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Behavior Problems in Physically Ill Children in Rwanda.

Jean Paul Rukabyarwema1, Natalie McCall2, Tharcisse Ngambe1

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Childhood behavior problems are common in Rwandan children, especially in outpatient care. Screening using the Kinyarwanda Pediatric Symptom Checklist (PSC) identified 7% of children needing mental health services.

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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.