Attention deficit hyperactivity disorder among children with sickle cell anaemia seen at the University of Benin Teaching Hospital, Benin City, Nigeria

Abstract

Background: Attention Deficit Hyperactivity Disorder (ADHD) is a disorder involving persistent and impaired levels of hyperactivity, impulsiveness and lack of attention associated with impairment in executive functioning of affected children. Diagnosis of ADHD in the background of sickle cell anaemia (SCA), a haemoglobinopathy associated with neurological complications may result in significant impairment of the child into adulthood, if not detected early. In view of the fact that ADHD can be managed if diagnosed early prompted the undertaking of this study.

Subjects and Methods: Study was conducted at the Paediatric Haematology Clinic of the University of Benin Teaching Hospital, Benin City. Parents of children with SCA were informed of the study and consent obtained. Demographic characteristics were recorded. Data collection instrument was the Parent Version of the National Institute for Children’s Health Quality (NICHQ) Vanderbilt ADHD Diagnostic Rating Scale (VADRS). Scoring was done for each participant using the scoring instructions for NICHQ VADRS following the DSM-IV criteria.

Results: A total of 103 children with SCA participated in this study. Sixty-two (60.2%) were males while 41 (39.8%) were females. Prevalence of ADHD was 15 (14.6%) with predominantly inattentive sub-type being the commonest. Children with stroke are two times more likely to develop ADHD than those without stroke (Fisher’s exact test = 0.269, 95% CI= 0.589 to 7.558, Odds Ratio=2.55). Age, sex and socioeconomic status did not significantly affect the diagnosis of ADHD.

Conclusion: Prevalence of parentreported ADHD in children with SCA is high, especially in SCA children with stroke than those without stroke.