Abstract
BackgroundAim of this study was to determine the prevalence of attention-deficit/hyperactivity disorder (ADHD), its associated correlates and relations with clinical and behavioural problems among children and adolescents with HIV/AIDS (CA-HIV) attending five HIV clinics in central and South Western Uganda.MethodsThis study used a quantitative design that involved a random sample of 1339 children and adolescents with HIV and their caregivers. The Participants completed an extensive battery of measures including a standardized DSM-5 referenced rating scale, the parent version (5–18 years) of the Child and Adolescent Symptom Inventory-5 (CASI-5). Using logistic regression, we estimated the prevalence of ADHD and presentations, correlates and its impact on negative clinical and behavioural factors.ResultsThe overall prevalence of ADHD was 6% (n = 81; 95%CI, 4.8–7.5%). The predominantly inattentive presentation was the most common (3.7%) whereas the combined presentation was the least prevalent (0.7%). Several correlates were associated with ADHD: socio-demographic (age, sex and socio-economic status); caregiver (caregiver psychological distress and marginally, caregiver educational attainment); child’s psychosocial environment (quality of child-caregiver relationship, history of physical abuse and marginally, orphanhood); and HIV illness parameters (marginally, CD4 counts). ADHD was associated with poor academic performance, school disciplinary problems and early onset of sexual intercourse.ConclusionsADHD impacts the lives of many CA-HIV and is associated with poorer academic performance and earlier onset of sexual intercourse. There is an urgent need to integrate the delivery of mental health services into routine clinical care for CA-HIV in Sub-Saharan Africa.
Highlights
Aim of this study was to determine the prevalence of attention-deficit/hyperactivity disorder (ADHD), its associated correlates and relations with clinical and behavioural problems among children and adolescents with Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) (CA-HIV) attending five HIV clinics in central and South Western Uganda
We examined the association of ADHD with several functional outcomes: poor academic performance at school, poor social functioning at school, number of visits to the health unit in the past month, hospital admissions in the last month, non-adherence to HIV treatment and risky sexual behaviour
Possible explanations suggested by others include heritability of ADHD, stressful family and social environments associated with ADHD, and the erosion of parenting capacities which often accompany a parent with HIV or mental illness [2, 21, 43]. In support of the latter, we found that deteriorating quality of the child-caregiver relationship was associated with all three ADHD presentations, which is consistent with the findings of others for both HIV [43] and non-HIV [44] samples
Summary
Aim of this study was to determine the prevalence of attention-deficit/hyperactivity disorder (ADHD), its associated correlates and relations with clinical and behavioural problems among children and adolescents with HIV/AIDS (CA-HIV) attending five HIV clinics in central and South Western Uganda. The Joint United Nations Programme on AIDS estimates that 88% of the global 3.3 million children and adolescents living with HIV (CA-HIV) reside in Sub-Saharan Africa [1]. Most of these CA-HIV who were perinatally infected with HIV are at risk of developing emotional. Whereas the Kenyan study used the MINI International Neuropsychiatric Interview for children and adolescents (MINI-KID) [18], a DSM IV based psychiatric assessment tool that undertakes both a symptom count and assessment of functional impairment, the South African study used the Swanson, Nolan and Pelham rating scale [15], a DSM IV-based psychiatric assessment tool that only assesses symptom count. No study has established the prevalence of ADHD among CA-HIV in Uganda
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