Prevalence and associated factors of attention deficit hyperactivity disorder (ADHD) among Ugandan children; a cross-sectional study
Tóm tắt
Attention deficit hyperactivity disorder (ADHD) is a common neuropsychiatric disorder among the children. The burden of ADHD or its associated factors in Uganda are not known. The objective of this study was to determine the prevalence and the associated factors of ADHD among children attending the neurology and psychiatry clinics at Mulago National Referral Hospital. Using the disruptive behavior scale (45 items), we investigated the presence of ADHD symptoms among children attending Mulago Hospital. Questionnaires were administered to the primary care-takers of the study participants to gather information on the factors associated with ADHD. All children were subject to a clinical examination. Children presumed to have ADHD, using the aforementioned rating scale were further assessed by a child psychiatrist to confirm the diagnosis and associated co-morbid conditions. The estimated prevalence of DSM-IV ADHD symptoms was 11%. Children aged less than 10 years were four times likely to have ADHD (OR 4.1, 95% CI 1.7–9.6, p < 0.001). The demographic factors independently associated with ADHD were age less than 10 years, male gender, history of maternal abnormal vaginal discharge during pregnancy, and no formal education or the highest level of education being primary school. The prevalence of ADHD among children attending the pediatric neurology and psychiatry clinics is high in our settings and is associated with delayed milestones. Early identification and addressing the co-morbid conditions associated with ADHD such as epilepsy, autism spectrum of disorder, conduct disorder, opposition defiant disorder and intellectual disability in our setting is needed.
Tài liệu tham khảo
Polanczyk G, de Lima MS, Horta BL, Biederman J, Rohde LA. The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatr. 2007;164(6):942–8.
American Academy of Pediatrics. Clinical practice guideline: diagnosis and evaluation of the child with attention-deficit/hyperactivity disorder. Pediatrics. 2000;105(5):1158–70.
Biederman J. Attention-deficit/hyperactivity disorder: a selective overview. Biol Psychiatr. 2005;57(11):1215–20.
Brown RTFW, Perrin JM, Stein MT, Amler RW, Feldman HM, Pierce K, Wolraich ML. Prevalence and assessment of attention-deficit/hyperactivity disorder in primary care settings. Pediatrics. 2001;107(3):e43.
Merrell CTP. Inattention, hyperactivity and impulsiveness: their impact on academic achievement and progress. Br J Educ Psychol. 2001;71(1):43–56.
Bakare M. Attention deficit hyperactivity symptoms and disorder (ADHD) among African children: a review of epidemiology and co-morbidities. Afr J Psychiatr. 2012;15(5):358–61.
Chinawa JM, Odetunde OI, Obu HA, Chinawa AT, Bakare MO, Ujunwa FA. Attention deficit hyperactivity disorder: a neglected issue in the developing world. Behav Neurol. 2014;2014:694764.
Kashala E, Tylleskar T, Elgen I, Kayembe KT, Sommerfelt K. Attention deficit and hyperactivity disorder among school children in Kinshasa, Democratic Republic of Congo. Afr Health Sci. 2005;5(3):172–81.
Adewuya AO, Famuyiwa OO. Attention deficit hyperactivity disorder among Nigerian primary school children: prevalence and co-morbid conditions. Eur Child Adolesc Psychiatr. 2007;16(1):10–5.
Ashenafi Y, Kebede D, Desta M, Alem A. Socio-demographic correlates of mental and behavioural disorders of children in southern Ethiopia. East Afr Med J. 2000;77(10):565–9.
Rohde LA, Biederman J, Busnello EA, Zimmermann H, Schmitz M, Martins S, Tramontina S. ADHD in a school sample of Brazilian adolescents: a study of prevalence, co-morbid conditions, and impairments. J Am Acad Child Adolesc Psychiatr. 1999;38(6):716–22.
Pelham WE Jr, Gnagy EM, Greenslade KE, Milich R. Teacher ratings of DSM-III-R symptoms for the disruptive behavior disorders. J Am Acad Child Adolesc Psychiatr. 1992;31(2):210–8.
Silva RR, Alpert M, Pouget E, Silva V, Trosper S, Reyes K, Dummit S. A rating scale for disruptive behavior disorders, based on the DSM-IV item pool. Psychiatr Q. 2005;76(4):327–39.
Sheehan DVSK, Shytle RD, Janavs J, Bannon Y, Rogers JE, Milo KM, Stock SL, Wilkinson B. Reliability and validity of the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID). J Clin Psychiatr. 2010;71:313–26.
Kashala E, Tylleskar T, Elgen I, Kayembe K, Sommerfelt K. Attention deficit and hyperactivity disorder among school children in Kinshasa, Democratic Republic of Congo. Afr Health Sci. 2007;5(3):172–81.
Meyer A. Attention deficit/hyperactivity disorder among North Sotho speaking primary school children in South Africa: prevalence and sex ratios. J Psychol Afr. 1998;8:186–95.
Meyer AED, Sundet JM, Tshifularo JG, Sagvolden T. Cross cultural similarities in ADHD-like behavior amongst South African primary school children. S Afr J Psychol. 2004;34:123–39.
Ashenafi YKD, Desta M, Alem A. Prevalence of mental and behavioural disorders in Ethiopian children. East Afr Med J. 2001;78(6):308–11.
Swanson JMSJ, Taylor E, Sonuga-Barke EJ, Jensen PS, Cantwell DP. Attention-deficit hyperactivity disorder and hyperkinetic disorder. Lancet. 1998;351:429–33.
Bird HR. The diagnostic classification, epidemiology and cross-cultural validity of ADHD. In: Jenkins PCJ, Kingston NJ, editors. Attention deficit hyperactivity disorder state of the science: best practices. Princeton: Civic Research Institute; 2002. p. 12–21.
LA Rohde SC, Polanczyk G, Schmitz M, Martins S, Tramontina S. Attention-deficit/hyperactivity disorder in a diverse culture: do research and clinical findings support the notion of a cultural construct for the disorder? Biol Psychiatr. 2005;57:1436–41.
Szatmari P, Offord DR, Boyle MH. Ontario Child Health Study: prevalence of attention deficit disorder with hyperactivity. J Child Psychol Psychiatr. 1989;30(2):219–23.
Cuffe SP, Moore CG, McKeown RE. Prevalence and correlates of ADHD symptoms in the national health interview survey. J Atten Disord. 2005;9(2):392–401.
Biederman JFS, Mick E, Williamson S, Wilens TE, Spencer TJ, Weber W, Jetton J, Kraus I, Pert J, Zallen B. Clinical correlates of ADHD in females: findings from a large group of girls ascertained from pediatric and psychiatric referral sources. J Am Acad Child Adolesc Psychiatr. 1999;38:966–75.
Biederman J, Mick E, Faraone SV. Age-dependent decline of symptoms of attention deficit hyperactivity disorder: impact of remission definition and symptom type. Am J Psychiatr. 2000;157:816–8.
Mann JR, McDermott S. Are maternal genitourinary infection and pre-eclampsia associated with adhd in school-aged children? Atten Disord. 2010;15(8):667–73.
Koneski JA, Casella EB. Attention deficit and hyperactivity disorder in people with epilepsy: diagnosis and implications to the treatment. Arq Neuropsiquiatr. 2010;68(1):107–14.
Larson K, Russ SA, Kahn RS, Halfon N. Patterns of comorbidity, functioning, and service use for US children with ADHD, 2007. Pediatrics. 2011;127(3):462–70.
Spencer TJ, Biederman J, Mick E. Attention-deficit/hyperactivity disorder: diagnosis, lifespan, comorbidities, and neurobiology. Ambul Pediatr. 2007;7(1):73–81.