Prevalence and risk factors for neurological disorders in children aged 6 months to 2 years in northern India

Abstract

GDD Global developmental delay LNDS Lucknow Neurodevelopment ScreenAIM To study prevalence and risk factors for neurological disorders -epilepsy, global developmental delay, and motor, vision, and hearing defects -in children aged 6 months to 2 years in northern India.METHOD A two-stage community survey for neurological disorders was conducted in rural and urban areas of Lucknow. After initial screening with a new instrument, the Lucknow Neurodevelopment Screen, screen positives and a random proportion of screen negatives were validated using predefined criteria. Prevalence was calculated by weighted estimates. Demographic, socio-economic, and medical risk factors were compared between validated children who were positive and negative for neurological disorders by univariate and logistic regression analysis. Neurological disorders are a leading cause of disability internationally. They have a considerable impact on the quality and duration of life. 1 Disorders of the brain may produce epilepsy as well as functional limitations in cognition, vision, hearing, and neuromotor ability. The same insult can cause disability in more than one domain and several different insults can affect one domain. Much of this disability is preventable at primary, secondary, or tertiary level. Prevalence of disability is dynamic and depends on factors such as age distribution of the population, lifespan of those affected, availability of preventive measures, and initial treatment received. RESULTS 2There are many causes of neurological disorders, which can be grouped as genetic, prenatal, perinatal, and postnatal. Many of the causes of neurological disorders are more common in resource-poor countries. Therefore, prevalence of neurological disability is expected to be higher in these countries but few studies have addressed this question in children. In resource-poor countries estimating the prevalence, epidemiology, and risk factors for neurological disorders is especially difficult owing to the paucity of health, mortality, and morbidity records. Such data, even if available, are often incomplete. In particular, data pertaining to infants below 2 years is largely unexplored so far. This age group is particularly challenging because neurological problems are difficult to pick up and are often evolving, which is why we prefer to use the term 'disorder' to 'disability' in this paper. However, because plasticity of a young child's brain allows a window of opportunity for remedial measures, it is important to study this age group.There is also a general lack of standardized screening tools for detecting neurological disorders in this age group. We have developed a tool -the Lucknow Neurodevelopmental Screen (LNDS) -to detect neurological disorders in this age group. A validation study of this tool in the hospital setting and then in the community has already been published. 3 The current paper reports the prevalence and risk factors for neurological disorders in this age group in the urban and rural community of Lucknow, India, using a t...

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