Wamulugwa Joan, Kakooza Angelina, Kitaka Sabrina Bakeera, Nalugya Joyce, Kaddumukasa Mark, Moore Shirley, Sajatovic Martha, Katabira Elly
Department of Pediatrics and Child Health, Mulago Hospital and Makerere University School of Medicine, P. O Box 7072, Kampala, Uganda.
Department of Psychiatry, Mulago Hospital and Makerere University School of Medicine, P. O Box 7072, Kampala, Uganda.
Child Adolesc Psychiatry Ment Health. 2017 Apr 14;11:18. doi: 10.1186/s13034-017-0155-6. eCollection 2017.
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.
注意缺陷多动障碍（ADHD）是儿童中常见的神经精神疾病。在乌干达，ADHD的负担或其相关因素尚不清楚。本研究的目的是确定穆拉戈国家转诊医院神经科和精神科门诊儿童中ADHD的患病率及其相关因素。
我们使用破坏性行为量表（45项）调查了穆拉戈医院儿童中ADHD症状的存在情况。向研究参与者的主要照顾者发放问卷，以收集与ADHD相关因素的信息。所有儿童均接受临床检查。使用上述评分量表推测患有ADHD的儿童，由儿童精神科医生进一步评估以确诊并确定相关的共病情况。
DSM-IV ADHD症状的估计患病率为11%。年龄小于10岁的儿童患ADHD的可能性是其他儿童的四倍（比值比4.1，95%置信区间1.7-9.6，p<0.001）。与ADHD独立相关的人口统计学因素包括年龄小于10岁、男性、母亲孕期有异常阴道分泌物史以及未接受过正规教育或最高学历为小学。
在我们的研究环境中，儿科神经科和精神科门诊儿童中ADHD的患病率较高，且与发育迟缓有关。需要在我们的环境中早期识别并处理与ADHD相关的共病情况，如癫痫、自闭症谱系障碍、品行障碍、对立违抗障碍和智力残疾。
