Department of Psychiatry, Mental Health Project, MRC/UVRI and LSHTM Uganda Research Unit, Makerere College of Health Sciences, P. O. Box 49, Entebbe, Uganda.
Department of Psychiatry, Mbarara University of Science and Technology, P. O. Box 1410, Mabarara, Uganda.
BMC Psychiatry. 2019 Jan 21;19(1):34. doi: 10.1186/s12888-019-2023-9.
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).
This 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.
The 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).
Neurological 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.
本研究旨在确定神经障碍的流行率及其与 HIV/AIDS 儿童和青少年（CA-HIV）的临床和行为问题的关联。
本研究纳入了 1070 名 CA-HIV/照顾者对，作为他们参与纵向研究的一部分，在他们的 6 个月随访中进行评估，该研究题为“乌干达坎帕拉和马萨卡感染 HIV 的儿童和青少年的心理健康（CHAKA 研究）”。参与者完成了一整套广泛的评估工具，包括一个标准化的 DSM-5 参考评级量表，儿童和青少年症状清单-5 的父母版本（5-18 岁）（CASI-5）。我们使用逻辑回归估计了神经障碍的流行率，并描述了它们与负面临床和行为因素的关联。
至少有一种神经障碍的总患病率为 18.5%（n=198；95%CI，16.2-20.8）。遗尿/遗粪症最常见（10%），其次是运动/发声抽动症（5.3%）；可能的癫痫症患病率最低（4%）。与神经障碍相关的因素有两个领域：社会人口因素（年龄、种族和居住在农村地区）和与 HIV 相关的因素（基线病毒载量抑制）。遗尿/遗粪症与精神共病有关。神经障碍与性接触的早期发生有关（调整后的 OR 4.06，95%CI 1.26-13.1，P=0.02）。
神经障碍影响许多 HIV/AIDS 儿童和青少年的生活。迫切需要将精神和神经健康服务的提供纳入撒哈拉以南非洲地区 HIV/AIDS 儿童和青少年的常规临床护理中。
