Peer-reviewed article
Prevalence of behavioral disorders and attention deficit/hyperactive disorder among school going children in Southwestern Uganda
Apollo Kivumbi, William Byansi, Christopher Damulira, Phionah Namatovu, James Mugisha et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study screened 2,434 school-age children in southwestern Uganda (ages 8-13) for behavioral disorders and ADHD. Researchers found that 6% of children screened positive for oppositional defiant disorder and 2% for conduct disorder, while 9.61% showed elevated ADHD symptoms. About one quarter of children experienced impairment in at least four life domains. The study suggests school-based screening could help detect behavioral challenges early and facilitate appropriate referrals.
Key points
- 6% of children scored positive for oppositional defiant disorder (ODD) and 2% for conduct disorder (CD) using the DBD scale
- 9.61% of children were reported to have elevated ODD symptoms and 2.67% elevated ADHD symptoms on the Iowa Connors scale
- 25% of children experienced impairment in at least four domains of functioning
- Sample of 2,434 children, 52% female, mean age 10.27 years from 30 public primary schools in Masaka region
- Study conducted as part of 5-year SMART Africa-Uganda scale-up study (2016-2021) in region impacted by poverty and HIV/AIDS
Limitations
This is a cross-sectional prevalence study based on caregiver screening reports rather than clinical diagnosis, so it provides estimates of potential behavioral challenges rather than confirmed prevalence. The study does not include longitudinal follow-up or intervention outcomes, limiting understanding of the trajectory or treatability of these conditions.
Abstract
BACKGROUND: Disruptive Behavioral Disorders (DBDs) and Attention Deficit/Hyperactivity Disorder (ADHD) are chronic, impairing, and costly child and adolescent mental health challenges which, when untreated, can result in disruptions in school performance, friendships and family relations. Yet, there is dearth of prevalence data on child and adolescent behavioral challenges within sub-Saharan Africa, including Uganda. This study aims to estimate the prevalence rate of behavioral challenges and ADHD among young school going children and early adolescents (ages 8-13 at study enrollment), utilizing a school-based sample in southwest Uganda. METHODS: We present screening results from a 5-year scale-up study titled SMART Africa-Uganda (2016-2021), set across 30 public primary schools located in the greater Masaka region in Uganda, a region heavily impacted by poverty and HIV/AIDS. Specifically, we draw on screening data from caregivers of 2434 children that used well-established standardized measures that had been pre-tested in the region. These were: 1) oppositional defiant disorder (ODD) and conduct disorder (CD) subscales of the Disruptive Behavior Disorders (DBD) scale; and 2) the Iowa Connors and Impairment scales. Slightly over half of the children in the sample were female (52%), with a mean age of 10.27 years. RESULTS: Of the 2434 participants screened for disruptive behaviors: 1) 6% (n = 136) scored positive on ODD and 2% (n = 42) scored positive on CD subscales of the DBD scale; 2) 9.61% (n = 234), and 2.67% (n = 65) were reported to have elevated symptoms of ODD and ADHD on the Iowa Connors caregiver report scale respectively. Twenty-five percent (n = 586) of children were described by their caregivers as having experienced some form of impairment in at least four domains of the Impairment scale. CONCLUSION: The results indicate the presence of behavioral challenges and ADHD among school going children, aged 8-13 years, in Uganda. Given the negative outcomes associated with behavioral challenges as children transition to adolescence and adulthood, detecting these emerging behavioral challenges early is critical in developing appropriate interventions. School settings could be considered as one of the contextually-relevant, culturally-appropriate, and non-stigmatizing venues to implement screening procedures and to detect emerging behavioral challenges and to make necessary referrals.