Pediatric Cerebral Palsy in Botswana: Etiology, Outcomes, and Comorbidities

Abstract

BACKGROUND Cerebral palsy is the most common cause of motor dysfunction in children worldwide and is often accompanied by multiple comorbidities. Although cerebral palsy has been studied extensively in high-resource settings, there are few published studies on cerebral palsy etiology, outcomes and comorbidities in low-resource settings. METHODS Children with cerebral palsy were prospectively enrolled from inpatient and outpatient settings at a referral center in Gaborone, Botswana, in a cross-sectional study conducted from 2013 to 2014. Cerebral palsy etiology, outcomes, and comorbidities were determined through caregiver interviews, review of medical records, and direct physical examination. RESULTS Sixty-eight children with cerebral palsy were enrolled. Subjects were 41% male, with a median age of 4 years (interquartile range = 2 to 7). The most common etiologies for cerebral palsy in our cohort were intrapartum hypoxic events (18%), postnatal infections (15%), prematurity (15%), focal ischemic strokes (10%), and prenatal infections (10%). Severe motor impairment was common, with the most severe category present in 41%. The predominant comorbidities were cognitive impairment (84%), epilepsy (77%), and visual impairment (46%). CONCLUSIONS Cerebral palsy in Botswana has different etiologies and is associated with poorer outcomes and higher prevalence of comorbidities than what has been reported in high-resource settings. Further studies are necessary to determine optimal preventative and treatment strategies in this population.

Physical Therapy Registry for Establishment of Cerebral Palsy in Alexandria City (Almontazah District), Egypt

“…This difference is expected in terms of high mortality rate of premature and LBW and higher incidence of perinatal hypoxic events. 8 Our results on the types of CP are similar to those reported in developing countries as reported by Kakooza-Mwesige et al 2015 9. Spastic CP is the most common type, worldwide.…”

Constipation, antiepileptic drugs, and gingivitis in children and adolescents with cerebral palsy

“…3 It is one of the most common comorbidities associated with motor damage in individuals with CP, affecting approximately 77% of patients with CP. 4 The clinical treatment of epilepsy is based on therapy with long-acting antiepileptic drugs (AEDs), according to an accurate diagnosis of the seizure type presented by the individual. 3 The control of neuronal excitability in the brain is maintained by voltage-gated ion channels that normalize cation flow.…”

Health beliefs regarding pediatric cerebral palsy among caregivers in Botswana: A qualitative study

“…The prevalence of cerebral palsy is thought to be even higher in Africa, ranging from 2 to 10 children per 1,000 (Donald, Samia, Kakooza‐Mwesige, & Bearden, ). Children with cerebral palsy in Africa may also have more severe disease and a higher frequency of comorbidities than children in high‐resource settings (Bearden et al, ; Kakooza‐Mwesige, Forssberg, Eliasson, & Tumwine, ). Despite the impact of cerebral palsy in Africa, there is sparse data regarding health beliefs about cerebral palsy held by patients and their families.…”