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Abate BB, Tegegne KM, Zemariam AB, Wondmagegn Alamaw A, Kassa MA, Kitaw TA, Abebe GK, Azmeraw Bizuayehu M. Magnitude and clinical characteristics of cerebral palsy among children in Africa: A systematic review and meta-analysis. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003003. [PMID: 38905321 PMCID: PMC11192420 DOI: 10.1371/journal.pgph.0003003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 05/22/2024] [Indexed: 06/23/2024]
Abstract
Cerebral palsy (CP) is the most common motor disability in childhood which causes a child's behavioral, feeding, and sleep difficulties. It remains a poorly studied health problem in Africa. The main aim of this study was assessing the pooled prevalence of Cerebral Palsy (CP) and its clinical characteristics in Africa context. Systematic review and meta-analysis were conducted using Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines to search articles from electronic databases (Cochrane library, Ovid platform) (Medline, Embase, and Emcare), Google Scholar, CINAHL, PubMed, Maternity and Infant Care Database (MIDIRS). The last search date was on 12/05/ 2023 G. C. A weighted inverse variance random-effects model was used to estimate the pooled estimates of cerebral palsy and its types. The subgroup analysis, publication bias and sensitivity analysis were done. Studies on prevalence and clinical characteristics of cerebral palsy were included. The primary and secondary outcomes were prevalence and clinical characteristics of cerebral palsy respectively. A total of 15 articles with (n = 498406 patients) were included for the final analysis. The pooled prevalence of cerebral palsy in Africa was found to be 3·34 (2·70, 3·98). The most common type is spastic cerebral palsy accounting 69·30% (66·76, 71·83) of all cases. The second one is quadriplegic cerebral palsy which was found to be 41·49% (33·16, 49·81). Ataxic cerebral palsy accounted 5·36% (3·22, 7·50). On the other hand, dyskinetic cerebral palsy was found to be 10.88% (6·26, 15·49). About 32·10% (19·25, 44.95) of cases were bilateral while 25·17% (16·84, 33·50) were unilateral. The incidence of cerebral palsy in Africa surpasses the reported rates in developed nations. Spastic and quadriplegic subtypes emerge as the most frequently observed. It is recommended to channel initiatives toward the strategic focus on preventive measures, early detection strategies, and comprehensive management protocols.
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Affiliation(s)
- Biruk Beletew Abate
- Assistant Professor in Pediatrics and Child Health Nursing, College of Health Science, Woldia University, Weldiya, Ethiopia
| | | | - Alemu Birara Zemariam
- MSc in Pediatrics and Child Health Nursing, College of Health Science, Woldia University, Weldiya, Ethiopia
| | - Addis Wondmagegn Alamaw
- MSc in Emergency Medicine and Critical Care Nursing, College of Health Science, Woldia University, Weldiya, Ethiopia
| | - Mulat Awoke Kassa
- MSc in Psychiatry, College of Health Science, Woldia University, Weldiya, Ethiopia
| | - Tegene Atamenta Kitaw
- MSc in Adult Health Nursing, College of Health Science, Woldia University, Weldiya, Ethiopia
| | - Gebremeskel Kibret Abebe
- MSc in Emergency Medicine and Critical Care Nursing, College of Health Science, Woldia University, Weldiya, Ethiopia
| | - Molla Azmeraw Bizuayehu
- MSc in Pediatrics and Child Health Nursing, College of Health Science, Woldia University, Weldiya, Ethiopia
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O'Regan E, Stadskleiv K, Czuba T, Alriksson-Schmidt AI. Cognitive assessments among children with cerebral palsy in Sweden and the use of augmentative and alternative communication and interpreters: a cross-sectional registry study. Disabil Rehabil 2023; 45:3656-3667. [PMID: 36308310 DOI: 10.1080/09638288.2022.2138571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 10/08/2022] [Accepted: 10/16/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE Children with cerebral palsy (CP) have an increased risk of cognitive difficulties and should be offered cognitive assessments. In Sweden, the CPCog protocol recommends children with CP undergo cognitive assessments at the start of primary and secondary school. To assess children with CP can be challenging, in particular when children are non-vocal or do not speak the local language. In such instances, augmentative and alternative communication (AAC) and qualified medical interpreters should be considered. The purpose of this study was to monitor the implementation and equitable delivery of the CPCog protocol in Sweden between the years 2017-2020. MATERIALS AND METHODS In this cross-sectional study, registry data were extracted from the combined follow-up program and national registry for individuals with CP (CPUP), and a convenience sample of psychologists responded to an online survey. RESULTS AND CONCLUSIONS Each year, less than 5% of eligible children had registered cognitive assessments in CPUP. There was underuse of AAC during assessments and a discrepancy between the registered versus reported use of interpreters. Psychologists perceived AAC as more reliable for cognitive assessments than interpreters. Greater availability of and capacity to offer cognitive assessments in other formats and languages could help increase test accessibility for all children with CP.Implications for RehabilitationThe cognitive assessment of children with cerebral palsy (CP) is a complex but important issue within disability and re/habilitation.Individualized cognitive assessments should be offered and carried out by psychologists.Rehabilitation centers should strive to be inclusive through reliable test adaptations for functional abilities, means of communication, and language.Greater availability of- and capacity to offer cognitive assessments in more formats and languages could help increase test accessibility for children with disabilities.
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Affiliation(s)
- Elisabeth O'Regan
- Department of Clinical Sciences, Lund Orthopedics, Lund University, Lund, Sweden
| | - Kristine Stadskleiv
- Department of Special Needs Education, University of Oslo, Oslo, Norway
- Department of Clinical Neurosciences for Children, Oslo University Hospital, Oslo, Norway
| | - Tomasz Czuba
- Department of Clinical Sciences, Lund University, Lund, Sweden
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Başaran A, Kilinç Z, Sari H, Gündüz E. Etiological risk factors in children with cerebral palsy. Medicine (Baltimore) 2023; 102:e33479. [PMID: 37058062 PMCID: PMC10101261 DOI: 10.1097/md.0000000000033479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 03/17/2023] [Indexed: 04/15/2023] Open
Abstract
To evaluate the etiological risk factors of cerebral palsy, especially the preventable ones. The study was carried out with the mothers of 210 children with cerebral palsy (CP) registered in Mardin Guidance and Research Center between February and May 2022. The data form prepared by the researchers was applied to the mothers by face-to-face interview technique. The data form consisted of 29 questions including sociodemographic characteristics of the child and mother, risk factors for CP, and secondary medical problems of the child. Of the 210 patients included in the study, 43.3% (91) were female and 56.7% (119) were male. The mean age of the children was 67.4 (SD = 50.6) weeks, and 73.3% of children were premature. The number of children with a birth weight below 2500 g was 48.1% (101). The mean birth weight was 2472.5 (SD = 871.8) g. The children with another disabled sibling consisted 6.2% of the population. Among the mothers, 41.9% stated that they were illiterate and 73.3% stated that their income status was low. The rate of the parents that were related to each other was 51%. In our study, it was noteworthy that most of the children were premature, had low birth weight, more than half of them had parents who were relatives, the education level of the mothers was low, the socioeconomic status of most of the families was low, and most of these risk factors were preventable.
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Affiliation(s)
- Alev Başaran
- Mardin Training and Research Hospital Physical Therapy and Rehabilitation Unit, Mardin, Turkey
| | - Zehra Kilinç
- Dicle University Faculty of Medicine Department of Public Health, Diyarbakir, Turkey
| | - Hidir Sari
- Dicle University Faculty of Medicine Department of Public Health, Diyarbakir, Turkey
| | - Ercan Gündüz
- Dicle University Faculty of Medicine, Department of Emergency Medicine, Diyarbakir, Turkey
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Nikolajsen H, Larsen CM, Holsgaard-Larsen A, Juul-Kristensen B, Hestbaek L. Physical impairments among adults in Denmark: a register-based study. BMC Public Health 2022; 22:2416. [PMID: 36550538 PMCID: PMC9783972 DOI: 10.1186/s12889-022-14747-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 11/28/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Knowledge of the prevalence and socio-demographic characteristics of physical impairments is limited. This study aimed to determine the prevalence of physical impairments among adults in Denmark, both in total and according to nine common diagnostic subgroups, describe the socio-demographic and socio-economic profile, and compare the data with those of the general adult population. METHODS This descriptive, cross-sectional, register-based study evaluated the general socio-demographic and socio-economic variables, including sex, age, geographical region, origin, educational level, occupation, marital status, and disability level, of adults with physical impairments extracted by diagnosis from the Danish National Patient Register and Statistics Denmark by 31 December 2018. These data were compared with those of the general adult population in Denmark extracted from Statistics Denmark by January 2019. RESULTS In total, 606,857 adults with physical impairments were identified. Of the nine selected diagnoses, osteoarthritis (69.4%) was the most prevalent, followed by acquired brain injury (29.0%), rheumatoid arthritis (6.7%), multiple sclerosis (2.6%), spinal cord injury (1.5%), cerebral palsy (1.2%), amputation (0.7%), muscular dystrophy (0.5%), and poliomyelitis (< 0.1%). There were large variations in the socio-demographic and socio-economic profile between the nine diagnostic subgroups. The adults with physical impairments were more often women, were older, were less often immigrants and employed adults, had a lower educational level, and were more commonly married than the general adult population. Only the geographical region did not differ. CONCLUSION The nine subgroups with diagnoses related to the musculoskeletal system represent 13% of the adult Danish population. The socio-demographic and socio-economic profile varied largely between the nine diagnostic subgroups, and almost all variables differed significantly between adults with physical impairments and the general adult population in Denmark. These findings reveal patterns and trends on socio-demographic and socio-economic variables essential for future planning at a societal level, including the healthcare and social sectors.
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Affiliation(s)
- Helene Nikolajsen
- grid.10825.3e0000 0001 0728 0170Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark ,grid.470076.20000 0004 0607 7033Department of Physiotherapy, Institute of Health Studies, University College South Denmark, Esbjerg-Haderslev, Denmark
| | - Camilla Marie Larsen
- grid.10825.3e0000 0001 0728 0170Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark ,grid.460785.80000 0004 0432 5638Health Sciences Research Centre, UCL University College, Odense, Denmark
| | - Anders Holsgaard-Larsen
- grid.10825.3e0000 0001 0728 0170Orthopaedic Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark ,grid.7143.10000 0004 0512 5013Department of Orthopaedics and Traumatology, Odense University Hospital, Odense, Denmark
| | - Birgit Juul-Kristensen
- grid.10825.3e0000 0001 0728 0170Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Lise Hestbaek
- grid.10825.3e0000 0001 0728 0170Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Provenzi L. The burden of Europe's immigration crisis on mother-child healthcare services and opportunities for culturally sensitive family-centred care. Acta Paediatr 2021; 110:19-21. [PMID: 32304592 DOI: 10.1111/apa.15316] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 03/27/2020] [Accepted: 04/15/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Livio Provenzi
- Child Neurology and Psychiatry Unit IRCCS Mondino Foundation Pavia Italy
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Wändell P, Fredrikson S, Carlsson AC, Li X, Gasevic D, Sundquist J, Sundquist K. Epilepsy in second-generation immigrants: a cohort study of all children up to 18 years of age in Sweden. Eur J Neurol 2019; 27:152-159. [PMID: 31340083 DOI: 10.1111/ene.14049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 07/10/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE Our purpose was to study the association between country of birth and incident epilepsy in second-generation immigrants in Sweden. METHODS The study population included all children (n = 4 023 149) aged up to 18 years in Sweden. Epilepsy was defined as at least one registered diagnosis of epilepsy in the National Patient Register. The incidence of epilepsy, using individuals with Swedish-born parents as referents, was assessed by Cox regression, expressed in hazard ratios (HRs) and 95% confidence interval (95% CI). All models were stratified by sex and adjusted for age, geographical residence in Sweden, educational level, marital status, neighbourhood socioeconomic status and comorbid conditions, also using data from the Total Population Register. RESULTS A total of 26 310 individuals had a registered epilepsy event, i.e. 6.5/1000 (6.6/1000 amongst boys and 6.3/1000 amongst girls). After adjustment, the risk of epilepsy was lower than in children of Swedish-born parents. Amongst girls the significant HR was 0.85 (95% CI 0.81-0.88), but in boys only when adjusting also for comorbidity (HR 0.96, 95% CI 0.92-0.99). Amongst specific immigrant groups, a higher incidence of epilepsy was observed amongst boys with parents from Turkey and Africa, but not when adjusting for comorbidity, and a lower risk was observed in many other groups (boys with parents from Latvia, girls with parents from Finland, Iceland, Southern Europe, countries from the former Yugoslavia, and Asia). CONCLUSION The risk of epilepsy was lower in second-generation immigrant children compared to children with Swedish-born parents, but with substantial differences between different immigrant groups.
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Affiliation(s)
- P Wändell
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - S Fredrikson
- Department of Clinical Neuroscience, Division of Neurology, Karolinska Institutet Huddinge, Stockholm, Sweden
| | - A C Carlsson
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - X Li
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - D Gasevic
- Usher Institute of Population Health Sciences and Informatics, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK.,School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - J Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden.,Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Center for Community-based Healthcare Research and Education (CoHRE), Department of Functional Pathology, School of Medicine, Shimane University, Matsue, Japan
| | - K Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden.,Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Center for Community-based Healthcare Research and Education (CoHRE), Department of Functional Pathology, School of Medicine, Shimane University, Matsue, Japan
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