Prevalence and associated factors of attention deficit hyperactivity disorder (ADHD) among Ugandan children; a cross-sectional study

Abstract

BackgroundAttention 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.MethodsUsing 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.ResultsThe 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.ConclusionThe 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.

Epidemiology of attention-deficit/hyperactivity disorder (ADHD) in children and adolescents in Africa: a systematic review and meta-analysis

“…The sample size of the included studies ranged from 100 to 1477. Ten studies were good in quality, one moderate (31), and one poor (34).…”

“…The characteristics of these studies are summarized in Table 1. Selected studies were conducted in Nigeria [30][31][32], Sudan [33], Uganda [34], Congo [35], Kenya [36,37], Egypt [38][39][40][41], and Ethiopia [42]. Age at diagnosis of ADHD varies from 4 to 18 years.…”

“…Age at diagnosis of ADHD varies from 4 to 18 years. Five studies DBRS (27,24,25,28,34) to assess ADHD, one used CASS (33), one used DICA-R (35), one used SNAP-IV-C (26), one used VARTRS (23), one used ADHD rating scale (31), and two used DM-IV (29,32). The sample size of the included studies ranged from 100 to 1477.…”

Prevalence of behavioral disorders and attention deficit/hyperactive disorder among school going children in Southwestern Uganda

“…Most studies conducted in Uganda have focused on ADHD and been carried out in health facilities. For example, Wamulugwa et al reported a prevalence rate of 11% and Mpango et al reported a prevalence rate of 6% for ADHD among children with psychiatric diagnoses and HIV-positive adolescents respectively in Uganda [15, 16]. Our study reported lower rates of ADHD (2.67%), which could be most likely due to the difference in study population.…”

“…Though the prevalence of behavioral problems varies across cultures in the sub-Saharan Africa, estimates indicate prevalence rates ranging from 12 to 33% [8, 13, 14]. Recent estimates from a specialized children’s clinic at Mulago National Referral Hospital in Uganda reported that 11% of the participants had attention deficit hyperactive disorder (ADHD) symptoms and 8.57% had conduct disorders [15]. In a related study, Mpango et al unraveled a prevalence rate for ADHD of 6% among children and adolescents with HIV/AIDS in specialized HIV/AIDS clinics in central and southwestern Uganda [16].…”