Prevalence and effect of attention-deficit/hyperactivity disorder on school performance among primary school pupils in the Hohoe Municipality, Ghana

The pooled prevalence of attention-deficit/hyperactivity disorder among children and adolescents in Ethiopia: A systematic review and meta-analysis

BACKGROUND

Attention-deficit/hyperactivity disorder is one of the most common childhood neurobehavioral disorders, which has a serious negative effect on educational achievement, peer relationships, social functioning, behavior, and self-esteem of children. However, the pooled prevalence of attention-deficit/hyperactivity disorder is not well known in Ethiopia. Therefore, the main objective of this systematic review and meta-analysis is to estimate the pooled prevalence of attention-deficit/hyperactivity disorder among children and adolescents in Ethiopia.

METHODS

PubMed, HINARI, Science Direct, Psych INFO, Google Scholar, African Journals Online, and cross-referenced were searched to identify relevant articles. Quality appraisal was done using the Joanna Briggs Institute checklist. Heterogeneity was tested using the I-square statistics. Publication bias was tested using a funnel plot visual inspection. Further, trim and fill analysis was done to correct publication bias.Forest plots and tables were used to present results. The random effect model was used to compute the pooled prevalence of attention-deficit/hyperactivity disorder among children and adolescents.

RESULTS

The overall pooled prevalence of attention-deficit/hyperactivity disorder among children and adolescents in Ethiopia was 14.2% (95% CI: 8.48, 22.83). Being male (OR: 2.19, 95% CI: 1.54; 3.12), being aged 6-11 years (OR: 3.67, 95% CI: 1.98; 6.83), low family socioeconomic status (OR: 3.45 95% CI: 2.17; 5.47), maternal complication during pregnancy (OR: 3.29, 95% CI: 1.97; 5.51) and family history of mental illness (OR: 3.83, 95% CI:2.17; 6.77) were factors associated with a higher odds of attention-deficit/hyperactivity disorder among children and adolescents.

CONCLUSIONS

The overall pooled prevalence of attention-deficit/hyperactivity disorder among children and adolescents is high in Ethiopia as compared to previous literature. To reduce the prevalence of attention-deficit/hyperactivity disorder among children and adolescents, emphasis has to be given to prevention, early detection, and management of pregnancy-related complications. Moreover, parents with mental illness should be supported and properly treated to reduce the impact of hostile parenting on their child's health.

TRIAL REGISTRATION

Registered in PROSPERO with ID: CRD42024536334.

Knowledge of developmental disabilities and referral sources among health workers in two Ghanaian hospitals

Proper treatment of developmental disabilities requires health workers to have adequate knowledge of etiology and referral procedures. There is a dearth of research on knowledge of developmental disabilities among health workers in Ghana. The purpose of this study was to document knowledge about developmental disorders, causes, and referral procedures among health workers. Researchers used a successive free-listing method to interview 37 health workers. Developmental disabilities which present with physical symptoms were the most salient disorders identified among health workers, while learning disabilities and attention deficit disorder were largely overlooked. The most commonly listed developmental disabilities were cerebral palsy, Down syndrome, and autism spectrum disorder. Respondents had limited knowledge about the causes of and referral resources for developmental disabilities. Results show the need for continuing medical education, public awareness, and enhanced resources to support the identification and care of children with developmental disabilities in Ghana.

Adaptation and Implementation of the Multiple-Family Group Intervention in Ghana

BACKGROUND

The health system in Ghana is severely underequipped to meet the needs of children with behavioral health problems. A substantial treatment gap exists among individuals with behavioral challenges, necessitating the implementation of an evidence-based intervention to address child behavioral challenges in Ghana. This article presents learning opportunities from the adaptation and initiation process of an evidence-based approach, the multiple-family group (MFG) intervention, aimed at addressing child behavioral challenges in northern Ghana.

METHODS

The MFG intervention will be tested and implemented in three schools selected through a clustered randomization process, with 60 child-caregiver dyads per school. Each school will be assigned to MFG delivery by parent peers, MFG delivery by School Health Education Program (SHEP) coordinators, or an intervention where students are supplied only with mental health wellness materials and educational supports. The providers will be assessed on a fidelity measure.

RESULTS

The approach of engaging stakeholders in Ghana is anticipated to prove challenging because multiple partners are involved in MFG implementation. Participants are expected to actively participate, however, given some changes to the protocol to adapt it to the Ghanaian context, including the types of MFG facilitators and sample size. Other anticipated challenges include obtaining permission from key partners such as the education authorities, timing of the study within the academic calendar in Ghana, and meeting the high expectations of school authorities for the study.

NEXT STEPS

The MFG intervention will be delivered by parent peers and SHEP coordinators at the selected schools.

Attention-deficit hyperactivity disorder in school-age children in Gaborone, Botswana: Comorbidity and risk factors

Background

Attention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders in children. Its occurrence and pattern of presentation are unknown in Botswana.

Aim

To determine the prevalence of attention-deficit hyperactivity disorder (ADHD), associated comorbid conditions and risk factors amongst school-age children in Botswana.

Setting

Primary schools in Gaborone, Botswana.

Methods

This study used a cross-sectional design. A two-stage random sampling technique was utilised to select learners from 25 out of the 29 public schools in the city. The Vanderbilt ADHD Diagnostic Rating Scale (VADRS), teacher and parent versions, was administered.

Results

Of the 1737 children, 50.9% (n = 884) were male, and their mean age was 9.53 years (s.d. = 1.97). The prevalence of ADHD was 12.3% (n = 213). The most prevalent presentation was the predominantly inattentive, 7.2% (n = 125). A family history of mental illness (odds ratio [OR] = 6.59, 95% CI: 1.36–32.0) and perinatal complications (OR = 2.16, 95% CI: 1.08–4.29) emerged as the independent predictors of ADHD.

Conclusions

The prevalence of ADHD in Botswana is slightly higher than that reported in the literature, but the pattern of presentations and comorbidities is similar. A positive family history of mental illness and perinatal complications independently predicted ADHD. Mental health screening amongst families of the affected individuals and improved perinatal care should be considered as health care priorities in Botswana.

The female side of pharmacotherapy for ADHD-A systematic literature review

OBJECTIVE

This comprehensive review examined sex differences in prescription rates and efficacy or effectiveness of pharmacotherapy treatment in girls and women with attention deficit hyperactivity disorder (ADHD), while identifying gaps in the scientific knowledge on this topic.

METHOD

A rigorous electronic database search was carried out in order to identify all published studies on female-specific effects of stimulants and non-stimulants in the treatment of ADHD. In total, 2672 studies were screened of which 21 studies (seven on prescription rates, 14 on effects of pharmacotherapy) met the inclusion criteria and were included for analysis.

RESULTS

In all seven studies on ADHD prescription rates, girls received significantly less prescriptions than boys, a difference however no longer seen in adults with the exception of one study. Each of the 14 studies on effectiveness / efficacy found at least one sex-difference in the effects of ADHD pharmacotherapy.

CONCLUSION

Several sex-differences are demonstrated in the prescription, usage and efficacy /effectiveness of both stimulant and non-stimulant ADHD pharmacotherapy. A single daily use of MPH may possibly not be optimal for girls with ADHD and ATX may be a promising medication for girls and women with ADHD. The robustness of this result requires further investigation.