Behavior Problems in Physically Ill Children in Rwanda.

Area of Science:

• Global Mental Health
• Pediatric Psychology
• Child Psychiatry

Background:

• Childhood behavior problems are frequently underidentified in low- and middle-income countries.
• Systematic screening is crucial for early detection and intervention in pediatric populations.

Purpose of the Study:

• To systematically screen for behavior problems in Rwandan children receiving medical care.
• To identify factors associated with behavior problems in this cohort.

Main Methods:

• The Pediatric Symptom Checklist (PSC) was translated into Kinyarwanda.
• Children aged 5.9–16 years in inpatient and outpatient departments were screened.
• PSC-positive children and a subset of PSC-negative children received specialist mental health assessments.

Main Results:

• 32% of screened children (235 total) were PSC-positive.
• 57% of assessed PSC-positive children (7% of all screened) required further mental health care.
• Behavior problems were associated with outpatient care, CNS trauma/infection, malnutrition, and traditional, complementary, and alternative medicine (TCAM) use.

Conclusions:

• Behavior problems are prevalent in Rwandan children attending a referral hospital, particularly in outpatient settings.
• The Kinyarwanda PSC demonstrates favorable screening characteristics for childhood behavior problems.
• Screening facilitated access to essential mental health care for a significant proportion of children.