Rates, types and co-occurrence of emotional and behavioural disorders among perinatally HIV-infected youth in Uganda: the CHAKA study
To describe the rates, types and comorbidity of emotional and behavioural disorders among perinatally HIV-infected children and adolescents attending care at five HIV youth clinics in Central and Southwestern Uganda.
1339 CA-HIV attending care at HIV youth clinics in Uganda were interviewed using the DSM-5-based Child and Adolescent Symptom Inventory-5 (CASI-5; caregiver reported) and the Youth Inventory-4R (YI-4R; youth reported). Prevalence, risk factors and comorbidity for psychiatric disorders were estimated using logistic regression models.
According to caregiver or youth report, the prevalence of ‘any DSM-5 psychiatric disorder’ was 17.4% (95% CI 15.4–19.5%), while that of ‘any behavioural disorder’ was 9.6% (95% CI 8.1–11.2%) and that of ‘any emotional disorder’ was 11.5% (95% CI 9.9–13.3%). The most prevalent behavioural disorder was attention deficit hyperactivity disorder (5.3%), while the most prevalent emotional disorder was separation anxiety disorder (4.6%). The statistically significant risk factors were: for behavioural disorders, sex (more among males than females) and age group (more among adolescents than among children); for emotional disorders, age group (more among adolescents than among children) and the caregiver’s highest educational attainment (more among CA-HIV with caregivers with secondary education and higher, than among CA-HIV with caregivers with no formal education or only primary level education). About a quarter (24.5%) of CA-HIV with at least one emotional disorder and about a third (33.5%) of the CA-HIV with at least one behavioural disorder had a comorbid psychiatric disorder.
There was a considerable burden of psychiatric disorders among CA-HIV that spanned a broad spectrum and showed considerable comorbidity.
KeywordsChildren Adolescents HIV Emotional and behavioural problems Psychiatric disorder Africa
We would like to acknowledge the work and support provided by the staff of the Mental Health Project at the MRC/UVRI & LSHTM Uganda Research Unit. We would also like to acknowledge the support and corporation of children/adolescents, caregivers and management of The AIDS Support Organisation (TASO) clinic (Masaka), Kitovu Mobile AIDS organisation (Masaka), The Uganda Cares clinic (Masaka), Joint Clinical Research Centre clinic (Kampala) and Nsambya Home care Department (Kampala). This work was supported by a Medical Research Council / Department for International Development—African Leadership Award to Eugene Kinyanda, Number MR/L004623/1.
Compliance with ethical standards
Conflict of interest
No conflict of interest to declare.
- 1.UNAIDS (2014) The Gap Report. http://files.unaids.org/en/media/unaids/contentassets/documents/unaidspublication/2014/UNAIDS_Gap_report_en.pdf. Accessed 15 Feb 2017
- 18.Kigozi FN, Ssebunnya J (2009) Integration of mental health into primary health care in Uganda: opportunities and challenges. Ment Health Fam Med 6(1):37–42Google Scholar
- 20.World Health Organisation (2015) Treat all people living with HIV, offer antiretrovirals as additional prevention choice for people at “substantial” risk. http://www.who.int/mediacentre/news/releases/2015/hiv-treat-all-recommendation/en/. Accessed 20 July 2017
- 21.Ministry of Health, Uganda (2016) Consolidated guidelines for prevention and treatment of HIV in Uganda. HIV in Uganda. https://elearning.idi.co.ug/pluginfile.php/83/mod_page/content/57/CONSOLIDATED%20GUIDELINES%20FOR%20PREVENTION%20AND%20TREATMENT%20OF%20HIV%20IN%20UGANDA.PDF Accessed 11 May 2018
- 22.Ministry of Health, Community Development, Gender, Elderly and Children, Tanzania (2017) National guidelines for the management of HIV and AIDS. http://www.nacp.go.tz/site/download/NATIONAL_DECEMBER_2017.pdf. Accessed 11 May 2018
- 23.Gadow KD, Sprafkin J (2013) Child and Adolescent Symptom Inventory-5. Checkmate Plus. 2013. Stony Brook. https://www.checkmateplus.com/product/casi5.htm. Accessed 20 Feb 2019
- 25.Gadow KD, Sprafkin J (1999) Youth’s Inventory-4 (YI-4). https://www.checkmateplus.com/product/yi-4.htm. Accessed 20 Feb 2019
- 27.Pallant J (2007) Designing a study. In: SPSS survival manual: a step by step guide to data analysis using SPSS for Windows, 3rd edn. Open University Press, London, pp 3–10Google Scholar
- 29.Ozbay F, Johnson DC, Dimoulas E, Morgan CA, Charney D, Southwick S (2007) Social support and resilience to stress. Psychiatry (Edgmont) 4(5):35–40Google Scholar