Behavioral problems in children with unoperated rheumatic heart disease at national referral hospital in Ethiopia: an observational study
Abstract Background The behavioral disorder is characterized by a profound abnormality in an individual’s cognition, emotion or behavior that reflects in psychological, biological or developmental dysfunction. Rheumatic heart disease (RHD) is a long-term sequel of single or recurrent acute rheumatic...
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2024-12-01
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| Series: | BMC Psychiatry |
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| Online Access: | https://doi.org/10.1186/s12888-024-06401-y |
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| author | Addishiwot Melesse Rediet Fasil Dejuma Yadeta Henok Tadele |
| author_facet | Addishiwot Melesse Rediet Fasil Dejuma Yadeta Henok Tadele |
| author_sort | Addishiwot Melesse |
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| description | Abstract Background The behavioral disorder is characterized by a profound abnormality in an individual’s cognition, emotion or behavior that reflects in psychological, biological or developmental dysfunction. Rheumatic heart disease (RHD) is a long-term sequel of single or recurrent acute rheumatic fever. Children with RHD are thought to be at increased risk for behavioral problems due to autoimmunity seen in pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS). Behavior disorder is not well studied among children with RHD. Hence, this study aimed to assess the pattern and predictors of behavioral problems among children with RHD enrolled in chronic care at a national cardiac referral Hospital. Methods This cross-sectional study used a validated parental-reported Amharic Strengths and Difficulties Questionnaire (SDQ) to assess behavior problems. Children with RHD aged 6–17 years on chronic outpatient cardiac care at Tikur Anbessa Specialized Hospital, Ethiopia between February and May 2023 were included. Factors associated with behavior problems were assessed using logistic regression models. Results The study included 166 children with a median age of 15 years [Interquartile range (IQR):13–17 years]. One-fourth of children, 24.7% (95% CI: 18.34–31.98), had behavioral problems. Of these, 46.4% (77) emotional, 35.5% (59) peer, 18.1% (30) conduct and 6.6% (11) hyperactivity problems were documented. Children who had good medication adherence, adjusted odds ratio AOR 0.29(95% CI: 0.09–0.94, P 0.040) and on New York Health Association (NYHA) class I, AOR 0.28(95% CI: 0.11–0.79, P 0.016) had lower odds for behavioral problems. Conclusion One-fourth of children with RHD had behavioral abnormalities. Medication adherence and NYHA predicted behavioral abnormality. Better physical symptom control was associated with fewer behavioral problems. Behavioral abnormalities should be considered and assessed among children with RHD. Further multi-center mixed studies are recommended to uncover the unseen behavioral problem and guide health policy action on modalities of integration of behavioral problems assessment tools in clinical care. |
| format | Article |
| id | doaj-art-bc386cc8741d45af8dbcdbe07fb64d5a |
| institution | Kabale University |
| issn | 1471-244X |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Psychiatry |
| spelling | doaj-art-bc386cc8741d45af8dbcdbe07fb64d5a2024-12-22T12:40:09ZengBMCBMC Psychiatry1471-244X2024-12-012411910.1186/s12888-024-06401-yBehavioral problems in children with unoperated rheumatic heart disease at national referral hospital in Ethiopia: an observational studyAddishiwot Melesse0Rediet Fasil1Dejuma Yadeta2Henok Tadele3Department of Pediatrics and Child Health, School of Medicine, College of Health Sciences, Addis Ababa UniversityAddis Continental Institute of Public HealthDepartment of Internal Medicine, School of Medicine, College of Health Sciences, Addis Ababa UniversityDepartment of Pediatrics and Child Health, School of Medicine, College of Health Sciences, Addis Ababa UniversityAbstract Background The behavioral disorder is characterized by a profound abnormality in an individual’s cognition, emotion or behavior that reflects in psychological, biological or developmental dysfunction. Rheumatic heart disease (RHD) is a long-term sequel of single or recurrent acute rheumatic fever. Children with RHD are thought to be at increased risk for behavioral problems due to autoimmunity seen in pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS). Behavior disorder is not well studied among children with RHD. Hence, this study aimed to assess the pattern and predictors of behavioral problems among children with RHD enrolled in chronic care at a national cardiac referral Hospital. Methods This cross-sectional study used a validated parental-reported Amharic Strengths and Difficulties Questionnaire (SDQ) to assess behavior problems. Children with RHD aged 6–17 years on chronic outpatient cardiac care at Tikur Anbessa Specialized Hospital, Ethiopia between February and May 2023 were included. Factors associated with behavior problems were assessed using logistic regression models. Results The study included 166 children with a median age of 15 years [Interquartile range (IQR):13–17 years]. One-fourth of children, 24.7% (95% CI: 18.34–31.98), had behavioral problems. Of these, 46.4% (77) emotional, 35.5% (59) peer, 18.1% (30) conduct and 6.6% (11) hyperactivity problems were documented. Children who had good medication adherence, adjusted odds ratio AOR 0.29(95% CI: 0.09–0.94, P 0.040) and on New York Health Association (NYHA) class I, AOR 0.28(95% CI: 0.11–0.79, P 0.016) had lower odds for behavioral problems. Conclusion One-fourth of children with RHD had behavioral abnormalities. Medication adherence and NYHA predicted behavioral abnormality. Better physical symptom control was associated with fewer behavioral problems. Behavioral abnormalities should be considered and assessed among children with RHD. Further multi-center mixed studies are recommended to uncover the unseen behavioral problem and guide health policy action on modalities of integration of behavioral problems assessment tools in clinical care.https://doi.org/10.1186/s12888-024-06401-yBehavioral problemsAbnormalitiesEmotionRheumatic heart diseaseEthiopia |
| spellingShingle | Addishiwot Melesse Rediet Fasil Dejuma Yadeta Henok Tadele Behavioral problems in children with unoperated rheumatic heart disease at national referral hospital in Ethiopia: an observational study BMC Psychiatry Behavioral problems Abnormalities Emotion Rheumatic heart disease Ethiopia |
| title | Behavioral problems in children with unoperated rheumatic heart disease at national referral hospital in Ethiopia: an observational study |
| title_full | Behavioral problems in children with unoperated rheumatic heart disease at national referral hospital in Ethiopia: an observational study |
| title_fullStr | Behavioral problems in children with unoperated rheumatic heart disease at national referral hospital in Ethiopia: an observational study |
| title_full_unstemmed | Behavioral problems in children with unoperated rheumatic heart disease at national referral hospital in Ethiopia: an observational study |
| title_short | Behavioral problems in children with unoperated rheumatic heart disease at national referral hospital in Ethiopia: an observational study |
| title_sort | behavioral problems in children with unoperated rheumatic heart disease at national referral hospital in ethiopia an observational study |
| topic | Behavioral problems Abnormalities Emotion Rheumatic heart disease Ethiopia |
| url | https://doi.org/10.1186/s12888-024-06401-y |
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