al.  The effect of social support on mental health in Chinese adolescents during the outbreak of COVID-19.   J Adolesc Health. 2020;67(4):514-518. doi:10.1016/j.jadohealth.2020.07.001PubMedGoogle ScholarCrossref
66.
Tang  W , Hu  T , Yang  L , Xu  J .  The role of alexithymia in the mental health problems of home-quarantined university students during the COVID-19 pandemic in China.   Pers Individ Dif. 2020;165:110131. doi:10.1016/j.paid.2020.110131PubMedGoogle ScholarCrossref
67.
Verma  K .  The mental health impact of the COVID-19 epidemic on college students in India.   Asian J Psychiatr. 2020;53:102398. doi:10.1016/j.ajp.2020.102398PubMedGoogle ScholarCrossref
68.
Vishwakarma  D , Ravi  RP , Thomas  E .  Impact of COVID-19 pandemic on mental health and effects of a sense of verdict of selected college students in Nepal, Nigeria, and India.   Indian J Public Health Res Dev. 2021;12(1):60-68.doi:10.37506/ijphrd.v12i1.13831Google ScholarCrossref
69.
Xu  J , Zheng  Y , Wang  M ,  et al.  Predictors of symptoms of posttraumatic stress in Chinese university students during the 2009 H1N1 influenza pandemic.   Med Sci Monit. 2011;17(7):PH60-PH64. doi:10.12659/MSM.881836PubMedGoogle ScholarCrossref
70.
Zhang  C , Ye  M , Fu  Y ,  et al.  The psychological impact of the COVID-19 pandemic on teenagers in China.   J Adolesc Health. 2020;67(6):747-755. doi:10.1016/j.jadohealth.2020.08.026PubMedGoogle ScholarCrossref
71.
Zhang  L , Zhang  D , Fang  J , Wan  Y , Tao  F , Sun  Y .  Assessment of mental health of Chinese primary school students before and after school closing and opening during the COVID-19 pandemic.   JAMA Netw Open. 2020;3(9):e2021482. doi:10.1001/jamanetworkopen.2020.21482PubMedGoogle ScholarCrossref
72.
Zhou  SJ , Zhang  LG , Wang  LL ,  et al.  Prevalence and socio-demographic correlates of psychological health problems in Chinese adolescents during the outbreak of COVID-19.   Eur Child Adolesc Psychiatry. 2020;29(6):749-758. doi:10.1007/s00787-020-01541-4PubMedGoogle ScholarCrossref
73.
Zhu  J , Su  L , Zhou  Y , Qiao  J , Hu  W .  The effect of nationwide quarantine on anxiety levels during the COVID-19 outbreak in China.   Brain Behav. 2021;11(1):e01938. doi:10.1002/brb3.1938PubMedGoogle ScholarCrossref
74.
Thahir  A , Sulastri  S , Zahra Bulantika  S , Novita  T .  Gender differences on COVID-19–related anxiety among students.   Pak J Psychol Res. 2021;36(1):71-83. Google Scholar
75.
Moitra  M , Rahman  M , Collins  PY ,  et al.  Mental health consequences for health care workers during the COVID-19 pandemic: a scoping review to draw lessons for LMICs.   Front Psychiatry. 2021;12:602614. doi:10.3389/fpsyt.2021.602614 PubMedGoogle ScholarCrossref
76.
Haberland  NA , McCarthy  KJ , Brady  M .  A systematic review of adolescent girl program implementation in low- and middle-income countries: evidence gaps and insights.   J Adolesc Health. 2018;63(1):18-31. doi:10.1016/j.jadohealth.2017.11.294 PubMedGoogle ScholarCrossref
77.
Rahman  M , Ahmed  R , Moitra  M ,  et al.  Mental distress and human rights violations during COVID-19: a rapid review of the evidence informing rights, mental health needs, and public policy around vulnerable populations.   Front Psychiatry. 2021;11:603875. doi:10.3389/fpsyt.2020.603875 PubMedGoogle ScholarCrossref
78.
Agorastos  A , Tsamakis  K , Solmi  M , Correll  CU , Bozikas  VP .  The need for holistic, longitudinal, and comparable, real-time assessment of the emotional, behavioral, and societal impact of the COVID-19 pandemic across nations.   Psychiatriki. 2021;32(1):15-18. doi:10.22365/jpsych.2021.010 PubMedGoogle ScholarCrossref
79.
Fricchione  GL , Borba  CPC , Alem  A , Shibre  T , Carney  JR , Henderson  DC .  Capacity building in global mental health: professional training.   Harv Rev Psychiatry. 2012;20(1):47-57. doi:10.3109/10673229.2012.655211 PubMedGoogle ScholarCrossref
80.
Jack  HE , Merritt  C , Medhin  G ,  et al.  Developing sustainable capacity-building in mental health research: implementation outcomes of training of trainers in systematic reviewing.   Glob Health Action. 2020;13(1):1715325. doi:10.1080/16549716.2020.1715325 PubMedGoogle ScholarCrossref
81.
Kumar  M , Osborn  TL , Mugo  C ,  et al.  A 4-component framework toward patient-centered, integrated mental health care in Kenya.   Front Public Health. 2021;9:756861. doi:10.3389/fpubh.2021.756861 PubMedGoogle ScholarCrossref
82.
Loades  ME , Chatburn  E , Higson-Sweeney  N ,  et al.  Rapid systematic review: the impact of social isolation and loneliness on the mental health of children and adolescents in the context of COVID-19.   J Am Acad Child Adolesc Psychiatry. 2020;59(11):1218-1239.e3. doi:10.1016/j.jaac.2020.05.009 PubMedGoogle ScholarCrossref
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