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Published on: January 16, 2015
Use of the creating opportunities for parent empowerment programme to decrease mental health problems in Ugandan
Paul Bangirana1, Annet Birabwa2, Mary Nyakato3
1Department of Psychiatry, Makerere University College of Health Sciences, Kampala, Uganda. pbangirana@yahoo.com.
Insights
A caregiver behavioral intervention did not improve mental health outcomes for Ugandan children after severe malaria. Further research is needed for effective interventions with longer follow-up periods.
Area of Science:
- Pediatric mental health
- Infectious disease epidemiology
- Behavioral interventions
Background:
- Severe malaria can lead to long-term mental health issues in children.
- Understanding the impact of interventions on post-malaria mental health is crucial.
Purpose of the Study:
- To evaluate a caregiver behavioral intervention's effect on children's mental health 6 months after severe malaria hospitalization.
- To assess the intervention's impact on caregiver anxiety and depression.
Main Methods:
- Randomized controlled trial involving 120 caregiver-child dyads in Uganda.
- Intervention group received psycho-education and behavioral support; control group received standard information.
- Mental health outcomes assessed using validated questionnaires at baseline and 6-month follow-up.
Main Results:
- No significant difference in child behavioral problems between intervention and control groups at 6 months (p=0.72).
- Caregiver depression and anxiety scores did not differ between groups at follow-up.
- Baseline caregiver depression, mother's education, and child's sex were associated with baseline child behavioral problems.
Conclusions:
- The tested behavioral intervention did not improve mental health outcomes for children post-severe malaria.
- Longer follow-up durations are necessary for future intervention studies.
- Developing targeted interventions for pediatric mental health after severe malaria requires further investigation.
Background:
Severe malaria is associated with long-term mental health problems in Ugandan children. This study investigated the effect of a behavioural intervention for caregivers of children admitted with severe malaria, on the children's mental health outcomes 6 months after discharge.
Methods:
This randomized controlled trial was conducted at Naguru Hospital in Kampala, Uganda from January 2018 to July 2019. Caregiver and child dyads were randomly assigned to either a psycho-educational arm providing information about hospital procedures during admission (control group), or to a behavioural arm providing information about the child's possible emotions and behaviour during and after admission, and providing age appropriate games for the caregiver and child (intervention group). Pre- and post-intervention assessments for caregiver anxiety and depression (Hopkins Symptom Checklist) and child mental health problems (Strength and Difficulties Questionnaire and the Child Behaviour Checklist) were done during admission and 6 months after discharge, respectively. T-tests, analysis of covariance, Chi-Square, and generalized estimating equations were used to compare outcomes between the two treatment arms.
Results:
There were 120 caregiver-child dyads recruited at baseline with children aged 1.45 to 4.89 years (mean age 2.85 years, SD = 1.01). The intervention and control groups had similar sociodemographic, clinical and behavioural characteristics at baseline. Caregiver depression at baseline, mother's education and female child were associated with behavioural problems in the child at baseline (p < 0.05). At 6 months follow-up, there was no difference in the frequency of behavioural problems between the groups (6.8% vs. 10% in intervention vs control groups, respectively, p = 0.72). Caregiver depression and anxiety scores between the treatment arms did not differ at 6 months follow-up.
Conclusion:
This behavioural intervention for caregivers and their children admitted with severe malaria had no effect on the child's mental health outcomes at 6 months. Further studies need to develop interventions for mental health problems after severe malaria in children with longer follow-up time. Trail registration ClinicalTrials.gov Identifier: NCT03432039.
