Abstract
BackgroundThe aim of this study was to determine the prevalence of neurological disorders and their associated correlates and relations with clinical and behavioural problems among children and adolescents with HIV/AIDS (CA-HIV).MethodsThis study involved a sample of 1070 CA-HIV/caregiver dyads who were evaluated at their 6-month follow-up visit as part of their participation in the longitudinal study, ‘Mental health among HIV infected CHildren and Adolescents in KAmpala and Masaka, Uganda (the CHAKA study)’. Participants completed an extensive battery of measures that included 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 neurological disorders and characterised their associations with negative clinical and behavioural factors.ResultsThe overall prevalence of at least one neurological disorders was 18.5% (n = 198; 95% CI, 16.2–20.8). Enuresis / encopresis was the most common (10%), followed by motor/vocal tics (5.3%); probable epilepsy was the least prevalent (4%). Correlates associated with neurological disorders were in two domains: socio-demographic factors (age, ethnicity and staying in rural areas) and HIV-related factors (baseline viral load suppression). Enuresis/encopresis was associated with psychiatric comorbidity. Neurological disorders were associated with earlier onset of sexual intercourse (adjusted OR 4.06, 95% CI 1.26–13.1, P = 0.02).ConclusionsNeurological disorders impact lives of many children and adolescents with HIV/AIDS. There is an urgent need to integrate the delivery of mental and neurological health services into routine clinical care for children and adolescents with HIV/AIDS in sub-Saharan Africa.
Highlights
The aim of this study was to determine the prevalence of neurological disorders and their 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)
In one study conducted in East Africa, approximately two-thirds of new patients presenting to a child and adolescent psychiatry service had epilepsy [3], and seizures are common among individuals with HIV/AIDS [4]
Neurological disorders are reported to be associated with HIV/AIDS [1, 2, 5], no such studies have been conducted among children and adolescents with HIV/AIDS (CA-HIV) in Uganda
Summary
The aim of this study was to determine the prevalence of neurological disorders and their associated correlates and relations with clinical and behavioural problems among children and adolescents with HIV/AIDS (CA-HIV). In sub Saharan Africa, with the exception of epilepsy, few studies have attempted to determine the prevalence of neurologic disease among children and adolescents and characterize their clinical correlates [1]. In one study conducted in East Africa, approximately two-thirds of new patients presenting to a child and adolescent psychiatry service had epilepsy [3], and seizures are common among individuals with HIV/AIDS [4]. Neurological disorders are reported to be associated with HIV/AIDS [1, 2, 5], no such studies have been conducted among CA-HIV in Uganda. The primary objectives of the present study were to (a) document the prevalence of neurological disorders among a large sample of CA-HIV attending rural and urban HIV clinics in Uganda, (b) characterize the relation of neurological disorders with a wide range of commonly studied clinical correlates, (c) establish the co-occurrence of neurological and psychiatric disorders, and (d) investigate the relation of neurological disorders with important indices of functioning
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