Department of Psychiatry, Makerere University College of Health Sciences, Kampala, Uganda.
Department of Mental Health and Community Psychology, Makerere University College of Humanities and Social Sciences, Kampala, Uganda.
Malar J. 2021 Jun 13;20(1):267. doi: 10.1186/s12936-021-03795-y.
Severe malaria is associated with long-term mental health problems in Ugandan children. This study investigated the effect of a behavioural intervention for caregivers of children admitted with severe malaria, on the children's mental health outcomes 6 months after discharge.
This randomized controlled trial was conducted at Naguru Hospital in Kampala, Uganda from January 2018 to July 2019. Caregiver and child dyads were randomly assigned to either a psycho-educational arm providing information about hospital procedures during admission (control group), or to a behavioural arm providing information about the child's possible emotions and behaviour during and after admission, and providing age appropriate games for the caregiver and child (intervention group). Pre- and post-intervention assessments for caregiver anxiety and depression (Hopkins Symptom Checklist) and child mental health problems (Strength and Difficulties Questionnaire and the Child Behaviour Checklist) were done during admission and 6 months after discharge, respectively. T-tests, analysis of covariance, Chi-Square, and generalized estimating equations were used to compare outcomes between the two treatment arms.
There were 120 caregiver-child dyads recruited at baseline with children aged 1.45 to 4.89 years (mean age 2.85 years, SD = 1.01). The intervention and control groups had similar sociodemographic, clinical and behavioural characteristics at baseline. Caregiver depression at baseline, mother's education and female child were associated with behavioural problems in the child at baseline (p < 0.05). At 6 months follow-up, there was no difference in the frequency of behavioural problems between the groups (6.8% vs. 10% in intervention vs control groups, respectively, p = 0.72). Caregiver depression and anxiety scores between the treatment arms did not differ at 6 months follow-up.
This behavioural intervention for caregivers and their children admitted with severe malaria had no effect on the child's mental health outcomes at 6 months. Further studies need to develop interventions for mental health problems after severe malaria in children with longer follow-up time. Trail registration ClinicalTrials.gov Identifier: NCT03432039.
在乌干达儿童中，严重疟疾与长期心理健康问题有关。本研究调查了对因严重疟疾住院的儿童的照顾者进行行为干预，对出院后 6 个月儿童心理健康结果的影响。
本随机对照试验于 2018 年 1 月至 2019 年 7 月在乌干达坎帕拉的纳古鲁医院进行。照顾者和儿童对被随机分配到接受入院期间医院程序信息的心理教育组（对照组），或接受有关儿童入院期间和之后可能情绪和行为的信息以及为照顾者和儿童提供适龄游戏的行为组（干预组）。在入院期间和出院后 6 个月分别对照顾者焦虑和抑郁（霍普金斯症状清单）和儿童心理健康问题（优势与困难问卷和儿童行为检查表）进行了预干预和后干预评估。使用 t 检验、协方差分析、卡方检验和广义估计方程比较了两组治疗结果。
共有 120 对照顾者-儿童在基线时入组，儿童年龄为 1.45 至 4.89 岁（平均年龄 2.85 岁，标准差=1.01）。干预组和对照组在基线时具有相似的社会人口统计学、临床和行为特征。基线时照顾者抑郁、母亲教育程度和女孩与儿童基线时的行为问题相关（p<0.05）。在 6 个月的随访中，两组之间的行为问题频率没有差异（干预组为 6.8%，对照组为 10%，p=0.72）。在 6 个月的随访中，治疗组之间的照顾者抑郁和焦虑评分没有差异。
对因严重疟疾住院的照顾者及其子女进行的这种行为干预，对儿童出院后 6 个月的心理健康结果没有影响。需要进一步研究制定针对儿童严重疟疾后心理健康问题的干预措施，随访时间更长。
ClinicalTrials.gov 标识符：NCT03432039。
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