RESUMEN
The relationship between mental health problems, Autism Spectrum Disorder (ASD) and challenging behaviour among children and adolescents is complex and multifaceted. The study investigated practitioners' perception of comorbidity of mental health and ASD in the management of challenging behaviours among children and adolescents in Kenya. Target population was 3490 practitioners. Sample size was 1047, comprising of 38 assessment staff, 27 mental health workers 548 regular teachers, 294 teachers from special schools, and 140 teachers from special units for children with ASD. Stratified and purposive sampling techniques were used. Interviews and structured questionnaires were used. Test-retest yielded a coefficient of 0.78 while Cronbachs' reliability coefficient was 0.830. There was a positive significant correlation between perception of challenging behaviours and mental health problems (r = .415, p = .000). Challenging behaviour perceptions have a negative significant effect on behaviour management strategies, (ß = -0.163, p = .000) implying that the choice of management strategies is dependent on the perceptions. Challenging behaviours accounts for 2.7% variance in the choice of the management strategies, R2 = .027, F(1,1045) = 28.471, p = .000.The practitioners' perception of mental health and comorbid ASD, showed that children with ASD, when enduring life stressors, can be at a higher risk of mental health difficulties than their peers There is need for multidisciplinary synergy in developing effective challenging behaviour programmes for children and adolescents with ASD.
RESUMEN
Introduction: the use of antiretroviral (ARVs) for the management of HIV (human immunodeficiency virus) infection has resulted in a prolonged lifespan among HIV-positive individuals. Both HIV infection and ARVs treatment put this population at a greater risk of developing hypertension. The study aimed at establishing the burden of hypertension and associated factors among HIV-positive population. Methods: a cross-sectional design was employed where a total of 280 HIV-positive adults in Busia County were selected in a multi-stage sampling procedure between March and August 2020. Sociodemographic, economic and behavioral information was collected using a structured questionnaire. Anthropometric measurements were taken using standard methods while clinical data were extracted from patients´ medical records. Proportion was used to establish hypertension burden. Analyses were done using the T-test, Chi-square, and odds ratio. Results: among the 280 study participants, 194 (69.3%) were females, and 239(85.4%) over 35 years of age. Hypertensive cases were 55 (19.6%). The hypertensive group had a significantly higher mean age (52.25±10.4 vs 44.9±11.3; p=0.002), waist-to-hip ratio (0.93±0.09 vs 0.89±0.07; p=0.016), HIV duration (8.64±4.63 vs 6.86±4.04; p=0.014) and cumulative ART treatment duration (8.31±4.61 vs 6.68±3.93; p=0.018). Factors found to be significantly associated with hypertension in the bivariate analysis included age (p=0.003); family history (p=0.024); duration of alcohol intake (p=0.034); HIV duration (p=0.033) and treatment duration (p=0.043). In the multivariate analysis, only age (p=0.045) and family history (p=0.018) contributed significantly in the logistic regression model. Conclusion: the study revealed a slightly lower burden of hypertension among HIV -positive adults in Busia County. Age and family history were the factors independently associated with hypertension in this study.