Pediatric Cerebral Palsy in Africa (original) (raw)
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Pediatric Cerebral Palsy in Africa: A Systematic Review
Seminars in Pediatric Neurology, 2014
Cerebral palsy is a common neurologic problem in children and is reported as occurring in approximately 2-2.5 of 1000 live births globally. As is the case with many pediatric neurologic conditions, very little has been reported on this condition in the African context. Resourcelimited settings such as those found across the continent are likely to result in a different spectrum of etiologies, prevalence, severity as well as management approaches. This review aims to establish what has been reported on this condition from the African continent so as to better define key clinical and research questions.
Journal of Child Neurology
Cerebral palsy is a common cause of pediatric motor disability. Although there are increasing amounts of data on the clinical profile of children with cerebral palsy in high-income countries, corresponding information about low-income countries and developing countries is lacking. Therefore, we aimed to describe the clinical spectrum of cerebral palsy in children in Benin, a representative West African low-income country. Our cross-sectional observational study included 114 children with cerebral palsy recruited from community-based rehabilitation centers and teaching hospitals (median age: 7 years, range 2-17; sex: 66% male). Data were collected through review of medical records and interviews with children’s mothers. Assessment included risk factors, clinical subtypes according to the Surveillance of CP in Europe criteria, severity of motor outcome scored by the Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System, comorbidities, and school a...
Aetiology and comorbidities of cerebral palsy in a developing country
International Journal of Research in Medical Sciences
Background: Cerebral palsy (CP) is a common disabling condition of movement and posture causing activity limitation arising from a static injury to the developing brain. Common risk factors for cerebral palsy in Africa include severe birth asphyxia, kernicterus and neonatal infections. This study is aimed at determining the aetiology and comorbidities associated with cerebral palsy in our environment.Methods: All children with CP presenting to the Paediatric Neurology clinic of the University of Calabar Teaching Hospital whose parent gave consent were recruited into the study. The biodata of the children and that of the parent’s/ care givers were obtained. A detailed pregnancy and delivery history, neonatal history, seizures during first three years of life and developmental mile stones was documented.Results: Seventy children with CP were recruited into the study of which 46 (65.7%) were males and 24 (34.3%) females. Majority of the children were from low social class and products ...
Clinical features and aetiology of cerebral palsy in children from Cross River State, Nigeria
Archives of Diseases in Childhood, 2020
Objective There are few studies on cerebral palsy (CP) in African children and our study aimed to describe the aetiology, characteristics and severity of CP in children from Nigeria. Design A population-based study using key informant methodology (KIM) was conducted as part of a clinical research trial. Children aged 4–15 years were clinically assessed for CP. Results The estimated prevalence of CP using KIM was 2.3/1000 children (95% CI 2.0 to 2.5/1000). 388 children were diagnosed with CP, with Gross Motor Function Classification System level 1 in 70 (18.1%), II in 156 (40.2%), III in 54 (13.9%), IV in 54 (13.9%), V in 54 (13.9%). 300/388 (77.3%) had Manual Ability Classification Scale of level 1–3 and 88 (22.7%) of level 4–5. CP types were spastic in 271 (70%), with 60% of these bilateral and 40% unilateral, ataxic 38 (9.8%), dystonic 18 (4.6%), choreoathetoid 29 (7.5%) and unclassifiable 32 (8.3%). Postneonatal risk factors for CP were seen in 140 (36.1%) children including malaria with seizures 101/140 (72.1%), malaria with coma 21/140 (15.0%), meningitis 12/140 (8.6%), tuberculosis 2/140 (1.4%), sickle cell disease 3/140 (2.2%), HIV 1/221 (0.7%). Prenatal/perinatal risk factors were seen in 248 (63.9%%), birth asphyxia 118 (47.6%) and clinical congenital rubella syndrome 8 (3.3%) and hyperbilirubinaemia 59 (23.8%) were identified as preventable risk factors for CP. Conclusion The profile of CP in this population is similar to that found in other low-income and middle-income countries (LMIC). Some risk factors identified were preventable. Prevention and management strategies for CP designed for LMIC are needed
Cerebral palsy is a common neurological problem that causes significant disabilities in children. Aim: To describe the clinical profile of children with cerebral palsy in Port Harcourt as well as to identify risk factors and its' impact. Methods: This was a 2 years prospective cross-sectional study in the Paediatric neurology clinic of the Rivers State University Teaching Hospital Nigeria. Children diagnosed with cerebral palsy and those whose parents gave consent were consecutively recruited into the study while their clinical information including laboratory findings was entered into a standard proforma. Results: Among the 296 children seen in the neurology clinic, 141(47.6%) had cerebral palsy. They were aged 6 months to 14 years, with a mean age of 3.07±3.5years and a M: F ratio of 1.6:1. They were mostly term babies 86(61.0%), delivered vaginally107(75.9%) by unqualified attendants 74(52.5%) with normal birth weight 61(43.3%) and 62(52.9%) had microcephaly. The common identifiable risk factors for cerebral palsy were perinatal asphyxia 65(46.1%), past history of meningitis 48(34.0%) and neonatal jaundice 31(22.0%) while the common co-existing neurologic disorders were seizure disorders 47(46.1%) and speech impairment 21(20.6%). Spastic quadriplegia 50(35.5%) was the most frequent type of cerebral palsy seen and it was significantly associated with a past history of perinatal asphyxia P=0.03 and prematurity 0.008. Only 11(44.0%) of the 25 children who were eligible to attend school did so, out of which 9(81.8%) performed poorly. Conclusion: Cerebral palsy is a major cause of neurodisability in Port Harcourt and its common risk factors are preventable.
CP contributes significantly to the poor health status of children in Nigeria. The incidence of CP varies significantly across different geographical zones, although the Centers for Disease Control and Prevention (CDC) study found that the average prevalence of CP in 2004 was 3.3 per 1,000 live births. The prevalence was significantly higher in boys than girls (male/female ratio 1.4:1). It is one of the commonest causes of motor disabilities in childhood. While there has been controversies regarding the alterations in the rates over time, studies in recent days have reported a prevalence of 2-3 per 1,000 live births. This comes about owing to a poor understanding of the associated risk factors and application of necessary preventive measures. In UNICEF 2011 annual report for Zimbabwe, it was stated that the total number of children with disabilities presenting for the first time had tripled Background: Cerebral palsy is the most commonly diagnosed condition in children presenting with disability. This could be attributed to the lack of awareness on the quantifiable and largely preventable risk factors associated with it and poor knowledge of simple public health measures against these factors.
Determinants of Cerebral Palsy in Pediatric Patients in Northern Ethiopia: A Hospital-Based Study
Neurology Research International, 2021
Introduction Cerebral palsy is the most common neurologic disorder of childhood with lifelong implications in majority of patients. Knowledge of the determinants of cerebral palsy is important for accurate mobilization of resources in obstetric, perinatal, and infant care besides implementation of prevention systems. In Ethiopia, however, this knowledge gap exists as there are no published studies on determinants of cerebral palsy in the country. Objective To assess the determinants of cerebral palsy in pediatric patients attending Ayder Comprehensive Specialized Referral Hospital between April 2019 and August 2019. Methods An unmatched case-control study was conducted among 50 pediatric cerebral palsy patients and 100 controls, pediatric patients without cerebral palsy or other motor or central nervous system illnesses, attending Ayder Comprehensive Specialized Hospital, Mekelle, Ethiopia. The data were analyzed using SPSS version 27. Results Significant factors were operative vagi...
International Journal of Medical Science and Public Health, 2015
CP contributes significantly to the poor health status of children in Nigeria. The incidence of CP varies significantly across different geographical zones, although the Centers for Disease Control and Prevention (CDC) study found that the average prevalence of CP in 2004 was 3.3 per 1,000 live births. The prevalence was significantly higher in boys than girls (male/female ratio 1.4:1). It is one of the commonest causes of motor disabilities in childhood. While there has been controversies regarding the alterations in the rates over time, studies in recent days have reported a prevalence of 2-3 per 1,000 live births. This comes about owing to a poor understanding of the associated risk factors and application of necessary preventive measures. In UNICEF 2011 annual report for Zimbabwe, it was stated that the total number of children with disabilities presenting for the first time had tripled Background: Cerebral palsy is the most commonly diagnosed condition in children presenting with disability. This could be attributed to the lack of awareness on the quantifiable and largely preventable risk factors associated with it and poor knowledge of simple public health measures against these factors.
Journal of Pediatrics Research Reviews & Reports, 2021
Background: Cerebral palsy is non-progressive motor disability syndrome largely attributed to abnormal development or damage from likely trauma in one or more parts of the brain especially the cerebellum and frontal lobe of the cerebrum that control muscle tone and motor activity and causing variable mental, motor and behavioral dilemmas generally referred to as delayed developmental milestone. Aims and Objectives: The study aims to investigate the gross features and clinical manifestation in cerebral palsy children in in cross-sectional patients in health facility. Materials and Methods: The study involved the use of 40 case files of cerebral palsy patients; 26 (65. 0%) out of them were girls, and 14 (35.0%) of them were boys, aged from 0 to 10 years old. Results: The main clinical presentation in this study was speech delay which was presented in 50.0% of the examined children, followed by delayed walking and movement in 25.0% of the patients. Analysis using records of imaging dia...
South African Journal of Child Health, 2018
Neurological disorders are common in childhood, with cerebral palsy (CP) being one of the leading causes of disability. [1,2] CP is a disorder of abnormal posture with scarcity of movement caused by lesions in an immature or developing brain with varying degrees of associated problems including seizure disorders, intellectual disabilities, communication difficulties, learning difficulties, visual impairment, bladder and bowel control problems and swallowing difficulties. [3] The prevalence of CP in well-resourced countries is between 1.5 to 2.5 per 1 000 live births while in Africa the prevalence is between 1.5 and 10 per 1 000 live births. [ 4-8] Reasons for this disparity have been attributed to poor government policies on healthcare, harmful traditional beliefs, higher rates of unsupervised deliveries and inadequate equipment to implement resuscitative procedure following complicated labour in many African countries. [9] CP can occur during the prenatal, perinatal or postnatal stages. [10] In some cases, the aetiology of CP is not known, however, some common identifiable causes include birth asphyxia, severe jaundice/ kernicterus, infections, neonatal seizures, prematurity and low birth weight. [5,10] Diagnosis of CP is made by clinical evaluation with or without cerebral imaging. Failure to identify aetiology in a child with a neurological condition does not exclude CP, provided the brain injury that resulted in the motor function deficits occurred before the child was older than three years of age. [10] Children with CP require lifelong healthcare, by a range of professional disciplines (including paediatrician, neurologist, orthopaedic surgeon, physiotherapist, occupational therapist and speech therapist), using substantial human and financial resources. [11,12] Physiotherapy plays a major role in the management of children with CP. [13] The aims of physiotherapy intervention include: strengthening of the mother-to-child bonding, optimisation of functional skills, physical endurance and motor development, therein facilitating school participation via provision of mobility devices, advising and facilitating appropriate handling and positioning and preventing complications such as contractures and other deformities. Physiotherapy treatment approaches include neurodevelopmental therapy, sensory integration therapy, conductive education, constraint induced movement therapy, context focused therapy, advance neuromotor rehabilitation, biofeedback and physical activity training. [13,14] Despite the important rehabilitative role of physiotherapy in the management of children with CP in Nigeria, standardised protocols or guidelines are lacking. Therefore, the aim of this study was to describe the pattern of CP in children attending the paediatric physiotherapy clinics located in tertiary hospitals, Osun State, Nigeria, to inform the development of a standardised clinical guideline for the physiotherapy management of the children. Methods Study design and participants This was a hospital-based, cross-sectional, descriptive study of consecutive children attending the paediatric physiotherapy clinics of three tertiary hospitals in Osun State, Nigeria, over a six-month period. There are also primary and secondary healthcare facilities available in the state but the physiotherapy services are inadequate at secondary centres. Children were eligible for inclusion if they were Background. Cerebral palsy (CP) is a major cause of disability in children and the most commonly encountered neurologic condition by paediatric physiotherapists in Nigeria. Local data on the pattern of presentation of CP and standardised management protocols are lacking. Objectives. To assess the pattern of CP seen in children attending paediatric physiotherapy clinics in Osun State tertiary hospitals. Methods. A hospital-based cross-sectional study was conducted in three tertiary hospitals within Osun State, Nigeria. Data were collected using caregiver questionnaires, medical records and physical assessment (Gross Motor Function Measure-88) and were recorded on a standardised case record form. Data were analysed using appropriate statistical tests with alpha set at p<0.05. Results. A total of 187 children with CP were seen during the six-month period. The male to female ratio was 1.2:1 and the children were aged 12 months to 12 years. The majority of the mothers (63.6%) were primiparous and, at the time of delivery, most mothers were aged between 28 and 33 years. Spastic (72.7%) and quadriplegic (69.5%) presentations were the leading sub-types of CP, with 76.5% of children having one or more associated problems. Birth asphyxia (57.2%) was the leading aetiology of CP while speech impairment was common in 63.6% of cases. One hundred and fourteen (61%) children were classified as being severely disabled and 53.5% had a gross motor function measure score of less than 40.9%. Conclusion. Severe CP is commonly encountered in the region, with children most frequently presenting with spastic quadriplegia and speech impairment. A good knowledge of the pattern of CP seen in southwestern Nigeria is one of the first steps in developing a standardised protocol.