Attention-deficit hyperactivity disorder in school-age children in Gaborone, Botswana: Comorbidity and risk factors

Background: Attention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders in children. Its occurrence and pattern of presentation are unknown in Botswana. Aim: To determine the prevalence of attention-deficit hyperactivity disorder (ADHD), associated comorbid conditions and risk factors amongst school-age children in Botswana. Setting: Primary schools in Gaborone, Botswana. Methods: This study used a cross-sectional design. A two-stage random sampling technique was utilised to select learners from 25 out of the 29 public schools in the city. The Vanderbilt ADHD Diagnostic Rating Scale (VADRS), teacher and parent versions, was administered. Results: Of the 1737 children, 50.9% ( n = 884) were male, and their mean age was 9.53 years (s.d. = 1.97). The prevalence of ADHD was 12.3% ( n = 213). The most prevalent presentation was the predominantly inattentive, 7.2% ( n = 125). A family history of mental illness (odds ratio [OR] = 6.59, 95% CI: 1.36–32.0) and perinatal complications (OR = 2.16, 95% CI: 1.08–4.29) emerged as the independent predictors of ADHD. Conclusions: The prevalence of ADHD in Botswana is slightly higher than that reported in the literature, but the pattern of presentations and comorbidities is similar. A positive family history of mental illness and perinatal complications independently predicted ADHD. Mental health screening amongst families of the affected individuals and improved perinatal care should be considered as health care priorities in Botswana.