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Swai EA, Msuya SE, Moshi H, Lindkvist M, Sörlin A, Sahlén KG. Children and adolescents with physical disabilities: describing characteristics and disability-related needs in the Kilimanjaro region, north-eastern Tanzania - a cross-sectional survey. BMJ Open 2023; 13:e064849. [PMID: 36592996 PMCID: PMC9809220 DOI: 10.1136/bmjopen-2022-064849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 12/22/2022] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES To describe the characteristics and disability-related needs of children and adolescents with physical disabilities in the Kilimanjaro region, North-Eastern Tanzania. DESIGN A cross-sectional community survey was conducted from November 2020 to June 2021. Trained research assistants interviewed primary children's carers using a questionnaire based on the International Classification of Functioning, Disability and Health-Children and Youth Framework. Data were analysed using IBM SPSS Statistics V.27. The Pearson χ2 test was used to examine differences between age, gender and self-reported needs. The independent t-test assessed difference in needs according to age and gender. SETTING Kilimanjaro region, Tanzania. PARTICIPANTS Children and adolescents, aged 2-18 years, with physical disabilities (n=212). RESULTS Almost 40% had severe speech (n=84) and joint mobility (n=79) impairments, and more than half (n=124) had severe or complete difficulties walking. In aspects of self-care (caring for body parts, toileting, dressing, eating and drinking), most had severe and complete difficulties. Almost 70% (n=135) of households were located near health facilities without rehabilitation services. About one-quarter (n=51) had never received rehabilitation services. More than 90% (n=196) needed assistive devices, and therapeutic exercises (n=193). Over three-quarters needed nutritional supplements (n=162). CONCLUSION Children and adolescents with physical disabilities in North-Eastern Tanzania have impaired speech and joint mobility, and difficulties in communication, self-care and walking. Rehabilitation services essential for addressing these impairments and activity limitations are either scarce or inaccessible. Action is needed to facilitate urban and rural access to rehabilitation services in order to improve the well-being of children and adolescents with physical disabilities.
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Affiliation(s)
- Elia Asanterabi Swai
- Epidemiology and Global Health, Umeå University, Umeå, Sweden
- Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
- Physiotherapy, Faculty of Rehabilitation Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Sia E Msuya
- Department of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Department of Community Health, Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Haleluya Moshi
- Physiotherapy, Faculty of Rehabilitation Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Marie Lindkvist
- Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Ann Sörlin
- Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
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Hasan SH, Rashid R, Samad R, Karim MR, Faiz MA, Rahman MR, Hossain MA, Gomes M. A study to validate the Ten-Question-Questionnaire + for the detection of moderate to severe neurological disabilities in older Bangladeshi children. Disabil Rehabil 2022:1-7. [DOI: 10.1080/09638288.2022.2079735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Syeda Humaida Hasan
- Department of Pediatrics, Chattogram Medical College Hospital, Chattogram, Bangladesh
| | - Rumana Rashid
- Department of Epidemiology and Community Medicine, Bangladesh Institute of Tropical and Infectious Diseases, Chattogram, Bangladesh
| | - Rasheda Samad
- Department of Pediatrics, Chittagong Medical College, Chattogram, Bangladesh
| | - Mohammad Rezaul Karim
- Department of Pediatrics, Chattogram Maa-O-Shishu Hospital Medical College, Chattogram, Bangladesh
| | | | - Md. Ridwanur Rahman
- Department of Medicine, Universal Medical College Research Center, Dhaka, Bangladesh
| | - Md. Amir Hossain
- Department of Medicine, Chattagram International Medical College, Chattogram, Bangladesh
| | - Melba Gomes
- World Health Organization, Geneva, Switzerland
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Dey NEY, Dziwornu E, Frimpong-Manso K, Duah HO, Agbadi P. Correlates of child functional difficulties status in Ghana: A further analysis of the 2017/18 multiple indicator cluster survey. Heliyon 2020; 6:e05727. [PMID: 33364496 PMCID: PMC7750366 DOI: 10.1016/j.heliyon.2020.e05727] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 11/06/2020] [Accepted: 12/10/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Functional difficulties have long-term implications for children's physical, cognitive, emotional, social, and academic growth and development. Although the subject of functional difficulties has received enough scholarly attention in the developed world, few studies have addressed the issue in Ghana. Therefore, the study aimed to regress child, maternal and household and geographical level factors associated with the functional difficulty of children in Ghana. METHOD We analysed the 2017/18 multiple indicator cluster survey dataset. The study sample consists of weighted cases of 21,871 children within the ages of 5-17 years. Summary statistics were produced for the study variables. Bivariate analyses were performed to select significant correlates for the multivariate analysis. We accounted for sample design and weight before using Poisson regression techniques to do the bivariate and multivariate analysis. RESULTS These factors were significantly associated with functional difficulties among 5-17 years old children in Ghana: not covered with health insurance, mothers who have a functional difficulty and those without information on their functional difficulty status, and children who dwelt in richer households compared to the richest households. Compared to the northern region, children from the remaining nine regions in Ghana were more likely to have had a child functional difficulty. CONCLUSION Given the results, the government of Ghana and other development partners should promote policies and programs to reduce the consequences of disability or functional difficulties in children by taking into consideration factors like mothers' functional difficulty, access to health insurance, and regional and economic disparities in Ghana.
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Affiliation(s)
| | - Emmanuel Dziwornu
- University of Health and Allied Sciences, Department of Psychological Medicine and Mental Health, School of Medicine, PMB 31, HO, Volta Region, Ghana
| | | | | | - Pascal Agbadi
- Department of Nursing, College of Health Sciences, Kwame Nkrumah University of Science and Technology, PMB, Kumasi, Ghana
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Namazzi G, Hildenwall H, Mubiri P, Hanson C, Nalwadda C, Nampijja M, Kakooza-Mwesige A, Waiswa P, Tumwine JK. Prevalence and associated factors of neurodevelopmental disability among infants in eastern Uganda: a population based study. BMC Pediatr 2019; 19:379. [PMID: 31651279 PMCID: PMC6813088 DOI: 10.1186/s12887-019-1769-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 10/07/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Neurodevelopmental disability (NDD) is increasingly acknowledged as one of the important causes of disease burden in low income countries. None the less, there is a dearth of data on the burden of NDD and its determinants in these settings. We aimed to establish the prevalence and factors associated with NDD among infants in Eastern Uganda. METHODS We assessed 487 infants aged 9-12 months within Iganga-Mayuge Health Demographic Surveillance Site in Eastern Uganda using the Malawi Developmental Assessment Tool. The tool has four domains: gross motor, fine motor, language and social domains. An infant failed a domain if she/he failed more than two parameters of the expected at his/her age. We interviewed mothers on factors that could influence the infants' neurodevelopmental outcomes. Data were analysed using STATA version 14. We used odds ratios and 95% confidence intervals to assess statistical significance of associations. RESULTS Of the 487 infants, 62(12.7%) had an NDD in at least one of the domains. The most affected was social behaviour where 52(10.7%) infants had an NDD. Severe impairment was seen among 9(1.8%) infants with NDD in either three or four domains. Factors associated with NDD at multivariate logistic regression included: parity of more than three children (aOR = 1.8, 95% CI: 1.02-3.18); failure to cry at birth (aOR = 3.6, 95% CI: 1.46-9.17) and post-neonatal complications (aOR = 4.15, 95% CI: 1.22-14.10). Low birth weight, immediate and exclusive breast feeding were not significantly associated with NDD. CONCLUSION We found a high NDD burden among infants particularly in the social behaviour domain. To optimise the socio-neural development of infants, programs are needed to educate and work with families on how to engage and stimulate infants. Existing immunisation clinics and community health worker strategies provide an excellent opportunity for stemming this burden.
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Affiliation(s)
- Gertrude Namazzi
- Makerere University School of Public Health, College of Health Sciences, Mulago Hill Road, P. O. Box, 7072 Kampala, Uganda
| | - Helena Hildenwall
- Global Health-Health Systems & Policy, Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Paul Mubiri
- Makerere University School of Public Health, College of Health Sciences, Mulago Hill Road, P. O. Box, 7072 Kampala, Uganda
| | - Claudia Hanson
- Global Health-Health Systems & Policy, Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, England
| | - Christine Nalwadda
- Makerere University School of Public Health, College of Health Sciences, Mulago Hill Road, P. O. Box, 7072 Kampala, Uganda
| | - Margaret Nampijja
- MRC/Uganda Virus Research Institute & LSHTM Research Unit, Entebbe, Uganda
| | - Angelina Kakooza-Mwesige
- Department of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Peter Waiswa
- Makerere University School of Public Health, College of Health Sciences, Mulago Hill Road, P. O. Box, 7072 Kampala, Uganda
| | - James K. Tumwine
- Department of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
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Jiang Y, Zhao H, Xia W, Li Y, Liu H, Hao K, Chen J, Sun X, Liu W, Li J, Peng Y, Hu C, Li C, Zhang B, Lu S, Cai Z, Xu S. Prenatal exposure to benzophenones, parabens and triclosan and neurocognitive development at 2 years. ENVIRONMENT INTERNATIONAL 2019; 126:413-421. [PMID: 30831476 DOI: 10.1016/j.envint.2019.01.023] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 01/08/2019] [Accepted: 01/09/2019] [Indexed: 05/21/2023]
Abstract
BACKGROUND Benzophenones (BPs), parabens, and triclosan (TCS) are widely used in personal care products and may be neurotoxic to children, but limited studies have estimated the associations between exposure to these potential endocrine disrupting chemicals during pregnancy and child neurocognitive development. OBJECTIVE Our aim was to evaluate the relationships of prenatal exposure to BPs, parabens and TCS with child neurocognitive development at age 2. METHODS From 2014 to 2015, 478 mother-child pairs from a longitudinal prenatal cohort in China were included in present study. We quantified BPs, parabens and TCS in three spot urine samples during pregnancy (in the first, second, and third trimester). The Bayley Scales of Infant Development (BSID) test to children was performed at 2 years. Multivariate linear regression models and generalized estimating equations were used to examine changes in mental developmental index (MDI) and psychomotor development index (PDI) per 2-fold increase in averaged and trimester-specific maternal urinary phenols, respectively. RESULTS In the adjusted models, each 2-fold increase in average prenatal paraben concentration was associated with lower MDI scores among girls [-1.08 (95% CI: -2.10, -0.06) and - 1.51 (95% CI: -2.69, -0.32) for methyl paraben (Mep) and Σparabens, respectively], but the association was not statistically significant among boys [-0.24 (95% CI: -1.46, 0.99), Psex-int = 0.37 and 0.18 (95% CI: -1.28, 1.64), Psex-int = 0.10 for Mep and Σparabens, respectively]. Increasing urinary 4-hydroxybenzophenone (4-OH-BP) concentration was associated with lower PDI scores among boys [-2.96 (95% CI: -4.48, -1.45)], not girls [-0.07 (95% CI: -1.57, 1.43)] and the association was significantly different in boys and girls (Psex-int = 0.01). No significant associations were observed between the average prenatal TCS exposure and BSID results. In trimester-specific analyses, increasing parabens was associated with lower girls' MDI only in the second trimester, while increasing 4-OH-BP was associated with lower boys' PDI in each trimester. CONCLUSION Our results suggest that prenatal exposure to BPs and parabens may be associated with impairment in child cognitive abilities at 2 years. Further human and animal studies are needed to verify our results and elucidate the biological mechanisms involved in these associations.
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Affiliation(s)
- Yangqian Jiang
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Hongzhi Zhao
- State Key Laboratory of Environmental and Biological Analysis, Department of Chemistry, Hong Kong Baptist University, Hong Kong, China
| | - Wei Xia
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Yuanyuan Li
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Hongxiu Liu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Ke Hao
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jia Chen
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Xiaojie Sun
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Wenyu Liu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Jiufeng Li
- State Key Laboratory of Environmental and Biological Analysis, Department of Chemistry, Hong Kong Baptist University, Hong Kong, China
| | - Yang Peng
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Chen Hu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Chunhui Li
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Bin Zhang
- Women and Children Medical and Healthcare Center of Wuhan, Wuhan, Hubei, People's Republic of China
| | - Shi Lu
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Zongwei Cai
- State Key Laboratory of Environmental and Biological Analysis, Department of Chemistry, Hong Kong Baptist University, Hong Kong, China.
| | - Shunqing Xu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China.
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Bitta M, Kariuki SM, Abubakar A, Newton CR. Burden of neurodevelopmental disorders in low and middle-income countries: A systematic review and meta-analysis. Wellcome Open Res 2018. [DOI: 10.12688/wellcomeopenres.13540.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Childhood mortality from infectious diseases has declined steadily in many low and middle-income (LAMIC) countries, with increased recognition of non-communicable diseases such as neurodevelopmental disorders (NDD). There is lack of data on the burden of NDD in LAMIC. Current global burden of these disorders are largely extrapolated from high-income countries. The main objective of the study was therefore to estimate the burden of NDD in LAMIC using meta-analytic techniques. Methods: We systematically searched online databases including Medline/PubMed, PsychoInfo, and Embase for studies that reported prevalence or incidence of NDD. Pooled prevalence, heterogeneity and risk factors for prevalence were determined using meta-analytic techniques. Results: We identified 4,802 records, but only 51 studies met the eligibility criteria. Most studies were from Asia-Pacific (52.2%) and most were on neurological disorders (63.1%). The median pooled prevalence per 1,000 for any NDD was 7.6 (95%CI 7.5-7.7), being 11.3 (11.7-12.0) for neurological disorders and 3.2 (95%CI 3.1-3.3) for mental conditions such as attention-deficit hyperactivity disorder (ADHD). The type of NDD was significantly associated with the greatest prevalence ratio in the multivariable model (PR=2.6(95%CI 0.6-11.6) (P>0.05). Incidence was only reported for epilepsy (mean of 447.7 (95%CI 415.3-481.9) per 100,000). Perinatal complications were the commonest risk factor for NDD. Conclusion: The burden of NDD in LAMIC is considerable. Epidemiological surveys on NDD should screen all types of NDD to provide reliable estimates.
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Bitta M, Kariuki SM, Abubakar A, Newton CRJC. Burden of neurodevelopmental disorders in low and middle-income countries: A systematic review and meta-analysis. Wellcome Open Res 2017. [PMID: 29881784 DOI: 10.12688/wellcomeopenres.13540.1] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background: Childhood mortality from infectious diseases has declined steadily in many low and middle-income (LAMIC) countries, with increased recognition of non-communicable diseases such as neurodevelopmental disorders (NDD). There is lack of data on the burden of NDD in LAMIC. Current global burden of these disorders are largely extrapolated from high-income countries. The main objective of the study was therefore to estimate the burden of NDD in LAMIC using meta-analytic techniques. Methods: We systematically searched online databases including Medline/PubMed, PsychoInfo, and Embase for studies that reported prevalence or incidence of NDD. Pooled prevalence, heterogeneity and risk factors for prevalence were determined using meta-analytic techniques. Results: We identified 4,802 records, but only 51 studies met the eligibility criteria. Most studies were from Asia (52.2%) and most were on neurological disorders (63.1%). The median pooled prevalence per 1,000 for all NDD was 7.6 (95%CI 7.5-7.7), being 11.3 (11.7-12.0) for neurological disorders and 3.2 (95%CI 3.1-3.3) for mental conditions such as attention-deficit hyperactivity disorder (ADHD). The type of NDD was significantly associated with the greatest prevalence ratio in the multivariable model (PR=2.6(95%CI 0.6-11.6) (P>0.05). Incidence was only reported for epilepsy (mean of 447.7 (95%CI 415.3-481.9) per 100,000). Perinatal complications were the commonest risk factor for NDD. Conclusion: The burden of NDD in LAMIC is considerable. Epidemiological surveys on NDD should screen all types of NDD to provide reliable estimates.
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Affiliation(s)
- Mary Bitta
- KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine Research , (Coast), Kilifi, Kenya
| | - Symon M Kariuki
- KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine Research , (Coast), Kilifi, Kenya
| | - Amina Abubakar
- KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine Research , (Coast), Kilifi, Kenya.,Department of Public Health, Pwani University, Kilifi, Kenya.,Department of Psychiatry, University of Oxford, Oxford, UK
| | - Charles R J C Newton
- KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine Research , (Coast), Kilifi, Kenya.,Department of Public Health, Pwani University, Kilifi, Kenya.,Department of Psychiatry, University of Oxford, Oxford, UK
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8
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Sherr L, Macedo A, Tomlinson M, Skeen S, Cluver LD. Could cash and good parenting affect child cognitive development? A cross-sectional study in South Africa and Malawi. BMC Pediatr 2017; 17:123. [PMID: 28499423 PMCID: PMC5427556 DOI: 10.1186/s12887-017-0883-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 05/08/2017] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Social protection interventions, including cash grants and care provision have been shown to effectively reduce some negative impacts of the HIV epidemic on adolescents and families. Less is known about the role of social protection on younger HIV affected populations. This study explored the impact of cash grants on children's cognitive development. Additionally, we examined whether combined cash and care (operationalised as good parenting) was associated with improved cognitive outcomes. METHODS The sample included 854 children, aged 5 - 15, participating in community-based organisation (CBO) programmes for children affected by HIV in South Africa and Malawi. Data on child cognitive functioning were gathered by a combination of caregiver report and observer administered tests. Primary caregivers also reported on the economic situation of the family, cash receipt into the home, child and household HIV status. Parenting was measured on a 10 item scale with good parenting defined as a score of 8 or above. RESULTS About half of families received cash (55%, n = 473), only 6% (n = 51) reported good parenting above the cut-off point but no cash, 18% (n = 151) received combined cash support and reported good parenting, and 21% (n = 179) had neither. Findings show that cash receipt was associated with enhanced child cognitive outcomes in a number of domains including verbal working memory, general cognitive functioning, and learning. Furthermore, cash plus good parenting provided an additive effect. Child HIV status had a moderating effect on the association between cash or/plus good parenting and cognitive outcomes. The association between cash and good parenting and child cognitive outcomes remained significant among both HIV positive and negative children, but overall the HIV negative group benefited more. CONCLUSIONS This study shows the importance of cash transfers and good parenting on cognitive development of young children living in HIV affected environments. Our data clearly indicate that combined provision (cash plus good parenting) have added value.
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Affiliation(s)
- Lorraine Sherr
- Research Department of Global Health, University College London, Rowland Hill Street, London, NW3 2PF UK
| | - Ana Macedo
- Research Department of Global Health, University College London, Rowland Hill Street, London, NW3 2PF UK
| | - Mark Tomlinson
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Sarah Skeen
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Lucie Dale Cluver
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- Department of Social Policy & Social Intervention, Centre for Evidence-Based Intervention, University of Oxford, Oxford, UK
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Bitta M, Kariuki SM, Abubakar A, Newton CRJC. Burden of neurodevelopmental disorders in low and middle-income countries: A systematic review and meta-analysis. Wellcome Open Res 2017; 2:121. [PMID: 29881784 PMCID: PMC5964629 DOI: 10.12688/wellcomeopenres.13540.3] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2017] [Indexed: 12/23/2022] Open
Abstract
Background: Childhood mortality from infectious diseases has declined steadily in many low and middle-income (LAMIC) countries, with increased recognition of non-communicable diseases such as neurodevelopmental disorders (NDD). There is lack of data on the burden of NDD in LAMIC. Current global burden of these disorders are largely extrapolated from high-income countries. The main objective of the study was therefore to estimate the burden of NDD in LAMIC using meta-analytic techniques. Methods: We systematically searched online databases including Medline/PubMed, PsychoInfo, and Embase for studies that reported prevalence or incidence of NDD. Pooled prevalence, heterogeneity and risk factors for prevalence were determined using meta-analytic techniques. Results: We identified 4,802 records, but only 51 studies met the eligibility criteria. Most studies were from Asia (52.2%) and most were on neurological disorders (63.1%). The median pooled prevalence per 1,000 for all NDD was 7.6 (95%CI 7.5-7.7), being 11.3 (11.7-12.0) for neurological disorders and 3.2 (95%CI 3.1-3.3) for mental conditions such as attention-deficit hyperactivity disorder (ADHD). The type of NDD was significantly associated with the greatest prevalence ratio in the multivariable model (PR=2.6(95%CI 0.6-11.6) (P>0.05). Incidence was only reported for epilepsy (mean of 447.7 (95%CI 415.3-481.9) per 100,000). Perinatal complications were the commonest risk factor for NDD. Conclusion: The burden of NDD in LAMIC is considerable. Epidemiological surveys on NDD should screen all types of NDD to provide reliable estimates.
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Affiliation(s)
- Mary Bitta
- KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine Research , (Coast), Kilifi, Kenya
| | - Symon M Kariuki
- KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine Research , (Coast), Kilifi, Kenya
| | - Amina Abubakar
- KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine Research , (Coast), Kilifi, Kenya.,Department of Public Health, Pwani University, Kilifi, Kenya.,Department of Psychiatry, University of Oxford, Oxford, UK
| | - Charles R J C Newton
- KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine Research , (Coast), Kilifi, Kenya.,Department of Public Health, Pwani University, Kilifi, Kenya.,Department of Psychiatry, University of Oxford, Oxford, UK
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Wanyua S, Ndemwa M, Goto K, Tanaka J, K'opiyo J, Okumu S, Diela P, Kaneko S, Karama M, Ichinose Y, Shimada M. Profile: the Mbita health and demographic surveillance system. Int J Epidemiol 2014; 42:1678-85. [PMID: 24415606 DOI: 10.1093/ije/dyt180] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The Mbita Health and Demographic Surveillance System (Mbita HDSS), located on the shores of Lake Victoria in Kenya, was established in 2006. The main objective of the HDSS is to provide a platform for population-based research on relationships between diseases and socio-economic and environmental factors, and for the evaluation of disease control interventions. The Mbita HDSS had a population of approximately 54 014 inhabitants from 11 576 households in June 2013. Regular data are collected using personal digital assistants (PDAs) every 3 months, which includes births, pregnancies, migration events and deaths. Coordinates are taken using geographical positioning system (GPS) units to map all dwelling units during data collection. Cause of death is inferred from verbal autopsy questionnaires. In addition, other health-related data such as vaccination status, socio-economic status, water sources, acute illness and bed net distribution are collected. The HDSS has also provided a platform for conducting various other research activities such as entomology studies, research on neglected tropical diseases, and environmental health projects which have benefited the organization as well as the HDSS community residents. Data collected are shared with the community members, health officials, local administration and other relevant organizations. Opportunities for collaboration and data sharing with the wider research community are available and those interested should contact shimadam@nagasaki-u.ac.jp or mhmdkarama@yahoo.com.
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Affiliation(s)
- Sheru Wanyua
- Nagasaki University Institute of Tropical Medicine-Kenya Medical Research Institute Project, Nairobi, Kenya, Department of Eco-Epidemiology, Nagasaki University, Nagasaki, Japan, Centre for Infectious Disease Research in Asia and Africa, Nagasaki University Institute of Tropical Medicine, Nairobi, Kenya and Centre for Public Health Research, Kenya Medical Research Institute, Nairobi, Kenya
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