Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #121323

Shuaib Kauchali, FCPaed, MS¹, Stephen Arpadi, MD, MS², Meera Chhagan, FCPaed, MS³, Jane Kvalsvig, PhD³, Leslie L. Davidson, MD, MSc⁴, Miriam Adhikari, MD³, and Zena Stein, MB, BCh⁵. (1) Paediatrics and Child Health (UKZN) AND Epidemiology (Columbia), Nelson R Mandela School of Medicine, University of KwaZulu-Natal AND Mailman School of Public Health, Columbia University, Room#491A, Medical School, 719 Umbilo Road, Durban, 4001, South Africa, +27-31-260-4352, sk2222@columbia.edu, (2) Epidemiology, Mailman School of Public Health, Columbia University, 722W 168 Street, New York, NY 10032, (3) Paediatrics and Child Health, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Medical School, 719 Umbilo Road, Durban, 4001, South Africa, (4) Heilbrunn Dept. of Population and Family Health, Columbia University, 60 Haven Ave. B-2, New York, NY 10032, (5) NYS Psychiatric Institute and Columbia University, HIV Center for Clinical & Behavioral Studies, 1051 Riverside Drive - Unit 15, New York, NY 10032

Background: Little is known about the prevalence and determinants of neurodevelopmental disabilities in children in developing countries with high HIV prevalence. Methods: During the planning process for a large epidemiologic study to be launched in KwaZulu-Natal, South Africa, children aged 2-9 years and caregivers were enrolled into a pilot study to explore the relationship between caregiver mental health and child HIV and neurodevelopmental disability. In Phase I, a convenient community-based sample of 105 children was screened using validated Ten-Questions-Plus (TQP) for child disability. Caregivers were screened for major depression using the WHO Self-Reporting-Questionnaire-20 (SRQ-20) and PRIME-MD (PHQ-9) questionnaires. In Phase II, comprehensive neuropsychological assessments were completed for 92% of children screened. Results: There was 80% acceptance of HIV testing. Of the 5 HIV-infected children, 3 had a neurodevelopmental disability. A significant correlation was found between the SRQ-20 scores and PHQ-9, and between TQP failure and neuropsychological assessment. Children who failed the TQP screen (OR 4.2; 95%CI 1.6 to 11.1) or were disabled on assessment (OR 1.9 95%CI 0.8 to 4.5) were more likely to have caregivers with depression. A large proportion of severely disabled children were not receiving social service grants. Disabled children were less likely than their non-disabled age peers to be attending school. Conclusion: These preliminary findings of a relationship between caregiver depression and child neurodevelopmental disability need further investigation in order to develop effective interventions.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Apply the 2-Phase method for population screening of children with neurodevelopmental disabilities in a resource poor setting
• Identify feasible, acceptable, and reliable measures of screening and assessing children for neurodevelopmental disabilties and their caregivers for depression in resource poor setting
• Construct testable hypothesis to evaluate child-caregiver interaction at a population level in developing countries

Keywords: Adult and Child Mental Health, Children With Special Needs

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.