Aspects of birth history and outcome in diplegics attending specialised educational facilities

Bischof, F; Rothberg, A. D.; Ratcliffe, Ingrid

doi:10.7196/samj.5252

Cited by 2 publications

(11 citation statements)

References 20 publications

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“…9 Many studies also reported varying functional impairments according to age, with a larger proportion of younger children more severely affected than older children. 9,41,43,74 Two community-based studies in Uganda reported similar associations between age and functional impairment in their cohort: 36% and 48% of children aged 2 to 5 years had severe gross motor (GMFCS levels IV and V) and fine motor (MACS levels IV and V) impairments versus 10% of children aged 6 to 17 years (p = 0.002 and p = 0.01 for gross and fine motor respectively). 74 In the second study, the association between age and number of cases was only significant for GMFCS levels IV and V (estimated coefficient = −0.2136, p = 0.008), that is, the lower number of older children living with CP was driven by a reduction in the number of children classified in higher GMFCS levels.…”

Section: Functional Outcomesmentioning

confidence: 77%

“…South Africa 43 and Botswana 22 found no association of CP with either gestational age or birthweight. Perinatal timing of brain injury was associated with a higher Gross Motor Function Classification System (GMFCS) level.…”

Section: T a B L E 8 (Continued)mentioning

confidence: 95%

“…46 Comorbidities differed according to clinical subtype (χ 2 = 21.51, df = 4, p < 0.001), GMFCS (χ 2 = 14.98, df = 2, p = 0.001), and fine motor function level (χ 2 = 25.60, df = 2, p < 0.001) in a cross-sectional study in Uganda, 19 and according to topography (p = 0.024) in a cross-sectional study in Nigeria. 40 Epilepsy was the most commonly reported comorbidity, 11,19,33,34,37,38,40,41,46,47,43,60,62,63,74,79,81,82,89,90 with the proportion of children with CP affected ranging from 11% 60 to 76%. 11 Although 85% of children with CP and comorbid epilepsy were treated with antiseizure medication in an Ethiopian hospital cohort, 46 irregular use of antiseizure medications was found in 5.4% of Nigerian children 81 and treatment gaps as high as 61% were reported in Uganda 74 in community-based studies.…”

Section: Comorbiditiesmentioning

confidence: 99%

“…Several studies measured functional outcomes using standardized and validated tools such as the GMFCS, the 66-item Gross Motor Function Measure, the Manual Ability Classification System (MACS), and the Communication Function Classification System (CFCS) to report the range of function among children living with CP (Table S 1). 9,11,19,20,32,38,41,43,46,54,63,94,[97][98][99][100][101][102] Studies of cohorts drawn from predominantly hospital-based neurology clinics tended to report a larger proportion of children with more severe gross motor impairments, that is, GMFCS or MACS levels IV and V, 11,20,38,41,46,63,83 compared to communitybased studies. 9,32,43,74,94,97,101 The difference in proportion was up to 55%, with a Ethiopian hospital-based study reporting 75.3% of children classified in GMFCS levels IV and V and 75.5% in MACS levels IV and V, 46 versus 20% of children in GMFCS levels IV and V in a community-based Ugandan study.…”

Section: Functional Outcomesmentioning

confidence: 99%

“…9,11,19,20,32,38,41,43,46,54,63,94,[97][98][99][100][101][102] Studies of cohorts drawn from predominantly hospital-based neurology clinics tended to report a larger proportion of children with more severe gross motor impairments, that is, GMFCS or MACS levels IV and V, 11,20,38,41,46,63,83 compared to communitybased studies. 9,32,43,74,94,97,101 The difference in proportion was up to 55%, with a Ethiopian hospital-based study reporting 75.3% of children classified in GMFCS levels IV and V and 75.5% in MACS levels IV and V, 46 versus 20% of children in GMFCS levels IV and V in a community-based Ugandan study. 9 Many studies also reported varying functional impairments according to age, with a larger proportion of younger children more severely affected than older children.…”

Section: Functional Outcomesmentioning

confidence: 99%

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Cerebral palsy in African paediatric populations: A scoping review

Murugasen,

Springer,

Olusanya

et al. 2024

Develop Med Child Neuro

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AimTo review the epidemiology and outcomes of African children with cerebral palsy (CP) over a 21‐year period.MethodThe PubMed, Scopus, and Web of Science online databases were searched for original research on African children with CP aged 18 years and younger published from 2000 to 2021.ResultsA total of 1811 articles underwent review against explicit criteria; 93 articles were selected for inclusion in the scoping review. The reported prevalence of CP ranged from 0.8 to 10 per 1000 children. Almost half had perinatal risk factors, but up to 26% had no identifiable risk factor. At least one‐third of children with CP had one or more comorbidities, most commonly epilepsy, intellectual disability, and malnutrition. African children with CP demonstrated excess premature mortality approximately 25 times that of the general population, predominantly from infections. Hospital‐based and younger populations had larger proportions of children with severe impairments. African children with CP had inadequate access to care and education, yet showed functional improvements compared to controls for all evaluated interventions.InterpretationThe prevalence of CP in Africa remains uncertain. African children with CP have different risk profiles, greater premature mortality, and more severe functional impairments and comorbidities compared to the Global North. Several barriers prevent access to optimal care. Larger African studies on validated and effective interventions are needed.

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