Prevalence of attention deficit hyperactivity disorder symptoms among primary school children in Nigeria: a comparison of teachers and parent reports
Keywords:Attention deficit hyperactivity disorder, Prevalence, Children, Ikot Ekpene
Background: Attention deficit hyperactivity disorder (ADHD) is one of the most common neuro-behavioral disorders of childhood.Though ADHD is the most extensively studied neuro-behavioral disorder in childhood, its prevalence rate has not been documented in our environment. Aim of the current study was to determine the prevalence and subtypes of ADHD among primary school pupils living in Ikot-Ekpene, a semi-urban area in Nigeria’s rainforest.
Methods: This was a cross-sectional study conducted among 1174 primary school pupils aged 6-12 years selected from twelve primary schools in Ikot Ekpene local government area of Akwa Ibom state. The Vanderbilt rating scale for both teachers and parents were administered by teachers and parents of the pupils and the prevalence rate of ADHD was determined.
Results: One hundred and forty-six pupils met the rating scale criteria for probable ADHD using the teacher’s scale with a prevalence of 12.4%, while 8.5% met the criteria using the parent’s scale. Of the three different subtypes of ADHD, the hyperactive subtype was the most prevalent subtype on both the teacher’s and parent’s scales (52.7% and 46% respectively). The inattentive subtype was 32.9% and 33.0% on the teachers and parents scale respectively. The combined subtype was the least prevalent on both scales.
Conclusions: Prevalence rate of ADHD in children is significant in our environment. Policies should be put in place to implement the screening test for ADHD under the school health program for the early identification of pupils with ADHD.
Natosha RC, Peter J. Attention –Deficit/Hyperactivity Disorder. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF eds. Nelson textbook of paediatrics. 18th ed. Philadelphia: Saunder Elsevier; 2007:30:108-12.
Miller TW, Nigg JT, Miller RL. Attention deficit hyperactivity disorder in African American children: what can be concluded from the past ten years? Clin Psych Rev. 2009; 28;29(1):77-86
American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5®). Am Psychiatry Pub; 2013.
Faraone SV, Banaschewski T, Coghill D, Zheng Y, Biederman J,Bellgrove MA, et al. The World Federation of ADHD International Consensus Statement: 208 Evidence-based Conclusions about the Disorder. Available at: https://www. neubiorev.2021.01.022. Accessed on 20 November 2021.
Polanczyk G, de Lima MS, Horta BL, Biederman J, Rohde LA. The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psych. 2007;164(6):942-8
Willcutt EG. The prevalence of DSM-IV attention deficit/hyperactivity disorder: a meta-analytical review. Neuropathics. 2012; 9(3):490-9.
Fayyad J, De Graaf R, Kessler R, Alonso J, Angermeyer M, Demyttenaere K, et al. cross-national prevalence and correlates of adult attention-deficit hyperactivity disorder. Br J Psychiatr. 2007; 190(5):402-9.
Biedermann J, Mick E, Faraone SV. Age dependent decline of symptoms of attention deficit hyperactivity disorder: impact of remission definition and symptom type. Am J Psychiatr. 2000;157(5): 816-8.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5R). Am Psychiatric Pub. 2013.
Loe IM, Feldman HM, Academic and educational outcomes of children with ADHD. J Paediatr Psychol. 2007;32(6):643-54.
Moon S. Cultural perspectives on attention deficit hyperactivity disorder: A comparison between korea and the United States. J Int Bus Cult Stud. 2012; 6(1):1-11
Araoye MO. Research Methodology with statistics for Health and Social Science. Illorin: Nathadex Publishers; 2004:115-29.
Fewtrell MS, Kennedy K, Singhal A, Martin RM, Ness A, Hadders-Algra M et al. How much loss to follow-up is acceptable in long-term randomised trials and prospective studies?. Arch Dis Childhood. 2008;93(6):458-61.
Wolraich M. Vanderbilt ADHD diagnostic teacher rating scale. (VADTRS). Available at: https://www.brightfutures.org/mentalhealth/pdf/professionals/bridges/adhd.pdf. Accessed on 20 November 2021.
Ambuabunos EA, Ofovwe EG, Ibadin MO. Community survey of attention-deficit/hyperactivity disorder among primary school pupils in Benin City, Nigeria. Ann Afr Med. 2011;10(2).91-6.
Adewuya AO, Famuyiwa OO. Attention deficit hyperactivity disorder among Nigerian primary school children, prevalence and co-morbid conditions. Eur Child Adolesc Psychiat. 2007;16(1): 10-5.
Alikor EAD, Frank-Briggs AI, Okoh BN, Attention Deficit Hyperactivity Disorder Among School Children in Port Harcourt, Nigeria. Am J Psychiatry Neurosci. 2015;3(2):23-9.
Ofovwe CE, Ofovwe GE, Meyer A. The prevalence of attention deficit/hyperactivity disorder among school aged children in Benin city, Nigeria. J Child Adolesc Psychiatr Mental Health. 2006;18(1):1-5.
Adeboye MA, Akande TM, Osagbemi GK, Buhari OI, Abdulkadir MB, Ojuawo A. Attention Deficit Hyperactivity Disorder in Ilorin: Screening with the Conner’s Teachers rating scale. Sierra Leone J Biomed Res. 2018;10(1):33-41.
Egbochuku EO, Abikwi MI. The prevalence of attention deficit/hyperactivity disorder (ADHD) among primary school pupils of Benin Metropolis, Nigeria J Hum Ecol. 2007;22(4):317-22.
Wadsworth J, Burnell I, Taylay B, Butler N. The influence of family type on children’s behavior and development at five years. J Child Psychiatr. 1985; 26:245-54.
Harland P, Regneveld S, Brugman F, Verloove-Vanhorick S, Verhulst F. Family factors and life events as risk factors for behavior and emotional problems in children. Eur Child Adolesc Psychiatr. 2000;11:176-84.
Louma I, Puura K, Kaukonen P, Piha J, Rasanen E et al. Emotional and behavioural symptoms in 8-9 year old child in relation to family structure. Eur Child Adolesc Psychiatri. 1999;8:29-40
Benner A, Qahtari RA, Abdelaal I. The prevalence of ADHD among primary school children in an Arabian society. J Atten Disord. 2006;10(1):77-82.
Bu-haroon A, Eapen V. The prevalence of hyperactivity symptoms in the United Arab Emirates. Nordic J Psychiatry. 1999;53(6):439-42.
American Academy of Paediatrics. Clinical practice guideline: Diagnosis and evaluation of the child with attention deficit hyperactivity disorder. Pediatr. 2004;105:1158-70.
Walmulugwa J. Prevalence and associated factors of attention deficit hyperactivity disorder among Ugandan children; a cross sectional study. Child Adol Psychiatry. 2017;11(18):45-9.
Huss M, Holling B, Kurt M. How often are German children and adolescents diagnosed with ADHD? Prevalence based on judgement of health care professionals: results of the German health and examinations survey (KIGGS) TL.17. Eur Child Adolesc Psychiatr. 2009;17:52-8.
Ersan E.E , Dogan O, Dogan S, Sumer H. The distribution of symptoms of attention deficit hyperactivity disorder and oppositional defiant disorder in school aged children in Turkey. Eur Child Adolesc Psychiatr. 2004;13(6):354-61.
Kingsley A, Nyarko SH. Prevalence and effect of ADHD on school performance among primary school pupils in Hahoe municipality, Ghana. Annals J gen Psychiatry. 2017;16(1):11.
Narad ME, Garner AA, Peugh JL, Tamm L, Antonini TN, Kingery KM et al. Parent- teacher agreement on ADHD symptoms across development. Psychol Assessment. 2015; 27(1):239.
Neyir G, Ahmet T, S.Ebru CK, MuratT, Ismail AK. Prevalence of attention deficit hyperactivity disorder and comorbid disruptive behavior disorders among school age children in Trabzon. Clin Psychopharmacol. 2010;20(1):50-6.
Ndukuba AC, Odinka PC, Muomah RC, Obindo JT, Omigbodun OO. ADHD among rural southeastern Nigerian primary school children: Prevalence and psychosocial factors. J Atten Disord. 2017;10:865-71.
Umar MU, Obindo JT, Omigbodun OO. Prevalence and correlates of ADHD among adolescent students in Nigeria. J Atten Disord. 2018;22(2):116-26.
Offiong UM, Ali I, Mairiga F. Attention Deficit Hyperactivity Disorder in primary school children with poor academic performance in FCT. Clin Psychopharmacol. 2009;19(2):45-8.
Scuitto MJ, Nolfi CJ, Bluhm C. Effects of child gender and symptoms type on referrals for ADHD by elementary school teachers. J Emotion Behav Disord. 2004:12(4):247-53.