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Cortina MA, Sodha A, Fazel M, Ramchandani PG. Prevalence of Child Mental Health Problems in Sub-Saharan Africa: A Systematic Review. Arch Pediatr Adolesc Med. 2012;166(3):276–281. doi:10.1001/archpediatrics.2011.592
Author Affiliations: Department of Psychiatry (Drs Cortina, Fazel, and Ramchandani) and Oxford University Hospitals NHS Trust (Dr Sodha), University of Oxford, Oxford, United Kingdom; and Medical Research Council/Wits Rural Public Health and Health Transitions Unit, University of the Witwatersrand, Johannesburg, South Africa (Dr Cortina). Dr Sodha is now with the Psychiatry Department, Norwick Park Hospital, Harrow, United Kingdom.
Objective To assess the prevalence of child mental health problems in community settings in sub-Saharan Africa.
Data Sources A systematic search of MEDLINE, EMBASE, and PsychInfo, supplemented by tracking of references from identified articles and personal communications with local researchers.
Study Selection Only community-based studies in sub-Saharan Africa that assessed the general psychopathology of children aged 0 to 16 years were included. For each eligible study, the following information was extracted: year of publication, country, population sampled, area type (rural or urban), sampling method and sample size (percentage boys), age range, assessment instrument, informant, diagnostic criteria, and prevalence rates of general psychopathology.
Main Outcome Measure Pooled prevalence rate of psychopathology in children, identified by questionnaire and, specifically, by clinical diagnostic instruments.
Results Eleven studies met the inclusion criteria, 10 of which were included in the meta-analysis. The 10 studies provided data for 9713 children from 6 countries, with substantial variation in assessment methods. Overall, 14.3% (95% CI, 13.6%-15.0%) of children were identified as having psychopathology. Studies using screening questionnaires reported higher prevalence rates (19.8%; 95% CI, 18.8%-20.7%) than did studies using clinical diagnostic instruments (9.5%; 8.4%-10.5%).
Conclusions Evidence suggests that considerable levels of mental health problems exist among children and adolescents in sub-Saharan Africa. One in 7 children and adolescents have significant difficulties, with 1 in 10 (9.5%) having a specific psychiatric disorder. There are clear sociodemographic correlates of psychopathology that may place children in areas of greatest deprivation at greatest risk.
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