Epidemiology of cerebral palsy among children in the remote Gorkha district of Nepal: findings from the Nepal cerebral palsy register.
Autor: | Jahan, Israt, Al Imam, Mahmudul Hassan, Muhit, Mohammad, Chhetri, Amir Banjara, Badawi, Nadia, Khandaker, Gulam |
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Předmět: |
PUBLIC health surveillance
REPORTING of diseases HEALTH services accessibility CONFIDENCE intervals MANN Whitney U Test FISHER exact test RISK assessment RESEARCH funding DISABILITIES CHI-squared test DESCRIPTIVE statistics CEREBRAL palsy LOGISTIC regression analysis DATA analysis software ODDS ratio EDUCATIONAL attainment DISEASE risk factors SYMPTOMS |
Zdroj: | Disability & Rehabilitation; Aug2023, Vol. 45 Issue 17, p2808-2817, 10p |
Abstrakt: | To describe the epidemiology of cerebral palsy (CP) among children in Gorkha, Nepal. We established the first population-based register of children with CP aged <18 y in Gorkha, Nepal (i.e., Nepal CP Register). Children with suspected CP underwent detailed neurodevelopmental assessment by a multidisciplinary assessment team. Socio-demographic, etiology, motor severity, rehabilitation, and educational status were documented. Between January and October 2018, 182 children with confirmed CP were registered (mean (standard deviation (SD)) age: 10 years 1 months (4 years 10 months), 37.4% females). The majority (88.3%) had CP acquired pre- or perinatally. Mean (SD) age of CP diagnosis was four years five months. Mothers who did not receive any formal schooling had 4.5, 3.1, and 6.3 times higher odds of having inadequate antenatal care, homebirth, and unskilled birth attendants, respectively, when adjusted for other factors. Most children had spastic CP (77.5%) and Gross Motor Function Classification System level III-V (54.9%). Overall, 45.8% had never received rehabilitation services, 58.0% of school-aged children were not attending schools. The median age of receiving rehabilitation services was three years zero months. The delayed diagnosis and clinical severity indicate the overall poor health status of children with CP in Nepal which could be improved by ensuring early diagnosis and intervention. The first population-based cerebral palsy register in Nepal suggests diagnosis of CP is considerably delayed among children. The high burden of severe motor impairment and poor communication skill with limited access to timely rehabilitation among children with CP in Nepal is concerning. Capacity development of community-based health workers and mothers of children with CP could help implementing community-based programs for prevention and early diagnosis of CP, and to promote early intervention for children with CP in remote Gorkha, Nepal. [ABSTRACT FROM AUTHOR] |
Databáze: | Complementary Index |
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