Behavior Problems in Physically Ill Children in Rwanda.
Jean Paul Rukabyarwema, Natalie McCall, Tharcisse Ngambe and 2 others
PMID 31369465WHAT IT FOUND
In physically ill children in Rwanda, 32% screened positive for behavior problems; of screen-positive children assessed, 57% had major problems or needed further assessment.
CNS trauma, infection, and shorter stature were linked to higher scores.
Key findings
01Among 234 children with valid scores, 74 (32%) were positive on the behavior screening test.
02Of 28 children with positive screens who were assessed, 16 (57%) were judged to have major problems or to need further assessment.
03Children with histories of CNS trauma or CNS infection were more likely to screen positive, and lower height was associated with higher scores.
STILL TO COME
How it was doneWhat they found
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What it does not show
The study was done at one referral hospital in Rwanda, so it may not apply to children in community settings or other hospitals. Staffing issues meant some eligible children were not recruited, and the effect of this on the results is unclear. Many referred children did not complete assessment: 41 of 69 screen-positive children were not assessed. The mental health assessments were not standardized research protocols, and the assessors may have learned the screening results from families. The mental health professionals did not report diagnoses, only their degree of concern. The screening test includes items such as aches and pains and tiring easily, which can be common in physically ill children. The study shows associations, not proof that CNS injury, infection, or malnutrition caused behavior problems.
Declared interests
The authors declared no conflict of interest.
The easy way to misread this
Do not treat the 32% screening-positive rate as a national estimate. It came from physically ill children at one hospital, and 41 of 69 screen-positive children referred for assessment did not complete it.