Behavioral Consequences Among Survivors of Cerebral Malaria and Acceptability to Different Disciplinary Methods

Abstract

Cerebral malaria (CM) is a life-threatening disease that affects mainly children in sub-Saharan Africa. Studies have shown that children who survive CM are often left with neurological disabilities after recovery, such as behavioral changes similar to attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD). However, diagnosis and treatments for ADHD are limited in many places in Africa. The purpose of this study was to assess behavioral changes following CM infection in Children in Malawi and parents' acceptability of behavioral treatments. Twenty-one parents of children who had survived CM were compared to forty parents from the general population. Assessment instruments included the Disruptive Behavior Rating Scale (DBRS), Treatment Evaluation Inventory-Short Form (TEI-SF), and ADHD symptom checklist. The results showed that the most acceptable treatments among parents in Malawi were interrupt/redirect, discussion, and medication. Parents of CM-surviving children were significantly more accepting of medication (F(1,59) = 7.92, p < 0.007). The majority of the children who survived CM were rated above the clinical cut-off for ADHD and ODD symptoms.

Keywords: ADHD; Malawi; ODD; cerebral malaria; children; treatment acceptability.