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Mitiku K, Nega T, Arefaynie M, Tilahun D, Kefale B, Damtie Y, Adane B, Yalew M. Gross motor developmental delay and associated factors among under-five children attending public health facilities of Dessie city, Ethiopia. BMC Pediatr 2023; 23:638. [PMID: 38110857 PMCID: PMC10726544 DOI: 10.1186/s12887-023-04461-9] [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: 08/15/2022] [Accepted: 12/04/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND Child psychomotor development and factors affecting it today is the subject of interest of many studies, in particular by the experts involved in the protection and improvement of children's health. There is limited evidence on developmental delay among under-five children in low-income countries like Ethiopia. The aim of this study was to assess gross motor developmental delay and associated factors among under-five children attending public health facilities of Dessie city, Ethiopia. METHODS Facility based cross sectional study design was used among under-five children attending under-five OPD in public health facilities of Dessie town from July 1, 2020 to August 15, 2021. A total of, 417 under-five children were systematically selected based on their average number of clients in a month. A pretested structured questionnaire was used for data collection, and data was entered into Epi-data 3.1 version and it was exported to STATA version 14 for analysis. Binary logistic regression analysis was used to identify factors associated with the outcome variable. Odds ratio with 95% confidence interval was used to show the strength and direction of association respectively and P-value less than 0.05 is used to declare statistical significance. RESULTS The overall proportion of gross motor developmental delay among under-five children attending health facilities of Dessie city, Ethiopia was 16.31%, 95% CI: (13.05, 20.19). Increased age of the child [AOR = 0.97, 95% CI: (0.96, 0.99)], increased gestational age during pregnancy [AOR = 0.47, 95% CI: (0.37, 0.65)], being male [AOR = 5.26, 95% CI: (1.76, 15.67)], having history of alcohol intake during pregnancy [AOR = 7.40, 95% CI: (2.36, 23.25)], taking iron during pregnancy [AOR = 0.04, 95% CI: (0.01, 0.15)], facing fetal and/or maternal complication [AOR = 4.98, 95% CI: (1.20, 20.62)], having instrumental delivery [AOR = 9.78, 95% CI: (2.48, 38.60)] were significantly associated with gross motor developmental delay. CONCLUSIONS The gross motor developmental delay among under-five children was higher as compared to other literatures. This study indicated that, age and sex of the child, iron and alcohol intake during pregnancy, gestational age, mode of delivery and any complication to her and or her neonate were independent variables which showed statistical significant association. The physicians should advise mothers to take iron-folic acid supplement properly and to avoid intake of alcohol during pregnancy. In addition, they should focus on those mothers who faced any complication to her and/or her neonate and better to discourage instrumental delivery unless there are no other options.
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Affiliation(s)
- Kefale Mitiku
- Department of Physiology, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia.
| | - Tilaye Nega
- Department of Developmental Psychology, College Social Sciences, Wollo University, Dessie, Ethiopia
| | - Mastewal Arefaynie
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Degalem Tilahun
- Department of Pediatrics, School of Medicine, College of Medicine and Health Sciences, Gondar University, Gondar, Ethiopia
| | - Bereket Kefale
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Yitayish Damtie
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
- Department of Reproductive Health, School of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Bezawit Adane
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Melaku Yalew
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
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French B, Outhwaite LA, Langley-Evans SC, Pitchford NJ. Nutrition, growth, and other factors associated with early cognitive and motor development in Sub-Saharan Africa: a scoping review. J Hum Nutr Diet 2020; 33:644-669. [PMID: 32734599 DOI: 10.1111/jhn.12795] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 06/05/2020] [Accepted: 06/08/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Food insecurity, poverty and exposure to infectious disease are well-established drivers of malnutrition in children in Sub-Saharan Africa. Early development of cognitive and motor skills - the foundations for learning - may also be compromised by the same or additional factors that restrict physical growth. However, little is known about factors associated with early child development in this region, which limits the scope to intervene effectively. To address this knowledge gap, we compared studies that have examined factors associated with early cognitive and/or motor development within this population. METHODS Predetermined criteria were used to examine four publication databases (PsycInfo, Embase, Web of Science and Medline) and identify studies considering the determinants of cognitive and motor development in children aged 0-8 years in Sub-Saharan Africa. RESULTS In total, 51 quantitative studies met the inclusion criteria, reporting on 30% of countries across the region. Within these papers, factors associated with early child development were grouped into five themes: Nutrition, Growth and Anthropometry, Maternal Health, Malaria and HIV, and Household. Food security and dietary diversity were associated with positive developmental outcomes, whereas exposure to HIV, malaria, poor maternal mental health, poor sanitation, maternal alcohol abuse and stunting were indicators of poor cognitive and motor development. DISCUSSION In this synthesis of research findings obtained across Sub-Saharan Africa, factors that restrict physical growth are also shown to hinder the development of early cognitive and motor skills, although additional factors also influence early developmental outcomes. The study also reviews the methodological limitations of conducting research using Western methods in sub-Saharan Africa.
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Affiliation(s)
- B French
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - L A Outhwaite
- Centre for Education Policy & Equalising Opportunities, Institute of Education, University College London, London, UK.,School of Psychology, University of Nottingham, Nottingham, UK
| | | | - N J Pitchford
- School of Psychology, University of Nottingham, Nottingham, UK
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Dubaj C, Czyż K, Furmaga-Jabłońska W. Vitamin B 12 deficiency as a cause of severe neurological symptoms in breast fed infant - a case report. Ital J Pediatr 2020; 46:40. [PMID: 32228659 PMCID: PMC7106665 DOI: 10.1186/s13052-020-0804-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 03/18/2020] [Indexed: 01/08/2023] Open
Abstract
Background Vitamin B12 (cobalamin, cbl) deficiency in children is rare and may occurs in exclusively breast fed infants of mothers on vegetarian or vegan diet with lack of appropriate supplementation. The clinical manifestation of vitamin B12 deficiency include neurological disorders, megaloblastic anemia and failure to thrive. Routine and commonly used laboratory tests such as cell blood count (CBC) or serum vitamin B12 level are sufficient for appropriate diagnosis. Typical therapy is based on intramuscular cobalamin injections. Early diagnosis and early onset of treatment are crucial factors for long-term prognosis of patients as the duration of deficiency may be correlated with the development of long lasting changes in the nervous system. The purpose of this article is to present influence of maternal vitamin B12 deficiency as a cause of infant psychomotor retardation. Case presentation We report the case of a 7 months old girl whose parents sought medical advice due to pathological somnolence and developmental regression of their daughter with onset approximately 2 months prior to the visit. Following several diagnostic tests it was determined that the infant’s symptoms were due to vitamin B12 deficiency which was secondary to the mother’s latent Addison-Biermer disease. Apart from neurological symptoms the infant also showed megaloblastic anemia which is typical to cobalamin deficiencies. Intramuscular vitamin B12 supplementation resulted in instant improvement of the patient’s general condition and blood morphology. Unfortunately, psychological examination indicated long-term psychomotor retardation due to delayed diagnosis of B12 deficiency. Conclusions Vitamin B12 levels should be considered during differential diagnosis of neurological symptoms in exclusively breast-fed infants especially if they co-exist with megaloblastic anemia and psychomotor retardation.
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Affiliation(s)
- Cezary Dubaj
- Department of Neonate and Infant Pathology, Medical University of Lublin, Prof. Gębali 6 str, 20-093, Lublin, Poland
| | - Katarzyna Czyż
- Department of Neonate and Infant Pathology, Medical University of Lublin, Prof. Gębali 6 str, 20-093, Lublin, Poland.
| | - Wanda Furmaga-Jabłońska
- Department of Neonate and Infant Pathology, Medical University of Lublin, Prof. Gębali 6 str, 20-093, Lublin, Poland
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Hermenau K, Goessmann K, Rygaard NP, Landolt MA, Hecker T. Fostering Child Development by Improving Care Quality: A Systematic Review of the Effectiveness of Structural Interventions and Caregiver Trainings in Institutional Care. TRAUMA, VIOLENCE & ABUSE 2017; 18:544-561. [PMID: 27075337 DOI: 10.1177/1524838016641918] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Quality of child care has been shown to have a crucial impact on children's development and psychological adjustment, particularly for orphans with a history of maltreatment and trauma. However, adequate care for orphans is often impacted by unfavorable caregiver-child ratios and poorly trained, overburdened personnel, especially in institutional care in countries with limited resources and large numbers of orphans. This systematic review investigated the effects of structural interventions and caregiver trainings on child development in institutional environments. The 24 intervention studies included in this systematic review reported beneficial effects on the children's emotional, social, and cognitive development. Yet, few studies focused on effects of interventions on the child-caregiver relationship or the general institutional environment. Moreover, our review revealed that interventions aimed at improving institutional care settings have largely neglected violence and abuse prevention. Unfortunately, our findings are partially limited by constraints of study design and methodology. In sum, this systematic review sheds light on obstacles and possibilities for the improvement in institutional care. There must be greater efforts at preventing violence, abuse, and neglect of children living in institutional care. Therefore, we advocate for combining attachment theory-based models with maltreatment prevention approaches and then testing them using rigorous scientific standards. By using approaches grounded in the evidence, it could be possible to enable more children to grow up in supportive and nonviolent environments.
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Affiliation(s)
- Katharin Hermenau
- 1 Department of Psychology, University of Konstanz, Konstanz, Germany
- 2 vivo international, Konstanz, Germany
| | | | | | - Markus A Landolt
- 2 vivo international, Konstanz, Germany
- 4 University Children's Hospital Zurich, Zurich, Switzerland
- 5 Department of Child and Adolescent Health Psychology, Institute of Psychology, University of Zurich, Zurich, Switzerland
| | - Tobias Hecker
- 1 Department of Psychology, University of Konstanz, Konstanz, Germany
- 2 vivo international, Konstanz, Germany
- 6 Division of Psychopathology & Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
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Hermenau K, Hecker T, Elbert T, Ruf-Leuschner M. MALTREATMENT AND MENTAL HEALTH IN INSTITUTIONAL CARE-COMPARING EARLY AND LATE INSTITUTIONALIZED CHILDREN IN TANZANIA. Infant Ment Health J 2014; 35:102-10. [DOI: 10.1002/imhj.21440] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Levin AR, Zeanah CH, Fox NA, Nelson CA. Motor outcomes in children exposed to early psychosocial deprivation. J Pediatr 2014; 164:123-129.e1. [PMID: 24161221 PMCID: PMC4059764 DOI: 10.1016/j.jpeds.2013.09.026] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Revised: 06/26/2013] [Accepted: 09/12/2013] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To determine the effect of psychosocial deprivation early in life on motor development, assess the impact of a foster care intervention on improving motor development, and assess the association between motor and cognitive outcomes in children with a history of institutional care. STUDY DESIGN In a randomized controlled trial, children living in Romanian institutions were randomly assigned to care as usual in the institution or placed in family-centered foster care as part of the Bucharest Early Intervention Project. The average age at placement into foster care was 23 months. At age 8 years, the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition, Short Form (BOT2-SF) was applied to assess the motor proficiency of children in both groups, as well as a never-institutionalized group from the Romanian community. RESULTS Children in the never-institutionalized group did significantly better on the BOT2-SF than children who had ever been institutionalized (P < .001). There was no significant difference in performance between children in the care as usual group and the foster care group. This finding also held true for all individual items on the BOT2-SF except sit-ups. Regression analyses revealed that the between-group and within-group differences in BOT2-SF scores were largely mediated by IQ. CONCLUSION Early deprivation had a negative effect on motor development that was not resolved by placement in foster care. This effect was predominantly mediated by IQ. This study highlights the importance of monitoring for and addressing motor delays in children with a history of institutionalization, particularly those children with low IQ.
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Affiliation(s)
- April R Levin
- Department of Neurology, Boston Children's Hospital/Harvard Medical School, Boston, MA; Laboratories of Cognitive Neuroscience, Boston Children's Hospital/Harvard Medical School, Boston, MA.
| | - Charles H Zeanah
- Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, New Orleans, LA
| | - Nathan A Fox
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD
| | - Charles A Nelson
- Laboratories of Cognitive Neuroscience, Boston Children's Hospital/Harvard Medical School, Boston, MA; Center on the Developing Child at Harvard University, Cambridge, MA
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Marquer C, Barry C, Mouchenik Y, Hustache S, Djibo DM, Manzo ML, Falissard B, Révah-Lévy A, Grais RF, Moro MR. A rapid screening tool for psychological distress in children 3-6years old: results of a validation study. BMC Psychiatry 2012; 12:170. [PMID: 23072651 PMCID: PMC3503833 DOI: 10.1186/1471-244x-12-170] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Accepted: 10/10/2012] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The mental health needs of young children in humanitarian contexts often remain unaddressed. The lack of a validated, rapid and simple tool for screening combined with few mental health professionals able to accurately diagnose and provide appropriate care mean that young children remain without care. Here, we present the results of the principle cross-cultural validation of the "Psychological Screening for Young Children aged 3 to 6" (PSYCAa3-6). The PSYCa 3-6 is a simple scale for children 3 to 6 years old administered by non-specialists, to screen young children in crises and thereby refer them to care if needed. METHODS This study was conducted in Maradi, Niger. The scale was translated into Hausa, using corroboration of independent translations. A cross-cultural validation was implemented using quantitative and qualitative methods. A random sample of 580 mothers or caregivers of children 3 to 6 years old were included. The tool was psychometrically examined and diagnostic properties were assessed comparing the PSYCa 3-6 against a clinical interview as the gold standard. RESULTS The PSYCa 3-6 Hausa version demonstrated good concurrent validity, as scores correlated with the gold standard and the Clinical Global Impression Severity Scale (CGI-S) [rho = 0.41, p-value = 0.00]. A reduction procedure was used to reduce the scale from 40 to 22 items. The test-retest reliability of the PSYCa 3-6 was found to be high (ICC 0.81, CI95% [0.68; 0.89]). In our sample, although not the purpose of this study, approximately 54 of 580 children required subsequent follow-up with a psychologist. CONCLUSIONS To our knowledge, this is the first validation of a screening scale for children 3 to 6 years old with a cross-cultural validation component, for use in humanitarian contexts. The Hausa version of the PSYCa 3-6 is a reliable and a valuable screening tool for psychological distress. Further studies to replicate our findings and additional validations of the PSYCa 3-6 in other populations may help improve the delivery of mental health care to children.
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Affiliation(s)
| | - Caroline Barry
- Inserm U669, Université Paris-Sud et Université Paris Descartes, Paris, France
| | - Yoram Mouchenik
- Université Toulouse le Mirail, Toulouse, France
- Hospital Sainte-Anne, Paris, France
- Médecins Sans Frontières, Paris, France
| | | | - Douma M Djibo
- National program of mental health, Ministry of Health, Niamey, Niger
| | | | - Bruno Falissard
- Inserm U669, Université Paris-Sud et Université Paris Descartes, Paris, France
| | - Anne Révah-Lévy
- Inserm U669, Université Paris-Sud et Université Paris Descartes, Paris, France
| | | | - Marie-Rose Moro
- Inserm U669, Université Paris-Sud et Université Paris Descartes, Paris, France
- Médecins Sans Frontières, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Hôpital Cochin, Assistance Publique Hôpitaux de Paris, Paris, France
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