1. Clinical features and aetiology of cerebral palsy in children from Cross River State, Nigeria.
- Author
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Duke R, Torty C, Nwachukwu K, Ameh S, Kim M, Eneli N, Onyedikachi A, Aghaji A, Burton K, Dyet L, and Bowman R
- Subjects
- Adolescent, Anemia, Sickle Cell complications, Anemia, Sickle Cell epidemiology, Birth Injuries complications, Birth Injuries epidemiology, Cerebral Palsy classification, Child, Child, Preschool, Cross-Sectional Studies, Female, HIV Infections complications, HIV Infections epidemiology, Humans, Hyperbilirubinemia complications, Hyperbilirubinemia epidemiology, Malaria complications, Malaria epidemiology, Male, Meningitis complications, Meningitis epidemiology, Nigeria epidemiology, Odds Ratio, Prevalence, Rubella Syndrome, Congenital complications, Rubella Syndrome, Congenital epidemiology, Severity of Illness Index, Tuberculosis complications, Tuberculosis epidemiology, Cerebral Palsy epidemiology, Cerebral Palsy etiology, Developing Countries statistics & numerical data
- Abstract
Objective: There are few studies on cerebral palsy (CP) in African children and our study aimed to describe the aetiology, characteristics and severity of CP in children from Nigeria., Design: A population-based study using key informant methodology (KIM) was conducted as part of a clinical research trial. Children aged 4-15 years were clinically assessed for CP., Results: The estimated prevalence of CP using KIM was 2.3/1000 children (95% CI 2.0 to 2.5/1000). 388 children were diagnosed with CP, with Gross Motor Function Classification System level 1 in 70 (18.1%), II in 156 (40.2%), III in 54 (13.9%), IV in 54 (13.9%), V in 54 (13.9%). 300/388 (77.3%) had Manual Ability Classification Scale of level 1-3 and 88 (22.7%) of level 4-5. CP types were spastic in 271 (70%), with 60% of these bilateral and 40% unilateral, ataxic 38 (9.8%), dystonic 18 (4.6%), choreoathetoid 29 (7.5%) and unclassifiable 32 (8.3%). Postneonatal risk factors for CP were seen in 140 (36.1%) children including malaria with seizures 101/140 (72.1%), malaria with coma 21/140 (15.0%), meningitis 12/140 (8.6%), tuberculosis 2/140 (1.4%), sickle cell disease 3/140 (2.2%), HIV 1/221 (0.7%). Prenatal/perinatal risk factors were seen in 248 (63.9%%), birth asphyxia 118 (47.6%) and clinical congenital rubella syndrome 8 (3.3%) and hyperbilirubinaemia 59 (23.8%) were identified as preventable risk factors for CP., Conclusion: The profile of CP in this population is similar to that found in other low-income and middle-income countries (LMIC). Some risk factors identified were preventable. Prevention and management strategies for CP designed for LMIC are needed., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2020
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