Study shows increased mental health risk for Malawi children living with HIV

Almost one-third of children living with HIV in Malawi experienced emotional and behavioural difficulties, according to their primary caregivers in new research led by Curtin University.

The research, published in the journal BMC Psychiatry, identified numerous family demographic and psychosocial factors, including the primary caregiver’s age, education and tribe, had a greater influence on mental health problems among children living with HIV than the illness itself.

Lead author Dr Fatch Kalembo, who completed the research as part of his PhD from the School of Nursing, Midwifery and Paramedicine at Curtin University, said the research aimed to assess the impact the disclosure of HIV status had on the prevalence of emotional and behavioural difficulties and associated risk factors in children living with HIV in Malawi.

“There are approximately 84,000 children under the age of 15 living with HIV in Malawi. Although the survival rate of children living with HIV has improved due to increased availability of medications, these children continue to experience numerous challenges that negatively impact their mental health,” Dr Kalembo said.

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“We conducted a cross-sectional survey involving 429 primary caregivers of children living with HIV in Malawi and found that more than 31 per cent of primary caregivers reported that their child experienced emotional and behavioural difficulties.

“It was determined that the primary caregivers’ younger ages, low levels of education, engagement in home duties and their community, as well as the severe impact of the child’s illness on the family, all contributed to the mental health problems of children living with HIV.”

Co-author Dr Garth Kendall, also from Curtin’s School of Nursing, Midwifery and Paramedicine, said the research findings highlighted that other factors impacted the emotional and wellbeing of a child living with HIV more than the disclosure of the illness to the child.

“The World Health Organisation (WHO) recommends that children living with HIV should be told about their HIV status in order to promote their physical and psychosocial wellbeing, but the results of our study indicate that disclosure of HIV does not necessarily affect this,” Dr Kendall said.

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“Instead, better support for the children living with HIV can lead to better health and development outcomes for parents, siblings and extended family members, help reduce the general burden of disease, and optimise the human capital of the population that is critical for Malawi’s future economic development.

“Our research findings may help inform mental health policy and the formulation of guidelines for children living with HIV and their families in Malawi and sub-Saharan African countries.”

The research was also co-authored by Dr Mohammed Ali from the School of Nursing, Midwifery and Paramedicine at Curtin University, and researchers from Mzuzu University and University of Malawi.

The research paper, ‘Prevalence and factors associated with emotional and behavioural difficulties among children living with HIV in Malawi: a cross-sectional study,’ can be found online here.

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