prevalence and factors associated with behavioural problems in children with epilepsy attending mulago national referral hospital

Description

Background: Worldwide, children with epilepsy have higher rates of behavioural problems than healthy controls, siblings, and other age-matched children with chronic diseases. These behavioural problems affect the quality of life of the children and their families significantly, often creating more of a challenge than epilepsy itself. However, in Africa and specifically in Uganda, there is very little information on the prevalence and factors associated with behav-ioural problems in childhood epilepsy that might give insight into early diagnosis and manage-ment. Objectives: This study was carried out to determine the prevalence of behavioural problems and determine the associated factors among children with epilepsy aged 6 to 17 years attending Mulago National Referral Hospital (MNRH). Methods: This was a quantitative cross-sectional study conducted over a 6-months study-period on children with epilepsy aged from 6 to 17 years attending Mulago National Referral Hospital. Among them, 300 were consecutively selected and assessed for behavioural problems using the Strengths and Difficulties Questionnaire (SDQ) completed by parents/caregivers (To-tal difficulties score of ≥17 was defined as behavioural problem). Data on socio-demographic characteristics and factors associated with behavioural problems were obtained by using pre-tested structured questionnaires, the Rosenberg Self-Esteem Scale (low self-esteem cutoff ≤66th percentile), the Kilifi Stigma Scale of Epilepsy (cutoff ≥66th percentile), the Morisky medica-tion adherence scale (low adherence score <8) and the “TUCH screener” and chart review for childhood disabilities and neurodeveopmental disorders (positive or negative). Simple logistic regression was used to test the association between factors and behavioural problems individu-ally. Multivariable analysis was performed to determine how the risk factors were jointly asso-ciated with the behavioural problems. A p-value of 5 % was used for statistical significance. Results: Among the 300 children enrolled, 172 (57.3%) were male, 200 (66.7%) were from an urban residence, 189 (63.0%) were attending school, 182 (60.7%) were attending the Paediatric Neurology Clinic and 129 (43%) had an underlying neurodevelopmental disorder or childhood disability. Their mean age was 11.3 ± 3.8 years, with the majority 201 (67%) aged between 10-17 years. Among the primary caregivers, 32 (10.7%) were illiterate and 231 (77.0%) were the biological parents.