ADHD in Mozambique: An epidemiological investigation in a Primary School Sample.

To evaluate the prevalence of ADHD, comorbidity rates with Disruptive Behavior Disorders (DBD), and main negative outcomes in primary-school students in Nampula, Mozambique. We selected a random sample of 748 students for ADHD screening from a population of around 43000 primary school students. The Swanson, Nolan, and Pelham Rating Scale version IV (SNAP-IV scale) was applied to both parents and teachers. All positive screened students (n = 76) and a propensity score-matched random subset of negative screened subjects (n = 76) had a psychiatric evaluation carried out by a child psychiatrist. The prevalence of ADHD was estimated to be 13.4% (CI95%: 11.5%-19.2%) and 30.6% of youths with ADHD presented a comorbid DBD. Students with ADHD (n=36) had significantly higher rates of both substance use (alcohol, marijuana) (p < .001), and school repetitions than controls (n=96; p < .001). Comorbidity between ADHD and DBD increased the chance of substance use (p < .001). Secondary analyses, using more restrictive ADHD diagnostic criteria determined a lower prevalence rate (6.7%; CI95%: 5.2%-12.9%) with similar patterns of associated factors and negative outcomes. Our findings demonstrated that ADHD is a prevalent mental disorder in Mozambique, and it is associated with similar comorbid profiles, predisposing factors, and negative outcomes as in other cultures.

Déclaration de conflit d'intérêts

Luis Augusto Rohde has received grant or research support from, served as a consultant to, and served on the speakers’ bureau of Abdiibrahim, Adium, Apsen, Abbott, Aché, Bial, Medice, Novartis/Sandoz, Pfizer/Upjohn, and Shire/Takeda in the last three years. The ADHD and Juvenile Bipolar Disorder Outpatient Programs chaired by Dr. Rohde have received unrestricted educational and research support from the following pharmaceutical companies in the last three years: Novartis/Sandoz and Shire/Takeda. Dr. Rohde has received authorship royalties from Oxford Press and ArtMed. AC has provided one consultancy session for Knight Therapeutics in 2022.