Undiagnosed attention deficit/hyperactivity disorder (ADHD) among unionized drivers in Ghana: Public health and policy implications.

Road traffic accidents (RTA) are among the leading causes of mortality in sub-Saharan Africa. Many males that drop out of school in Ghana, a population at risk for attention-deficit hyperactivity disorder (ADHD), find employment by joining driver's unions. Moreover, the vehicles of Ghanaian unionized drivers are over-represented in fatal road accidents. Untreated ADHD has been linked with higher rates of RTAs. The objectives of this cross-sectional analysis is to determine the following among unionized drivers in Ghana: 1) the prevalence of ADHD, and 2) the association between self-reported ADHD risk and driving behavior. Data comes from participants' responses (200 unionized drivers and 171 community controls) to a 6-item ADHD Self - Report Scale (ASRS), the Driving Behavior Survey (DBS), and a culturally adapted version of the Jerome Driving Questionnaire (JDQ-GH). The self-reported prevalence of ADHD was 17.6% for the unionized drivers and 7.8% for the control group (χ2=7.7, df=1, p=0.006). Also, ADHD drivers endorsed that they were more likely to pay bribes to police and having worse driving behaviors across among both unionized drivers and controls. Study findings suggest that increased awareness of ADHD and possible screening of drivers for ADHD with subsequent evaluation and treatment may result in prevention of vehicle accidents.