Pattern of cerebral palsy seen in children attending the outpatient paediatric physiotherapy clinics in Osun State tertiary hospitals in Nigeria

Abstract

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, descr...

Clinical Profile, Risk Factors and Impact of Cerebral Palsy on Children in a Tertiary Hospital in Port Harcourt, Nigeria

“…Seizure disorder was also observed to be the commonest co-morbid condition in Sagamu (Ogunseli et al, 2008) (Kwak & Sobaniec, 2003) and Sweden (Carlsson, Hargberg, Orsson, 2003). Contrary to the present study, speech impairment was the commonest co-morbid condition followed by seizure disorder in Osun state (Omole et al, 2018) whereas in India (Pratihba et al, 2002; Scrivatsava, Laisram, Srivatsava, 1992), intellectual disabilities was the commonest co-morbidity. The reason for this difference could be due to different geographic locations.…”

“…A study in Jos (Ejeliogu et al, 2017), Nigeria observed that the families of lower socio-economic class were mostly affected. This trend was also observed in Sagamu (Ogunseli et al), Osun State (Omole et al, 2018), previous study in Port Harcourt (Frank-Briggs & Alikor, 2011), Nigeria and in India (Pratibha,Munni, Gunmala, 2002). This is not surprising as families of lower socio-economic classes are usually less educated with less awareness, low income and may have lower paid jobs resulting in limited antenatal care and delivery services.…”

“…Identified commonest risk factor in the present study was birth asphyxia followed by past history of meningitis and severe neonatal jaundice accounting for 46.1%, 34.0% and 22.0% respectively. This pattern was also observed in other parts of Nigeria (Lagunju et al, 2016;Ogunseli et al, 2008;Adogu et al, 2016;Omole et al, 2018;Frank-Briggs & Alikor, 2011;Lagunju & Fatunde, 2009;Belonwu, Gwarzo, Adeleke, 2009). Birth asphyxia being the commonest cause of CP was also observed in Turkey (Erkin, Delialioglu, Ozei, Culha, Sirza, 2008).…”

“…Over two third of children with CP were 1 st and 2 nd born. First born were also observed to account for more than 2/3 rd of cases of CP in Osun State (Omole et al, 2018) and Zaria ( Sathiakuma & Yakubu, 1987) in Nigeria. This is not surprising as primigravid women are more at risk of prolonged obstructed labour which may lead to birth asphyxia and subsequent CP (Indra, Usharani, Bendigeri, 2017).…”

Características epidemiológicas y clínicas de pacientes pediátricos con parálisis cerebral.

“…El 61.1% de los niños con PC de este estudio procedieron del área urbana y el 42.1% perteneció a la clase social media baja, características demográficas asociadas a PC porque tal como lo mencionan los estudios de Tseng [21], García [15], y Martínez [23], las áreas urbanas pobres también tienen limitación en acceder a unidades de salud para la adecuada atención de la madre y del niño. Se ha atribuido la edad de la madre, mayor a 35 años o menor a 15 años, como factor de riesgo para las discapacidades en los niños, sin embargo, como los estudios de Omole [24], Genes [25], y Bringas [17], esta investigación presenta una edad media similar de 25.3 años.…”