• Melissa A Cortina, Anisha Sodha, Mina Fazel, and Paul G Ramchandani.
• Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX United Kingdom. cortina.melissa@gmail.com
• Arch Pediatr Adolesc Med. 2012 Mar 1; 166 (3): 276-81.

ObjectiveTo assess the prevalence of child mental health problems in community settings in sub-Saharan Africa.Data SourcesA systematic search of MEDLINE, EMBASE, and PsychInfo, supplemented by tracking of references from identified articles and personal communications with local researchers.Study SelectionOnly community-based studies in sub-Saharan Africa that assessed the general psychopathology of children aged 0 to 16 years were included. For each eligible study, the following information was extracted: year of publication, country, population sampled, area type (rural or urban), sampling method and sample size (percentage boys), age range, assessment instrument, informant, diagnostic criteria, and prevalence rates of general psychopathology.Main Outcome MeasurePooled prevalence rate of psychopathology in children, identified by questionnaire and, specifically, by clinical diagnostic instruments.ResultsEleven studies met the inclusion criteria, 10 of which were included in the meta-analysis. The 10 studies provided data for 9713 children from 6 countries, with substantial variation in assessment methods. Overall, 14.3% (95% CI, 13.6%-15.0%) of children were identified as having psychopathology. Studies using screening questionnaires reported higher prevalence rates (19.8%; 95% CI, 18.8%-20.7%) than did studies using clinical diagnostic instruments (9.5%; 8.4%-10.5%).ConclusionsEvidence suggests that considerable levels of mental health problems exist among children and adolescents in sub-Saharan Africa. One in 7 children and adolescents have significant difficulties, with 1 in 10 (9.5%) having a specific psychiatric disorder. There are clear sociodemographic correlates of psychopathology that may place children in areas of greatest deprivation at greatest risk.

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