A Comparative Study of Postnatally‐acquired Cerebral Palsy in Cape Town

Abstract

SUMMARY The importance of socio‐economic conditions in the causation of postnatally‐acquired cerebral palsy has not been stressed in previous studies. A comparative survey was undertaken in Cape Town, South Africa. Three ethnic groups were compared—white, coloured (mixed ancestry) and black. The percentage of postnatally‐acquired cerebral palsy in these groups was 13·2, 24·0 and 36·1 per cent, respectively. These figures can be explained by the differing socio‐economic conditions of each group, the white group belonging to the highest socio‐economic stratum and the black group to the lowest. The main causes of postnatally‐acquired cerebral palsy were cerebral infections (particularly meningitis), cerebral trauma and cerebrovascular accidents. The proportion in each group, the main causal factors, age at onset, types of cerebral palsy and intellectual status are similar to those of most previous studies. RÉSUMÉ Etude comparative de l'IMC d'origine post‐natale au Cap L'importance des conditions socio‐économiques dans les IMC d'origine postnatale n'a pas été soulignée au cours d'études précédentes. Une recherche comparative a été entreprise au Cap, en Union Sud‐Africaine. Trois groupes ethniques ont été compareés, blanc, métis et noir. Le pourcentage d'IMC par cause post‐natale dans les trois groupes a été respectivement de 13·2, 24·0 et 36·1. Ces écarts peuvent être expliqués par les conditions socio‐économiques propres à chaque groupe, le status socio‐économique des blancs étant le plus élevé, celui des noirs le plus bas. Les principales causes des IMC d'origine post‐natales étaient: l'infection cérébrale (en particulier, meningite), les traumatismes cérébraux et les accidents cérébrovasculaires. La proportion dans chaque groupe, les principaux facteurs responsables, l'âge de début, les types d'IMC et l'état intellectuel sont apparus identiques à ceux de la plupart des études antérieures. ZUSAMMENFASSUNG Eine Vergleichsstudie über postnatal erworbene Cerebralparese in Kapstadt Die Bedeutung der sozio‐ökonomischen Bedingung als Ursache der postnatal erworbenen Cerebralparese ist in früheren Studien nicht erwähnt worden. In Kapstadt, Südafrika, wurde eine Vergleichsstudie durchgeführt. Es wurden drei ethnische Gruppen verglichen—weiß, farbig (gemischete Vorfahren) und schwarz. Der Prozentsatz der erworbenen Cerebralparese in diesen Gruppen betrug 13·2, 24·0 und 36·1. Diese Zahlen können durch die Unterschiede der sozio‐ökonischen Bedingungen für die einzelnen Gruppen erklärt werden, die weiße Gruppe gehört zu der höchsten sozio‐ökonomischen Schicht und die schwarze zur niedrigsten. Die Hauptursachen für die postnatal erworbene Cerebralparese waren: Hirninfektionen (insbesondere Meningitis), Hirntrauma und cerebrovaskuläre Unfälle. Das Verhältnis in jeder Gruppe, die Hauptursachen, Alter bei Beginn, Art der Cerebralparese und intellektueller Stand ähneln den Angaben der meisten früheren Untersuchungen. RESUMEN Estudio comparativo de la parálisis cerebral adquirida postnatalmente en la Ciudad del Cabo La importancia d...

Childhood Disability in Low- and Middle-Income Countries: Overview of Screening, Prevention, Services, Legislation, and Epidemiology

“…[26][27][28][29][30][31][32][33] Some studies focused on the parents of children with disabilities and tried to assess their needs and attitudes with respect to disability. [34][35][36] Among the others, 3 studies [37][38][39] were clinic based, with a primary focus on the epidemiology and available services for cerebral palsy. One group of investigators 40 used participants from clinics and special institutions, and a control group of normal children, to assess maternal risk factors for disability.…”

“…93 More recently, 4 studies focused on children with cerebral palsy. [37][38][39]45 Two studies 38,39 found that spastic diplegia was the most common type of cerebral palsy. Associated visual defect was present in 54% of the children assessed by Bhatia and Joseph, 39 but the parents were unaware of the problem.…”

Postnatal cerebral infection leading to hemiplegic cerebral palsy: Clinical description of 13 children in Stockholm, Sweden

“…Some 26.4% of the cases were caused by cerebral infection and 55.4% of them had become hemiplegic. Arens and Molteno [6] studied 82 children, who acquired cerebral palsy after birth. Cerebral infection was the most common cause of cerebral palsy and hemiplegia was the most common type.…”

“…Cerebral palsy is also classified as being prenatal, perinatal and postnatal or postneonatal according to the presumed timing of the insult [2,4 -7]. Earlier studies used the definition postnatal cerebral palsy [5,6,8] but later ones, have adopted the term postneonatal cerebral palsy if the damage to the brain took place after the 28th postnatal day [2,7,9]. Two centres participating in the ongoing SPCE study (surveillance of cerebral palsy in Europe), which includes 13 European centres [9] did not register postneonatal cases, and the upper age limit varies from one to seven years.…”

Participation in age-related activities and influence of cultural factors–comments from youth and parents of children with postnatal post infectious hemiplegia in Stockholm, Sweden

“…Two children with similar medical backgrounds may cope differently with their special challenges and they may receive help of different quantity and quality. Among the cerebral palsies the postnatal are the easiest to prevent and there is a strong association to social disadvantage and poverty [2,3]. An infectious aetiology is the most common cause for postnatal cerebral palsy in developing countries [4 -6] whereas in developed countries the incidence decreases.…”