Prevalence and factors associated with emotional and behavioural difficulties among children living with HIV in Malawi: A cross-sectional study

Background: Approximately 84,000 children under the age of 15 years are living with HIV in Malawi. Although the survival rate of children living with HIV in Malawi has improved due to the increased availability of antiretroviral medications, these children continue to experience numerous challenges...

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Main Authors: Kendall, Garth, Ali, Mohammed, Kalembo, F., Chimwaza, A.
Format: Journal Article
Language:English
Published: BMC 2019
Subjects:
Online Access:http://hdl.handle.net/20.500.11937/75339
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author Kendall, Garth
Ali, Mohammed
Kalembo, F.
Chimwaza, A.
author_facet Kendall, Garth
Ali, Mohammed
Kalembo, F.
Chimwaza, A.
author_sort Kendall, Garth
building Curtin Institutional Repository
collection Online Access
description Background: Approximately 84,000 children under the age of 15 years are living with HIV in Malawi. Although the survival rate of children living with HIV in Malawi has improved due to the increased availability of antiretroviral medications, these children continue to experience numerous challenges negatively impacting on their mental health. The aim of this study was to investigate the prevalence of, and factors associated with, emotional and behavioural difficulties in children aged between 6 and 12 years living with HIV in Malawi. Methods: A random sample of 429 primary caregivers of children living with HIV drawn from the three main administrative regions of Malawi was recruited in a cross-sectional study. They completed a questionnaire about family socio-demographic characteristics, HIV disclosure, and child demographic and clinical characteristics, as well as the Strengths and Difficulties Questionnaire, Life Stress Scale, Support Function Scale, and Impact on Family Scale which were pre-tested and translated into the local Chichewa language. Data were analysed using descriptive statistics and logistic regression. Findings: Using the newer band categorisations of the Strengths and Difficulties Questionnaire, parent version, 31% of primary caregivers reported that their child had a slightly raised to very high level of total difficulties. Factors that were associated with difficulties were: primary caregivers' young age (adjusted odds ratio [aOR] 3.6; 95% confidence interval [CI]: 1.4-9.5); low level of education (aOR 2.6; 95% CI: 1.2-5.7); lack of employment (aOR 2.7; 95% CI: 1.2-5.9); the report of a substantial impact of the child's illness on the family (3.1; 95% CI: 1.5-6.5); and a low level of family functional support (aOR 2.0; 95% CI: 1.1-4.1). Neither non-disclosure of HIV status nor any of the child demographic or clinical factors were significant in multivariate analysis (p >.0.05). Conclusion: Close to one-third of children living with HIV in this study had high scores indicative of emotional and behavioural difficulties. Emotional and behavioural difficulties in children living with HIV were associated with family demographic and psychosocial factors, but not HIV disclosure. Effective policies and programs that promote the mental wellbeing of children living with HIV in Malawi are indicated.
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spelling curtin-20.500.11937-753392019-04-29T06:57:00Z Prevalence and factors associated with emotional and behavioural difficulties among children living with HIV in Malawi: A cross-sectional study Kendall, Garth Ali, Mohammed Kalembo, F. Chimwaza, A. Science & Technology Life Sciences & Biomedicine Psychiatry Emotional and behavioural difficulties Children HIV AIDS Malawi MENTAL-HEALTH PROBLEMS SOUTH-AFRICA POSITIVE CHILDREN INFECTED CHILDREN FAMILY SCALE RISK-FACTORS ADOLESCENTS IMPACT DISCLOSURE HIV/AIDS Background: Approximately 84,000 children under the age of 15 years are living with HIV in Malawi. Although the survival rate of children living with HIV in Malawi has improved due to the increased availability of antiretroviral medications, these children continue to experience numerous challenges negatively impacting on their mental health. The aim of this study was to investigate the prevalence of, and factors associated with, emotional and behavioural difficulties in children aged between 6 and 12 years living with HIV in Malawi. Methods: A random sample of 429 primary caregivers of children living with HIV drawn from the three main administrative regions of Malawi was recruited in a cross-sectional study. They completed a questionnaire about family socio-demographic characteristics, HIV disclosure, and child demographic and clinical characteristics, as well as the Strengths and Difficulties Questionnaire, Life Stress Scale, Support Function Scale, and Impact on Family Scale which were pre-tested and translated into the local Chichewa language. Data were analysed using descriptive statistics and logistic regression. Findings: Using the newer band categorisations of the Strengths and Difficulties Questionnaire, parent version, 31% of primary caregivers reported that their child had a slightly raised to very high level of total difficulties. Factors that were associated with difficulties were: primary caregivers' young age (adjusted odds ratio [aOR] 3.6; 95% confidence interval [CI]: 1.4-9.5); low level of education (aOR 2.6; 95% CI: 1.2-5.7); lack of employment (aOR 2.7; 95% CI: 1.2-5.9); the report of a substantial impact of the child's illness on the family (3.1; 95% CI: 1.5-6.5); and a low level of family functional support (aOR 2.0; 95% CI: 1.1-4.1). Neither non-disclosure of HIV status nor any of the child demographic or clinical factors were significant in multivariate analysis (p >.0.05). Conclusion: Close to one-third of children living with HIV in this study had high scores indicative of emotional and behavioural difficulties. Emotional and behavioural difficulties in children living with HIV were associated with family demographic and psychosocial factors, but not HIV disclosure. Effective policies and programs that promote the mental wellbeing of children living with HIV in Malawi are indicated. 2019 Journal Article http://hdl.handle.net/20.500.11937/75339 10.1186/s12888-019-2046-2 English http://creativecommons.org/licenses/by/4.0/ BMC fulltext
spellingShingle Science & Technology
Life Sciences & Biomedicine
Psychiatry
Emotional and behavioural difficulties
Children
HIV
AIDS
Malawi
MENTAL-HEALTH PROBLEMS
SOUTH-AFRICA
POSITIVE CHILDREN
INFECTED CHILDREN
FAMILY SCALE
RISK-FACTORS
ADOLESCENTS
IMPACT
DISCLOSURE
HIV/AIDS
Kendall, Garth
Ali, Mohammed
Kalembo, F.
Chimwaza, A.
Prevalence and factors associated with emotional and behavioural difficulties among children living with HIV in Malawi: A cross-sectional study
title Prevalence and factors associated with emotional and behavioural difficulties among children living with HIV in Malawi: A cross-sectional study
title_full Prevalence and factors associated with emotional and behavioural difficulties among children living with HIV in Malawi: A cross-sectional study
title_fullStr Prevalence and factors associated with emotional and behavioural difficulties among children living with HIV in Malawi: A cross-sectional study
title_full_unstemmed Prevalence and factors associated with emotional and behavioural difficulties among children living with HIV in Malawi: A cross-sectional study
title_short Prevalence and factors associated with emotional and behavioural difficulties among children living with HIV in Malawi: A cross-sectional study
title_sort prevalence and factors associated with emotional and behavioural difficulties among children living with hiv in malawi: a cross-sectional study
topic Science & Technology
Life Sciences & Biomedicine
Psychiatry
Emotional and behavioural difficulties
Children
HIV
AIDS
Malawi
MENTAL-HEALTH PROBLEMS
SOUTH-AFRICA
POSITIVE CHILDREN
INFECTED CHILDREN
FAMILY SCALE
RISK-FACTORS
ADOLESCENTS
IMPACT
DISCLOSURE
HIV/AIDS
url http://hdl.handle.net/20.500.11937/75339