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

Kalembo, Fatch Welcome; Kendall, Garth; Ali, Mohammed; Chimwaza, Angela

doi:10.1186/s12888-019-2046-2

Cited by 23 publications

(31 citation statements)

References 70 publications

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“…Delayed disclosure might result in transmitting HIV to potential sexual partners and others, and results in unsafe sex practices among older adolescents with PHIV. These findings are compatible with those of other studies that documented the serious consequences of delaying informing the child about his/her HIV status [ 7 , 32 , 42 , 47 , 48 ].…”

Section: Discussionsupporting

confidence: 91%

The Consequences of Delaying Telling Children with Perinatal HIV About Their Diagnosis as Perceived by Healthcare Workers in the Eastern Cape; A Qualitative Study

Madiba

2020

Children

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Although the benefits of disclosure are considerable, informing children with perinatal HIV of their own HIV status is often delayed to late adolescence. This study examined the social and contextual challenges that influence delaying disclosure to children and assessed the outcomes of delayed disclosure on the psychosocial health of children as perceived by the healthcare workers (HCWs) providing care to these children. Data were collected from HCWs via focus group discussions. Nurses, lay counsellors, social workers, and dieticians were selected from facilities in a rural South African health district. Thematic analysis was performed. The caregivers’ social context was the main barrier against informing children timely about their HIV diagnosis. The extent of the internalised HIV stigma influenced the delay in disclosing to the children. Delaying disclosure contributes to children’s refusing to take their medication, leads to the accidental disclosure of HIV, give rise to anger and resentment towards the caregiver, increase the risk of secondary transmitting of HIV, and poor health outcomes. It is essential to train HCWs to support caregivers and children through the disclosure process to ensure that caregivers realise the benefits of disclosure. Strategies to encourage caregivers to disclose early should be sensitive to their concerns about the negative impacts of disclosure.

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Section: Discussionsupporting

confidence: 91%

The Consequences of Delaying Telling Children with Perinatal HIV About Their Diagnosis as Perceived by Healthcare Workers in the Eastern Cape; A Qualitative Study

Madiba

2020

Children

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“…19 It is a well-validated tool, translated into 60 languages of the world including those of African countries like Chichewa (Malawian local language). 20 The SDQ has 25 items rated on a three-point Likert Scale: not true=0, somewhat true=1 and certainly true=2. It has five subscales: emotional problems, conduct problems, hyperactivity/inattention, peer relationship problems and pro-social behaviour.…”

Section: Main Outcome Variablementioning

confidence: 99%

Children emotional and behavioural problems and its association with maternal depression in Jimma town, southwest Ethiopia

et al. 2020

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BackgroundIn sub-Saharan countries, one in five children and one in three women experiences emotional and behavioural problems (EBPs) and depression, respectively. While various factors were reported to affect the mental health of children, little is known about the impact of maternal depression on the offspring. Moreover, the magnitude of children’s EBPs is barely known in Ethiopia.AimTo determine the magnitude of child EBPs and its association with maternal depression in Jimma town, southwest Ethiopia.MethodsA quantitative cross-sectional study was conducted among 734 mother–child pairs in Jimma town from January to June, 2019. EBP was assessed by using the parent version of Strengths and Difficulties Questionnaire (SDQ) with cut-off score of ≥14. Maternal depression was assessed using Patient Health Questionnaire-9 with a cut-off score of ≥10. Data were entered into Epidata V.3.1 and exported to SPSS V.24 for analysis. Multivariable logistic regression was fitted to identify the strength of association between exposure and outcome variables.ResultsOf the 734 participants, 146 (19.9%, 95% CI: 16.9% to 22.9%) met EBP criteria based on parent version of SDQ. Maternal depression had significant association with child EBP (adjusted OR=2.38, 95% CI: 1.55 to 3.66). In addition, children aged 7–10 years, family size categories of ≤3 and 4–6, maternal intimate partner violence and maternal khat use had significant association with child EBP.Conclusions and recommendationsA significant number of children suffer from EBP in Jimma town. Maternal depression is found to be a predictor of children’s EBPs. Thus, there is a need to design and implement an integrated maternal and child mental health programme. The maternal and child health section at the national level should integrate and cascade routine maternal and child mental health screening and intervention modalities down to the family healthcare system.

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“…Delayed disclosure denies children the opportunity to make correct and informed decisions about their health and increases the risk of their transmitting HIV to potential sexual partners and others. 8 - 11 The benefits of timely and safe disclosure include improved adherence, retention in care, involvement of the adolescents in their care, and safer sex behaviors. 2 , 7 , 12 …”

Section: Introductionmentioning

confidence: 99%

Truth, Deception, and Coercion; Communication Strategies Used by Caregivers of Children with Perinatally Acquired HIV During the Pre-Disclosure and Post-Disclosure Period in Rural Communities in South Africa

Molokwane

Madiba

2021

Global Pediatric Health

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Typically, children with perinatal HIV (PHIV) receive antiretroviral treatment (ART) for a long time prior to receiving disclosure. Communication with children about HIV and treatment is critical for monitoring adherence and retention in care. However, there is a dearth of information on communication between caregivers and their children. This study examines what and how caregivers tell their their children about their illness and medication in the pre-disclosure and post-disclosure period. A qualitative study using semi-structured one-on-one interviews and focus group discussions was conducted with caregivers recruited via purposive sampling from a rural sub-district in South Africa. The interviews were analyzed using thematic analysis. The sample consisted of 38 caregivers, 24 of whom were the children’s biological mothers, 20 had disclosed to the children and 18 had not done so. Caregivers who had disclosed had told their children the truth and named the disease as HIV, but communication about HIV was infrequent and focused on pill taking. Those who had not disclosed had lied, deflected illness-related information, and attributed the children’s ill health to co-morbid conditions. To enforce adherence, most caregivers used coercion and threats of the grave consequences of non-adherence as a communication strategy. Those who had not disclosed used deception, deflecting, and coercion as strategies for coping through the pre-disclosure period. There is a need for healthcare workers to prepare, support, and empower caregivers to develop appropriate responses to children’s questions and to understand the implications of deception on future full disclosure and children’s acceptance of their HIV status.

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

Cited by 23 publications

References 70 publications

The Consequences of Delaying Telling Children with Perinatal HIV About Their Diagnosis as Perceived by Healthcare Workers in the Eastern Cape; A Qualitative Study

The Consequences of Delaying Telling Children with Perinatal HIV About Their Diagnosis as Perceived by Healthcare Workers in the Eastern Cape; A Qualitative Study

Children emotional and behavioural problems and its association with maternal depression in Jimma town, southwest Ethiopia

Truth, Deception, and Coercion; Communication Strategies Used by Caregivers of Children with Perinatally Acquired HIV During the Pre-Disclosure and Post-Disclosure Period in Rural Communities in South Africa

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