Prevalence and associated factors of attention deficit hyperactivity disorder among children and adolescents attending outpatient departments in public hospitals, in Addis Ababa, Ethiopia

Abstract

Abstract Background: Attention deficit hyperactivity disorder (ADHD) is one of childhood and adolescence's common neurodevelopmental disorders. There is a lack of data in Sub-Saharan Africa, particularly Ethiopia, which creates a big gap in the appropriate and efficient management of these groups of populations. Objectives: To assess the prevalence of ADHD and associated factors among children and adolescents who visit outpatient departments at public hospitals in Addis Ababa, Ethiopia. Methods: A Multicenter, cross-sectional study was conducted from October 2 - December 1, 2023, G.C. at St. Paul’s Hospital Millennium Medical College, Ras Desta Memorial Hospital, and Menelik Second referral hospital. The sample size was 227 children and adolescents between the ages of 5 and 14 years residents who were selected by using systematic random sampling techniques, and the Disruptive Behavioral Disorder rating scale was used to assess ADHD. To look for associations, logistic regression analysis, both binary and multivariable, was done. The variables with an association with the outcome variable with a p-value of <0.05 were used to declare statistical significance in the final multivariable logistic regression. Results: The prevalence of ADHD among these participants (n=227) was found to be 13.2 % (95% CI = 9.1 – 18.3). ADHD was associated with child age (AOR: 3.39; 95% CI (1.05,10.9), maternal illness during pregnancy (AOR: 4.704; 95% CI (1.28,17.2), maternal substance use during pregnancy (AOR: 3.89, 95% CI (1.2,12.637), an externalizing score for slightly raised and high & very high score (AOR: 2.6, 95% CI (0.57,12.03) and (AOR: 20.77; 95% CI(2.23,193.6), respectively and TDS for slightly raised and high & very high score (AOR: 7.48; 95% CI(1.71,32.78) and (AOR: 8.1; 95% CI(1.35,48.5) respectively. Conclusion: Overall, the current finding showed that ADHD is prevalent among children attending OPDs at different Hospitals in Addis Ababa. While screening for ADHD is done, risk factors such as maternal illness and substance use during pregnancy, child history of head injury, and externalizing symptoms like aggression, impulsivity, and disruptive tendencies should be considered. Addressing these risk factors may alleviate or prevent the hazard of developing this condition in these age groups. This result helps to try to fill the gap and provide information for policymakers to develop and improve ADHD treatments and services. Keywords: ADHD, prevalence, children and adolescents, Addis Ababa