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Moges FY, Mengistu Z, Tilahun SW. Determinants of speech and language delay among children aged 12 months to 12 years at Yekatit 12 Hospital, Addis Ababa, Ethiopia: a case-control study. BMC Pediatr 2024; 24:393. [PMID: 38867169 PMCID: PMC11167758 DOI: 10.1186/s12887-024-04862-4] [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: 11/17/2023] [Accepted: 05/29/2024] [Indexed: 06/14/2024] Open
Abstract
BACKGROUND Speech and language delay among children can result in social interaction problems, attention difficulties, decreased writing and reading abilities, and poor cognitive and behavioral development. Despite the mounting prevalence of speech and language delays in Ethiopia, there is a lack of literature addressing the factors contributing to this delay. Consequently, this study aims to identify determinants of speech and language delay among children aged 12 months to 12 years at Yekatit 12 Hospital in Addis Ababa, Ethiopia. METHODS We conducted an institutional-based at Yekatit 12 Hospital, unmatched case-control study with 50 cases and 100 controls aged 12 months to 12 years. Interviewer-administered questionnaires were used to collect data from the parents or caregivers of the participating children. Epi Info v7 was used for sample calculation, and SPSS v26 was used for analysis. The chi-square test was performed to determine the relationship between speech and language delay and determining factors, which was then followed by logistic regression. The significant determining factors were identified based on the adjusted odds ratio (AOR), with a 95% CI and p-value (< 0.05). RESULTS Case group constituted 23 males and 27 females, totaling 50 children. Upon completing the multivariate analysis, birth asphyxia [AOR = 4.58, 95CI (1.23-16.99)], bottle-feeding [AOR = 4.54, 95CI (1.29-16.04)], mother-child separation [AOR = 2.6, 95CI (1.05-6.43)], multilingual family [AOR = 2.31, 95CI (1.03-5.18)], and screen time greater than two hours [AOR = 3.06, 95CI (1.29-7.28)] were found to be statistically significant determinants of speech and language delay. CONCLUSIONS Our study found that birth asphyxia, bottle-feeding, mother-child separation, being from a multilingual family, and excessive screen time contribute significantly to speech and language delay. As a result, it is important to develop interventions that target these modifiable factors, while also ensuring that early diagnosis and treatment options are readily accessible.
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Affiliation(s)
- Feven Y Moges
- Department of Nursing, College of Health Sciences, Arsi University, Asella, Ethiopia
| | - Zuriyash Mengistu
- Department of Nursing, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Sosina W Tilahun
- Department of Nursing, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
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Sharma AR, Siddiqui MS, Magar S, Kale A, Nelanuthala M, Singh SP. The Etiological Profile of Global Developmental Delay at a Tertiary Care Hospital in India: An Observational Study. Cureus 2023; 15:e41066. [PMID: 37519562 PMCID: PMC10375252 DOI: 10.7759/cureus.41066] [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] [Accepted: 06/28/2023] [Indexed: 08/01/2023] Open
Abstract
Background Global developmental delay (GDD) is common and has a significant impact on affected children, families, and society. Understanding its etiology is crucial for management and prevention strategies. However, data on the etiological profile of GDD in developing countries are limited. This study aimed to identify the etiological profile of GDD at a tertiary care hospital in India. Methodology This observational study included children aged three months to five years with a developmental quotient below 70%. Data on demographics, clinical features, relevant investigations, and diagnoses were collected. Etiologies were categorized into prenatal, perinatal, postnatal, and unknown causes. Informed consent was obtained from the parents. Results A total of 52 children, with a median age of 15.5 months, were included in the study, with 69.2% being males. Prenatal causes accounted for half of the cases, with genetic abnormalities (32.7%) and chromosomal abnormalities (7.7%) being prominent. Perinatal causes were the next most common (34.6%), including hypoxic-ischemic encephalopathy (26.7%). Postnatal causes were rare (3.8%). The overall etiological yield was 88.4%, with some cases remaining unidentified. Conclusions Prenatal causes, including genetic and chromosomal abnormalities, are common in GDD. The utilization of genetic testing enhances etiological yield. Hypoxic-ischemic encephalopathy remains a significant factor and highlights the importance of perinatal care in preventing developmental delays. Large multicentric studies are needed for a comprehensive database of etiological profiles.
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Affiliation(s)
- Amulya R Sharma
- Department of Paediatrics, Mahatma Gandhi Mission's (MGM) Medical College and Hospital, A Constituent Unit of MGM Institute of Health Sciences, Aurangabad, IND
| | - Mohd Saeed Siddiqui
- Department of Paediatrics, Mahatma Gandhi Mission's (MGM) Medical College and Hospital, A Constituent Unit of MGM Institute of Health Sciences, Aurangabad, IND
| | - Suvarna Magar
- Department of Paediatrics, Mahatma Gandhi Mission's (MGM) Medical College and Hospital, A Constituent Unit of MGM Institute of Health Sciences, Aurangabad, IND
| | - Ajay Kale
- Department of Paediatrics, Mahatma Gandhi Mission's (MGM) Medical College and Hospital, A Constituent Unit of MGM Institute of Health Sciences, Aurangabad, IND
| | - Madhurasree Nelanuthala
- Department of Paediatrics, Mahatma Gandhi Mission's (MGM) Medical College and Hospital, A Constituent Unit of MGM Institute of Health Sciences, Aurangabad, IND
| | - Surya Pratap Singh
- Department of Paediatrics, Mahatma Gandhi Mission's (MGM) Medical College and Hospital, A Constituent Unit of MGM Institute of Health Sciences, Aurangabad, IND
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Mangamba DCK, Enyama D, Foko LPK, Tankou J, Njinkui DN, Essome H, Mangamba LME, Eposse Ekoube C, Betoko RM, Eboumbou PE, Njankoua YM, Penda CI. Epidemiological, clinical, and treatment-related features of children with cerebral palsy in Cameroon: A hospital-based study. Arch Pediatr 2022; 29:219-224. [PMID: 35094907 DOI: 10.1016/j.arcped.2022.01.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 11/14/2021] [Accepted: 01/13/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Pediatric cerebral palsy (CP) remains a poorly studied public health problem in sub-Saharan Africa, especially in Cameroon. This study aimed at determining the epidemiological, clinical, and treatment-related characteristics of CP in Cameroonian children. METHODS A cross-sectional study was conducted at the pediatric department of the Douala Gynaeco-Obstetric and Pediatric Hospital (DGOPH). Medical records of children attending the department during the study period were reviewed. Only medical records of children aged from 3 months to 15 years and diagnosed with CP were included. Parents/guardians of children presenting with CP were contacted and invited to come with their children to the DGOPH where they were examined by a pediatric neurologist. A questionnaire designed for the study was used to collect sociodemographic, clinical, paraclinical, and treatment data for each child. RESULTS Out of the 4064 medical records reviewed, CP was diagnosed in 198 children (4.86%). These children were predominantly male (53.6%), aged 3-24 months (54.0%). Perinatal disorders were the main CP etiologies, especially neonatal asphyxia (55.1%), jaundice (32.8%), and neonatal infections (25.8%). Most of the children were born at term (81.6%) and by vaginal delivery (62.6%), with a normal birth weight (83.2%). Several comorbidities were found including speech delay (74.2%) and epilepsy (34.4%). The patients with CP presented predominantly with the spastic form of the disease, especially spastic quadriplegia (44.3%). Less than half of the children were managed at hospital, while the majority of parents were following various traditional treatments. CONCLUSION Addressing preventable causes of CP and improving awareness in the population will be of great help to reduce CP in Cameroon.
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Affiliation(s)
- D C Kedy Mangamba
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - D Enyama
- Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon.
| | - L P Kojom Foko
- Faculty of Science, University of Douala, Douala, Cameroon
| | - J Tankou
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - D Noukeu Njinkui
- Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
| | - H Essome
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - L M Endale Mangamba
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - C Eposse Ekoube
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - R Mbono Betoko
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - P Epée Eboumbou
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Y Mapoure Njankoua
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - C I Penda
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
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Kengne Kamga K, De Vries J, Nguefack S, Munung NS, Wonkam A. Explanatory models for the cause of Fragile X Syndrome in rural Cameroon. J Genet Couns 2021; 30:1727-1736. [PMID: 34145661 PMCID: PMC8642261 DOI: 10.1002/jgc4.1440] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 04/04/2021] [Accepted: 05/01/2021] [Indexed: 11/18/2022]
Abstract
Among the myriad causes of intellectual disability (ID), Fragile X Syndrome (FXS) is the leading genetic cause. Yet, little is known of how people affected by this condition make sense of it. The present study aimed to investigate the explanatory models for the causes of FXS in an extended family mainly affected by this condition and members of the village from which they originated in Cameroon. Using an ethnographic approach, 92 participants were interviewed (59 females and 33 males) through 10 focus group discussions and 23 in‐depth interviews between April 2018 and February 2020. Data analysis revealed four explanatory models regarding the etiologies of FXS in the community. Firstly, the curse model described a curse from the chief because of the belief that his wives did not mourn his intellectually disabled servant. Secondly, the spiritual model relates FXS to a punishment from God. Thirdly, the socioeconomic model attributes FXS to events in the prenatal and perinatal periods. Finally, the genetic model describes the pattern of inheritance of the disease in the family. This paper helps to understand the explanatory disease models that exist for FXS in rural Cameroon and could inform genetic counseling practices, community genetic education, and policymakers when drafting protocols for public engagement activities.
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Affiliation(s)
- Karen Kengne Kamga
- Division of Human Genetics, Department of Pathology, University of Cape Town, Cape Town, South Africa
| | - Jantina De Vries
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Séraphin Nguefack
- Department of Pediatrics, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | - Nchangwi Syntia Munung
- Division of Human Genetics, Department of Pathology, University of Cape Town, Cape Town, South Africa
| | - Ambroise Wonkam
- Division of Human Genetics, Department of Pathology, University of Cape Town, Cape Town, South Africa.,Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.,Institute of Infectious Disease and Molecular Medicine (IDM), Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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Cascade Testing for Fragile X Syndrome in a Rural Setting in Cameroon (Sub-Saharan Africa). Genes (Basel) 2020; 11:genes11020136. [PMID: 32012997 PMCID: PMC7074341 DOI: 10.3390/genes11020136] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 01/13/2020] [Accepted: 01/22/2020] [Indexed: 11/17/2022] Open
Abstract
Fragile X Syndrome (FXS), an X-linked dominant monogenic condition, is the main genetic cause of intellectual disability (ID) and autism spectrum disorder (ASD). FXS is associated with an expansion of CGG repeat sequence in the Fragile X Mental Retardation gene 1 (FMR1) on chromosome X. Following a neuropediatric assessment of two male siblings who presented with signs of FXS that was confirmed with molecular testing, we provided cascade counselling and testing to the extended family. A total of 46 individuals were tested for FXS; among them, 58.70% (n = 27) were females. The mean age was 9.4 (±5) years for children and 45.9 (±15.9) years for adults. Pedigree analysis suggested that the founder of these families was likely a normal transmitting male. Four out of 19 males with clinical ID were confirmed to have a full mutation for FXS, while 14/27 females had a pathologic CGG expansion (>56 CGG repeats) on one of their X chromosomes. Two women with premature menopause were confirmed of being carriers of premutation (91 and 101 CGG repeats). We also identified maternal alleles (91 and 126 CGG repeats) which expanded to a full mutation in their offspring (>200 CGG repeats). This study is a rare report on FXS from Africa and illustrates the case scenario of implementing genetic medicine for a neurogenetic condition in a rural setting.
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Park KB, Nam KE, Cho AR, Jang W, Kim M, Park JH. Effects of Copy Number Variations on Developmental Aspects of Children With Delayed Development. Ann Rehabil Med 2019; 43:215-223. [PMID: 31072088 PMCID: PMC6509583 DOI: 10.5535/arm.2019.43.2.215] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 10/19/2018] [Indexed: 11/06/2022] Open
Abstract
Objective To determine effects of copy number variations (CNV) on developmental aspects of children suspected of having delayed development. Methods A retrospective chart review was done for 65 children who underwent array-comparative genomic hybridization after visiting physical medicine & rehabilitation department of outpatient clinic with delayed development as chief complaints. Children were evaluated with Denver Developmental Screening Test II (DDST-II), Sequenced Language Scale for Infants (SELSI), or Preschool Receptive-Expressive Language Scale (PRES). A Mann-Whitney U test was conducted to determine statistical differences of developmental quotient (DQ), receptive language quotient (RLQ), and expressive language quotient (ELQ) between children with CNV (CNV(+) group, n=16) and children without CNV (CNV(–) group, n=37). Results Of these subjects, the average age was 35.1 months (mean age, 35.1±24.2 months). Sixteen (30.2%) patients had copy number variations. In the CNV(+) group, 14 children underwent DDST-II. In the CNV(–) group, 29 children underwent DDST-II. Among variables, gross motor scale was significantly (p=0.038) lower in the CNV(+) group compared with the CNV(–) group. In the CNV(+) group, 5 children underwent either SELSI or PRES. In the CNV(–) group, 27 children underwent above language assessment examination. Both RLQ and ELQ were similar between the two groups. Conclusion The gross motor domain in DQ was significantly lower in children with CNV compared to that in children without CNV. This result suggests that additional genetic factors contribute to this variability. Active detection of genomic imbalance could play a vital role when prominent gross motor delay is presented in children with delayed development.
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Affiliation(s)
- Kee-Boem Park
- Department of Rehabilitation Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyung Eun Nam
- Department of Rehabilitation Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ah-Ra Cho
- Department of Rehabilitation Medicine, St. Paul's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Woori Jang
- Department of Laboratory Medicine College of Medicine, The Catholic University of Korea, Seoul, Korea.,Department of Catholic Genetic Laboratory Center, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Myungshin Kim
- Department of Laboratory Medicine College of Medicine, The Catholic University of Korea, Seoul, Korea.,Department of Catholic Genetic Laboratory Center, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Joo Hyun Park
- Department of Rehabilitation Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Tchoungui Oyono L, Pascoe M, Singh S. The Prevalence of Speech and Language Disorders in French-Speaking Preschool Children From Yaoundé (Cameroon). JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2018; 61:1238-1250. [PMID: 29710276 DOI: 10.1044/2018_jslhr-l-16-0400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 01/11/2018] [Indexed: 06/08/2023]
Abstract
PURPOSE The purpose of this study was to determine the prevalence of speech and language disorders in French-speaking preschool-age children in Yaoundé, the capital city of Cameroon. METHOD A total of 460 participants aged 3-5 years were recruited from the 7 communes of Yaoundé using a 2-stage cluster sampling method. Speech and language assessment was undertaken using a standardized speech and language test, the Evaluation du Langage Oral (Khomsi, 2001), which was purposefully renormed on the sample. A predetermined cutoff of 2 SDs below the normative mean was applied to identify articulation, expressive language, and receptive language disorders. Fluency and voice disorders were identified using clinical judgment by a speech-language pathologist. RESULTS Overall prevalence was calculated as follows: speech disorders, 14.7%; language disorders, 4.3%; and speech and language disorders, 17.1%. In terms of disorders, prevalence findings were as follows: articulation disorders, 3.6%; expressive language disorders, 1.3%; receptive language disorders, 3%; fluency disorders, 8.4%; and voice disorders, 3.6%. CONCLUSION Prevalence figures are higher than those reported for other countries and emphasize the urgent need to develop speech and language services for the Cameroonian population.
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Affiliation(s)
- Lilly Tchoungui Oyono
- Division of Communication Sciences and Disorders, Department of Health and Rehabilitation Sciences, University of Cape Town, South Africa
| | - Michelle Pascoe
- Division of Communication Sciences and Disorders, Department of Health and Rehabilitation Sciences, University of Cape Town, South Africa
| | - Shajila Singh
- Division of Communication Sciences and Disorders, Department of Health and Rehabilitation Sciences, University of Cape Town, South Africa
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