Factors associated with cognitive developmental delay among infants attending Reproductive and Child Health clinics in Dar es salaam, Tanzania

Abstract

Background; Early child cognitive development is important throughout one’s life span. It is estimated that more than 200 million children under five years of age fail to achieve full cognitive development in the world and 80% of them are in south Asia and sub-Sahara-Africa. Genetic and environmental factors play a role in early child development (ECD). Most of the ECD occurs in the first 2years of life, but largely during infancy. Malnutrition, poverty and poor health care to children have been found to have association with poor cognitive development and create a vicious cycle of poverty. This study gives the proportion and factors that are associated with infants’ cognitive developmental delay in our setting. Knowing these factors enhance early intervention to break the viscious cycle.This study aimed to determine the proportion and factors associated with cognitive developmental delay among infants attending RCH clinics in Dar es Salaam. Patients/ Material and Methods; This was a health facility based descriptive cross-sectional study conducted by using a structured data collecting tool done in three health centers in Dar es Salaam from July to December 2012. A two- stage sampling technique and Lottery were used to get the health centers. The data were analyzed using SPSS software by Pearson’s chi-square, Fisher exact test and logistic regressions. Results; A total of 350 infants were assessed for cognitive development in a period of six months. Male infants were the majority by 50.6%. Our study Participants aged 1to 12 months with a mean (SD) of 7.26 (3.43) months with their birth weight ranging from 1.3 to 4.6kg with mean (SD) of 3.11(0.50) kg. The Proportion of infants with cognitive developmental delay was 12.3%. Age of the child, caretakers and wasting were significantly associated with cognitive developmental delays even after adjusting for confounders. Infants aged less than 6months were 14 times more likely to have cognitive developmental delay compared to those aged six months and above (adjusted oddis ratio{aOR=14; 95%CI 5.3-38.3, P<0.001}). Infants cared by assistant caretakers especially during day-time, were 12 times more likely to have cognitive developmental delay compared to infants who stayed with their mothers (aOR=12.1; 95%CI 3.0-53, P=0.001). Wasted infants were 4 times more likely to have cognitive developmental delay (aOR=3.9; 95%CI 1.1-13.3, P=0.032) compared to infants with good nutritional status. Conclusion; The proportion of cognitive developmental delay among infants attending Reproductive and Child Health( RCH) clinics in Dar es Salaam was 12.3%. Young age of the child, use of other caretakers in absence of the mother, and wasting were associated with cognitive developmental delays. Infants need Mothers to spend time with them and prevention of malnutrition plays a role in cognitive development.

A cross-sectional study addressing the cognitive development of two-year-old children

“…In a study among 3-to 4-year-old children in UNICEF's Multiple Cluster Indicators Surveys in 51 middle and low-income countries found 10.1% had significant cognitive delay and in 73 middle and low-income countries found 9.7% had significant cognitive delay (5,13). Another study among infants aged 1-12 months attending Reproductive and Child Health clinics in Dar es salaam, Tanzania in 2012 reported the Proportion of infants with cognitive developmental delay was 12.3% (14). A study in North India from 2011 to 2013 among 12-30 months old toddler observed nearly one-fifth (17.3%) of the toddlers had cognitive delay (15).…”

Pembelajaran Berbasis Multimedia untuk Meningkatkan Kemampuan Kognitif Anak Usia Dini

“…Berbagai aspek dapat mempengaruhi gangguan perkembangan kognitif anak. Usia anak, kehadiran pengasuh, dan wasting secara signifikan terkait dengan keterlambatan perkembangan kognitif (Gudila Valentine Shirima et al, 2021). Wasting merupakan kondisi dimana anak mengalami penurunan berat badan yang terus menerus.…”

“…Studi tersebut juga menjelaskan bahwa bayi membutuhkan ibu untuk menghabiskan waktu bersama mereka dan pencegahan malnutrisi berperan dalam perkembangan kognitif. Studi lain juga memperjelas kondisi ini dengan melaporkan bahwa penting bagi ibu untuk hadir menemani anak sepanjang hari (Gudila Valentine Shirima et al, 2021). Ketidakhadiran ibu terutama pada siang hari, memungkinkan 12 kali lebih mungkin bagi bayi untuk mengalami keterlambatan perkembangan kognitif dibandingkan yang tidak.…”

Risk factors of delayed developmental milestones among infants attending RCH clinics in Dodoma region. A cross-sectional studydoma region

“…(Sepeku & Kohi, 2011;Mangu et al, 2021) the prevalence rate of DDM was 2.3%; among children aged five years and above, overall 7.8% of females had DDM compared to 5.7% of males (Murphy et al, 2020). The frequency of newborns with cognitive developmental delay, on the other hand, was found to be 12.3% in a Dar es Salaam (Shirima., 2013). Studies conducted in Morogoro and Manyara also revealed that the main factors of DDM in cognitive, communication and motor domains were poverty malnutrition and inadequate skills among health care providers in primary health care level (Sudfeld et al, 2015;Ribe et al, 2018 ;MOHCDGEC., 2022).…”

“…The gap increased from 19.1% to 31.4% (Kim., 2022). According to (Gil et al, 2020) the incidence of DDM varied by region, ranging from 10% in Europe and Central Asia to 42% in West and Central Africa (Padayachee & Ballot, 2013;Shirima, 2013;Oluwafemi et al, 2018;Abdel et al, 2018;Sunderajan & Kanhere, 2020;Saleem et al, 2020). The situation is worse for children born under a variation of medical conditions, including BA (WHO, 2011; Shaahmadi et al, 2015;Boskabadi et al, 2015 ;Lee et al, 2019 ;Lancaster et al, 2018).…”