Caregiver and youth self-reported emotional and behavioural problems in Ugandan HIV-infected children and adolescents

Publication Date: 
Thursday, September 20, 2018
Leigh L. van den Heuvel, Jonathan Levin, Richard S. Mpango, Kenneth D. Gadow, Vikram Patel, Jean B. Nachega, Soraya Seedat, and Eugene Kinyanda

We determined the prevalence of, and factors associated with, self-rated emotional and behavioural problems (EBPs) and assessed the agreement between self-rated and caregiver-rated EBPs in the ‘Mental health among HIV-infected Children and Adolescents (CA-HIV) in Kampala and Masaka, Uganda’ (CHAKA) study. Existing literature demonstrates that CA-HIV face increased mental health challenges related to a broad range of biological and psychosocial factors. There is scarce data on self-reported EBPs in CA-HIV.

In a cross-sectional sample, caregiver-reported EBPs were assessed with the Child and Adolescent Symptom Inventory-5 (CASI-5), and self-reported problems were evaluated with the Youth Inventory-4 (YI-4) in 469 adolescents aged 12–17 years and the Child Inventory-4 (CI-4) in 493 children aged 8–11 years. Logistic regression models were utilised to determine factors related to self-reported EBPs.

Self-reported emotional problems (EPs) were present in 28.8% of the adolescents and were associated with caregivers being separated and having a lower level of education. Among adolescents, 14.5% had self-reported behavioural problems (BPs), and these were associated with caregiver unemployment and food insecurity. Self-reported EPs were reported by 36.9% of children and were associated with rural study sites, having missed school and caregivers having a lower level of education. There was only modest agreement (maximum r = 0.29) between caregiver- and CA-HIV-reported EBPS, with caregivers reporting more EPs and adolescents reporting more BPs.

Self-reported EBPs are frequently endorsed by CA-HIV, and these problems are related to unique psychosocial factors. Including CA-HIV, self-report measures can assist in identifying problems that caregivers may not be aware of, particularly BPs.

S Afr J Psychiatr
MRC/UVRI Authors: