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Reliability of the Luganda version of the Child Behaviour Checklist in measuring behavioural problems after cerebral
Paul Bangirana1, Noeline Nakasujja, Bruno Giordani
1Department of Psychiatry, Makerere University School of Medicine, Kampala, Uganda. pbangirana@yahoo.com
Insights
The Luganda version of the Child Behaviour Checklist (CBCL) shows fair reliability for assessing childhood behavior in Uganda. Cerebral malaria may lead to depressive and thought problems in children.
Area of Science:
- Child and Adolescent Psychiatry
- Global Health
- Neuropsychology
Background:
- Uganda lacks validated childhood behavior measures, despite known risks.
- Cerebral malaria is a significant risk factor for behavioral issues in children.
- Behavioral outcomes following cerebral malaria remain under-described in this population.
Purpose of the Study:
- To evaluate the reliability of the Luganda version of the Child Behaviour Checklist (CBCL).
- To describe the behavioral outcomes in Ugandan children following cerebral malaria.
Main Methods:
- The Luganda CBCL was administered to parents of 64 children (aged 7-16) post-cerebral malaria.
- Internal consistency was assessed using Cronbach's Alpha; test-retest reliability was determined via control group correlations.
- Multicultural norms identified clinically significant behavioral problems.
Main Results:
- Internalizing scales demonstrated good reliability (0.64-0.66); Externalizing scales (0.74-0.78) and Total Problems (0.67-0.83) showed strong reliability.
- Commonly reported issues included withdrawn/depressed (15.6%), thought problems (12.5%), aggressive behavior (9.4%), and oppositional defiant behavior (9.4%).
Conclusions:
- The Luganda CBCL is a reasonably reliable tool for assessing behavioral problems in Ugandan children.
- Depressive and thought problems appear to be potential behavioral sequelae of cerebral malaria.
- Further validation in clinical settings with psychiatric diagnoses is recommended.
Background:
No measure of childhood behaviour has been validated in Uganda despite the documented risks to behaviour. Cerebral malaria in children poses a great risk to their behaviour, however behavioural outcomes after cerebral malaria have not been described in children. This study examined the reliability of the Luganda version of the Child Behaviour Checklist (CBCL) and described the behavioural outcomes of cerebral malaria in Ugandan children.
Methods:
The CBCL was administered to parents of 64 children aged 7 to 16 years participating in a trial to improve cognitive functioning after cerebral malaria. These children were assigned to the treatment or control group. The CBCL parent ratings were completed for the children at baseline and nine weeks later. The CBCL was translated into Luganda, a local language, prior to its use. Baseline scores were used to calculate internal consistency using Cronbach Alpha. Correlations between the first and second scores of the control group were used to determine test-retest reliability. Multicultural norms for the CBCL were used to identify children with behavioural problems of clinical significance.
Results:
The test-retest reliability and internal consistency of the Internalising scales were 0.64 and 0.66 respectively; 0.74 and 0.78 for the Externalising scale and 0.67 and 0.83 for Total Problems. Withdrawn/Depressed (15.6%), Thought Problems (12.5%), Aggressive Behaviour (9.4%) and Oppositional Defiant Behaviour (9.4%) were the commonly reported problems.
Conclusion:
The Luganda version of the CBCL is a fairly reliable measure of behavioural problems in Ugandan children. Depressive and thought problems are likely behavioural outcomes of cerebral malaria in children. Further work in children with psychiatric diagnoses is required to test its validity in a clinical setting.
