Emotional and behavioural problems of HIV-infected children: findings from a southeastern Nigeria tertiary healthcare facility.

Abstract

Background: In children, HIV infection presents with grave consequences, including a predisposition to
emotional and behavioural problems (EBP). These are mental health problems affecting thoughts,
emotions, behaviours and relationships, and may be categorised into emotional problems (EP) and
behavioural problems (BP). Studies have shown a high burden of EBP in children; however, knowledge
gaps still exist regarding the burden of EBP on HIV-infected children. Our study seeks to address these
gaps by determining the prevalence and type of EBP among HIV-infected children.
Methodology: This cross-sectional and comparative study enrolled 386 participants (193 subjects and
193 controls). The subjects were HIV-infected children aged 2-15 years attending the Paediatric HIV
Clinic of Federal Medical Centre, Umuahia. The controls were age and sex-matched HIV-negative
children attending primary or secondary schools in Umuahia. Sociodemographic characteristics were
assessed, and EBP was determined using the strengths and difficulties questionnaire.
Results: Sixty-one subjects (31.6%) had EBP compared to 15 controls (7.8%) and this difference was
significant (p<0.001). The subjects were three times more likely to have EBP than the controls
(aOR=3.03; CI=1.17-7.82). The EBP type showed that, while there was no significant difference in the
multivariate analysis of the behavioural problems, emotional problems were significantly higher in the
subjects than in the controls (p = 0.001). The subjects were six times more likely to have emotional
problems than the controls (aOR=6.26; CI=2.80-13.97).
Conclusion: There is a high burden of EBP among HIV-infected children in Umuahia with emotional
problems as the common type.