Burden, risk factors, and comorbidities of behavioural and emotional problems in Kenyan children: a population-based study
Burden, risk factors, and comorbidities of behavioural and emotional problems in Kenyan children: a population-based study
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DOI：
10.1016/s2215-0366(16)30403-5
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发表时间：
2017-02-01
影响因子：
64.3
通讯作者：
Newton, Charles R. J. C.
中科院分区：
文献类型：
--
作者：
Kariuki, Symon M.;Abubakar, Amina;Newton, Charles R. J. C.
四分之三的心理健康问题发生在低收入和中等收入国家，但很少有关于撒哈拉以南非洲学龄前儿童这些问题的流行病学研究发表。行为和情绪问题往往始于幼儿期，这在非洲可能特别重要，因为在非洲，围产期和早期风险因素的发生率很高。因此，我们的目的是估计的患病率和风险因素的行为和情绪问题的幼儿在农村地区的肯尼亚coast.Methods我们做了一项以人口为基础的流行病学研究，以评估负担的行为和情绪问题的学龄前儿童和合并症的基利菲健康和人口监测系统（KHDSS，一个由与基利菲县医院入院有关的常规监测下的人口组成的数据库）。我们使用儿童行为检查表（CBCL）来评估行为和情绪问题。然后，我们确定了与行为和情绪问题相关的风险因素和医学共病。的风险因素和行为和情绪问题之间的关联的强度估计使用广义线性模型，适当的分布和链接functions.Findings 3539家庭随机选择的KHDSS。其中，3273名儿童接受了CBCL评估。总体行为和情绪问题的患病率为13%（95% CI 12-14），外部问题为10%（9-11），内部问题为22%（21-24）。最常见的CBCL综合征是躯体问题（21%，20-23），而最常见的DSM-IV导向量表是焦虑问题（13%，12-14）。与总问题相关的因素包括食用木薯（风险比5.68，95%CI 3.22-10.03），围产期并发症（4.34，3.21-5.81），癫痫发作（2.90，2.24-3.77）和家庭状况（0.11，0.08-0.14）。癫痫发作障碍，烧伤痕迹，呼吸问题的行为和情绪问题的重要合并症。解释行为和情绪问题是常见的学龄前儿童在肯尼亚农村地区，并与可预防的危险因素。行为和情绪问题以及相关的合并症应在幼儿中识别和解决。版权所有（C）作者。爱思唯尔有限公司出版
Background Three-quarters of the burden of mental health problems occurs in low-and-middle-income countries, but few epidemiological studies of these problems in preschool children from sub-Saharan Africa have been published. Behavioural and emotional problems often start in early childhood, and this might be particularly important in Africa, where the incidence of perinatal and early risk factors is high. We therefore aimed to estimate the prevalence and risk factors of behavioural and emotional problems in young children in a rural area on the Kenyan coast.Methods We did a population-based epidemiological study to assess the burden of behavioural and emotional problems in preschool children and comorbidities in the Kilifi Health and Demographic Surveillance System (KHDSS, a database formed of the population under routine surveillance linked to admissions to Kilifi County Hospital). We used the Child Behaviour Checklist (CBCL) to assess behavioural and emotional problems. We then determined risk factors and medical comorbidities associated with behavioural and emotional problems. The strength of associations between the risk factors and the behavioural and emotional problems was estimated using generalised linear models, with appropriate distribution and link functions.Findings 3539 families were randomly selected from the KHDSS. Of these, 3273 children were assessed with CBCL. The prevalence of total behavioural and emotional problems was 13% (95% CI 12-14), for externalising problems was 10% (9-11), and for internalising problems was 22% (21-24). The most common CBCL syndrome was somatic problems (21%, 20-23), whereas the most common DSM-IV-oriented scale was anxiety problems (13%, 12-14). Factors associated with total problems included consumption of cassava (risk ratio 5.68, 95% CI 3.22-10.03), perinatal complications (4.34, 3.21-5.81), seizure disorders (2.90, 2.24-3.77), and house status (0.11, 0.08-0.14). Seizure disorders, burn marks, and respiratory problems were important comorbidities of behavioural and emotional problems.Interpretation Behavioural and emotional problems are common in preschool children in this Kenyan rural area and are associated with preventable risk factors. Behavioural and emotional problems and associated comorbidities should be identified and addressed in young children. Copyright (C) The Author(s). Published by Elsevier Ltd.