Prevalence, comorbidity and predictors of anxiety disorders in children and adolescents in rural north-eastern Uganda

BACKGROUND:Child and adolescent anxiety disorders are the most prevalent form of childhood psychopathology. Research on child and adolescent anxiety disorders has predominantly been done in westernized societies. There is a paucity of data on the prevalence, comorbidity, and predictors of anxiety disorders in children and adolescents in non-western societies including those in sub-Saharan Africa. This paper investigates the prevalence, comorbidity, and predictors of anxiety disorders in children and adolescents in north-eastern Uganda.OBJECTIVE:To determine the prevalence of DSM-IV anxiety disorders, as well as comorbidity patterns and predictors in children and adolescents aged 3 to 19 years in north-eastern Uganda. METHODS: Four districts (Lira, Tororo, Kaberamaido and Gulu) in rural north-eastern Uganda participated in this study. Using a multi-stage sampling procedure, a sample of 420 households with children aged 3-19 years from each district was enrolled into the study. The MINI International Neuropsychiatric Interview for children and adolescents (MINI KID) was used to assess for psychiatric disorders in 1587 of 1680 respondents. RESULTS: The prevalence of anxiety disorders was 26.6%, with rates higher in females (29.7%) than in males (23.1%). The most common disorders in both males and females were specific phobia (15.8%), posttraumatic stress disorder (PTSD) (6.6%) and separation anxiety disorder (5.8%). Children below 5 years of age were significantly more likely to have separation anxiety disorder and specific phobias, while those aged between 14-19 were significantly more likely to have PTSD. Anxiety disorders were more prevalent among respondents with other psychiatric disorders; in respondents with two or more co-morbid psychiatric disorders the prevalence of anxiety disorders was 62.1%. Predictors of anxiety disorders were experience of war trauma (OR=1.93, p<0.001) and a higher score on the emotional symptom scale of the SDQ (OR=2.58, p<0.001). Significant socio-demograghic associations of anxiety disorders were found for female gender, guardian unemployment, living in permanent housing, living without parents, and having parents without education. CONCLUSION: The prevalence of anxiety disorders in children and adolescents in rural north-eastern Uganda is high, but consistent in terms of gender ratio and progression over time with a range of prior work in other contexts. Patterns of comorbidity and predictors of anxiety disorders in this setting are also broadly consistent with previous findings from western community studies. Both psychosocial stressors and exposure to war trauma are significant predictors of anxiety disorders.Prevention and treatment strategies need to be put in place to address the high prevalence rates of anxiety disorders in children and adolescents in Uganda

The orphaning experience: descriptions from Ugandan youth who have lost parents to HIV/AIDS

The HIV/AIDS epidemic has continued to pose significant challenges to countries in Sub-Saharan Africa. Millions of African children and youth have lost parents to HIV/AIDS leaving a generation of orphans to be cared for within extended family systems and communities. The experiences of youth who have lost parents to the HIV/AIDS epidemic provide an important ingress into this complex, evolving, multi-dimensional phenomenon. A fundamental qualitative descriptive study was conducted to develop a culturally relevant and comprehensive description of the experiences of orphanhood from the perspectives of Ugandan youth. A purposeful sample of 13 youth who had lost one or both parents to HIV/AIDS and who were affiliated with a non-governmental organization providing support to orphans were interviewed. Youth orphaned by HIV/AIDS described the experience of orphanhood beginning with parental illness, not death. Several losses were associated with the death of a parent including lost social capitol, educational opportunities and monetary assets. Unique findings revealed that youth experienced culturally specific stigma and conflict which was distinctly related to their HIV/AIDS orphan status. Exploitation within extended cultural family systems was also reported. Results from this study suggest that there is a pressing need to identify and provide culturally appropriate services for these Ugandan youth prior to and after the loss of a parent(s)

Research priorities for HIV/M. tuberculosis co-infection

Submitted by Éder Freyre ([email protected]) on 2012-05-14T19:29:55Z No. of bitstreams: 1 Research_priorities_HIV_tuberculosis_coinfection.pdf: 642718 bytes, checksum: a71964f1be150cb7428e7017c5c0418b (MD5)Made available in DSpace on 2012-05-14T19:29:55Z (GMT). No. of bitstreams: 1 Research_priorities_HIV_tuberculosis_coinfection.pdf: 642718 bytes, checksum: a71964f1be150cb7428e7017c5c0418b (MD5) Previous issue date: 2011MS is funded by the EU; AM is funded by the EU and the Bill and Melinda Gates foundation. The EUCO-Net project leading to these results has received funding from the European Community's Seventh Framework Programme.Consejo Nacional de Investigaciones Científicas y Técnicas - CONICET. Buenos Aires, CABA, Argentina.Universidad de Antioquia. Medellín, Colombia.Fundação Oswaldo Cruz. Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Rio de Janeiro, RJ, Brasil.University of Amsterdam. Academic Medical Center. Amsterdam,The Netherlands.Postgraduate Institute of Medical Education & Research. Chandigarh, India.Russian Academy of Sciences. Institute of Numerical Mathematics. Moscow, Russia.Russian Academy of Sciences. Institute of Immunology and Physiology, Moscow, Russia.Joint United Nations Program on HIV/AIDS - UNAIDS. Geneva, Switzerland.Institute of Immunology and Genetics. Germany.Russian Academy of Medical Sciences. Central Research Institute of Tuberculosis. Moscow, Russia.Kuratorium Tuberkulose in der Welt e.V. Germany.European Research & Project Office. Germany.BPS Women University. India.Imperial College London. South Kensington Campus, London, UK.Russian Academy of Medical Sciences. D.I. Ivanovsky Institute of Virology. Moscow, Russia.BOTUSA. Botswana.Ministry of Health and Social Development of the Russian Federation. Moscow, Russia.Istituto Superiore di Sanitá. Roma, Italy.Universidade Federal do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.Research Center Borstel. Germany.Instituto de Salud Carlos III. Spain.Community Working Group On Health. Zimbabwe.Institute of Tropical Medicine. Belgium.Makerere University. College of Health Sciences. Uganda.London School of Hygiene & Tropical Medicine. UK.Saarland University. Saarbrücken, Germany / Germany & ICREA. Germany / University Pompeu Fabra. Barcelona, Spain.Fondazione Salvatore Maugeri. Pavia, Italy.Johns Hopkins University. Baltimore, Maryland, USA.Karonga Prevention Study. Malawi.European AIDS Treatment Groups - EATG. Brussels, Belgium.Medical Research Council Unit - MRC. Fajara, The Gambia.Luzerne General Hospital. Switzerland.Stellenbosch University. South Africa.Corporación para Investigaciones Biológicas - CIB-UPB. Colombia.Hinduja National Hospital. Mahim, Mumbai, India.Argentinean National Reference Center for AIDS. Argentina.Instituto Aragonés de Ciencias de la Salud - I+CS. Spain.Asociacion Civil Impacta, Salud y Educacion. Peru.Saarland University. Germany.Seth Research Foundation. India.AIDS & RIGHTS Alliance for Southern Africa. South Africa.SRC Institute of Immunology. Russia.L.R.S. Institute of Tuberculosis & Respiratory Diseases. India.University of Brescia. Brescia, Italy.Careggi University Hospital, Italy.Fraunhofer Institute for Biomedical Engineering - Fraunhofer IBMT. Germany.Indian Council of Medical Research. New Delhi, India.Treatment Action Group. USA.This document summarizes priority areas for joint research and concerted actions to counteract the public health threat of AIDS/TB as identified within the European Support Action “EUCO-Net” funded under the 7th Framework Programme of the European Commission