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Goldsmith S, Smithers-Sheedy H, Almasri N, Andersen GL, Diviney L, Gincota EB, Himmelmann K, Jahan I, Waight E, McIntyre S. Cerebral palsy registers around the world: A survey. Dev Med Child Neurol 2024; 66:765-777. [PMID: 37946559 DOI: 10.1111/dmcn.15798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 09/28/2023] [Accepted: 10/04/2023] [Indexed: 11/12/2023]
Abstract
AIM To provide a description of cerebral palsy (CP) registers globally, identify which aim to report on CP epidemiology, and report similarities and differences across topics of importance for the sustainability and collaboration between registers. METHOD Representatives of all known CP registers globally (n = 57) were invited to participate. The online survey included 68 questions across aims, methodologies, output/impact, and stakeholder involvement. Responses were analysed using descriptive statistics. RESULTS Forty-five registers participated, including three register networks. Twenty were newly established or under development, including 12 in low- and middle-income countries (LMICs). An epidemiological aim was reported by 91% of registers. Funding is received by 85% of registers, most often from not-for-profit organizations. CP definitions are comparable across registers. While the minimum data set of a register network is used by most registers, only 25% of identified items are collected by all three register networks. Ninety per cent of registers measure research activities/output, and 64% measure research impact. People with lived experience are involved in 62% of registers. INTERPRETATION There has been a recent surge in CP registers globally, particularly in LMICs, which will improve understanding of CP epidemiology. Ongoing efforts to address identified methodological differences are essential to validate comparison of results and support register collaboration. WHAT THIS PAPER ADDS Cerebral palsy (CP) registers represent an increasing number of regions, including low- and middle-income, worldwide. Most registers collect the minimum data set of a CP register network. Research activities/output and impact are measured by most registers. The majority of registers involve people with lived experience in operation or research.
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Affiliation(s)
- Shona Goldsmith
- Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, Australia
| | - Hayley Smithers-Sheedy
- Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, Australia
| | - Nihad Almasri
- Department of Physiotherapy, The University of Jordan, Amman, Jordan
| | - Guro L Andersen
- Norwegian Quality and Surveillance Registry for Cerebral Palsy, Vestfold Hospital Trust, Tønsberg, Norway
| | - Leanne Diviney
- Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, Australia
| | - Ecaterina Bufteac Gincota
- Republican Rehabilitation Center for Children, Chisinau, Moldova
- State Medical and Pharmaceutical University 'N. Testemitanu', Chisinau, Moldova
| | - Kate Himmelmann
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Göteborg, Sweden
| | - Israt Jahan
- CSF Global, Dhaka, Bangladesh
- Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Australia
- Central Queensland Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, Australia
| | - Emma Waight
- Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, Australia
| | - Sarah McIntyre
- Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, Australia
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Smithers-Sheedy H, Waight E, Swinburn KL, Given F, Hooke K, Webb A, McIntyre S, Henry G, Honan I. Evaluation of a Modified Mindfulness-Based Stress Reduction Intervention for Adults with Cerebral Palsy and Anxiety and/or Emotion Regulation Difficulties-A Randomised Control Trial. J Clin Med 2023; 13:1. [PMID: 38202008 PMCID: PMC10779681 DOI: 10.3390/jcm13010001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/10/2023] [Accepted: 12/13/2023] [Indexed: 01/12/2024] Open
Abstract
Mindfulness-Based Stress Reduction (MBSR) has not yet been evaluated for people with cerebral palsy (CP). The aims of this randomised control trial were to investigate whether a modified telehealth MBSR program could improve mindfulness and reduce depression, anxiety, and emotion regulation difficulties among adults with CP with elevated anxiety and/or emotional regulation difficulties. Participants (n = 31) with elevated anxiety and/or emotion regulation difficulties and no/mild intellectual impairment were randomised to a modified telehealth MBSR program (90 min weekly, 9 weeks) group or a wait-list group. Measurements were collected prior to (T1), after (T2), and 8 weeks post-intervention (T3). The primary outcome was the mean between-group difference in the change in Cognitive and Affective Mindfulness Scale-R (CAMS-R) scores in T1-T2. The secondary outcomes included mean within-group differences over time for the CAMS-R total scores, Depression Anxiety and Stress Scale-21 subscales, and Difficulties in Emotion Regulation Scale (DERS) total t-score. We found no statistically significant between-group difference in mean change in mindfulness scores for T1-T2 (primary outcome). Secondary outcomes: The MBSR intervention group had improved CAMS-R scores with respect to T1-T2 and T1-T3; improved mean scores for Depression and Stress subscales for T1-T2; and improved DERS t-scores for T1-T2 and T1-T3. In conclusion, this study found no significant between-group difference for the primary outcome of mindfulness. The MBSR program was successfully modified for adults with CP and was effective in improving depression, stress, and emotion regulation. ACTRN12621000960853.
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Affiliation(s)
- Hayley Smithers-Sheedy
- Cerebral Palsy Alliance Research Institute, Sydney Medical School, The University of Sydney, Camperdown, NSW 2050, Australia; (E.W.); (K.L.S.); (F.G.); (K.H.); (A.W.); (S.M.); (G.H.); (I.H.)
| | - Emma Waight
- Cerebral Palsy Alliance Research Institute, Sydney Medical School, The University of Sydney, Camperdown, NSW 2050, Australia; (E.W.); (K.L.S.); (F.G.); (K.H.); (A.W.); (S.M.); (G.H.); (I.H.)
| | - Katherine L. Swinburn
- Cerebral Palsy Alliance Research Institute, Sydney Medical School, The University of Sydney, Camperdown, NSW 2050, Australia; (E.W.); (K.L.S.); (F.G.); (K.H.); (A.W.); (S.M.); (G.H.); (I.H.)
| | - Fiona Given
- Cerebral Palsy Alliance Research Institute, Sydney Medical School, The University of Sydney, Camperdown, NSW 2050, Australia; (E.W.); (K.L.S.); (F.G.); (K.H.); (A.W.); (S.M.); (G.H.); (I.H.)
- UTS Disability Research Network, University of Technology, Ultimo, NSW 2007, Australia
| | - Kate Hooke
- Cerebral Palsy Alliance Research Institute, Sydney Medical School, The University of Sydney, Camperdown, NSW 2050, Australia; (E.W.); (K.L.S.); (F.G.); (K.H.); (A.W.); (S.M.); (G.H.); (I.H.)
| | - Annabel Webb
- Cerebral Palsy Alliance Research Institute, Sydney Medical School, The University of Sydney, Camperdown, NSW 2050, Australia; (E.W.); (K.L.S.); (F.G.); (K.H.); (A.W.); (S.M.); (G.H.); (I.H.)
| | - Sarah McIntyre
- Cerebral Palsy Alliance Research Institute, Sydney Medical School, The University of Sydney, Camperdown, NSW 2050, Australia; (E.W.); (K.L.S.); (F.G.); (K.H.); (A.W.); (S.M.); (G.H.); (I.H.)
| | - Georgina Henry
- Cerebral Palsy Alliance Research Institute, Sydney Medical School, The University of Sydney, Camperdown, NSW 2050, Australia; (E.W.); (K.L.S.); (F.G.); (K.H.); (A.W.); (S.M.); (G.H.); (I.H.)
| | - Ingrid Honan
- Cerebral Palsy Alliance Research Institute, Sydney Medical School, The University of Sydney, Camperdown, NSW 2050, Australia; (E.W.); (K.L.S.); (F.G.); (K.H.); (A.W.); (S.M.); (G.H.); (I.H.)
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Ruiz Brunner MDLM, Jahan I, Cuestas E, Cieri ME, Escobar Zuluaga J, Condinanzi AL, Sanchez F, McIntyre S, Smithers-Sheedy H, Muhit M, Badawi N, Díaz R, Diaz A, Carranza J, Durán C, Quintero Valencia CA, Melaragno M, Khandaker G. Latin American Cerebral Palsy Register (LATAM-CPR): study protocol to develop a collaborative register with surveillance of children with cerebral palsy in Latin American countries. BMJ Open 2023; 13:e071315. [PMID: 38070889 PMCID: PMC10729276 DOI: 10.1136/bmjopen-2022-071315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 10/23/2023] [Indexed: 12/18/2023] Open
Abstract
INTRODUCTION Cerebral palsy (CP) is one of the leading causes of childhood disability globally with a high burden in low-income and middle-income countries (LMICs). Preliminary findings from the global LMIC CP Register (GLM CPR) suggest that the majority of CP in LMICs are due to potentially preventable causes. Such data are lacking in the Latin American region. Generating comparable epidemiological data on CP from this region could enable translational research and services towards early diagnosis and early intervention. We aim to establish a Latin American multicountry network and online data repository of CP called Latin American Cerebral Palsy Register (LATAM-CPR). METHODS AND ANALYSIS The LATAM-CPR will be modelled after the GLM CPR and will support new and emerging Latin American CP registers following a harmonised protocol adapted from the GLM CPR and piloted in Argentina (ie, Argentine Register of Cerebral Palsy). Both population-based and institution-based surveillance mechanisms will be adopted for registration of children with CP aged less than 18 years to the participating CP registers. The data collection form of the LATAM-CPR will include risk factors, clinical profile, rehabilitation, socioeconomical status of children with CP. Descriptive data on the epidemiology of CP from each participating country will be reported, country-specific and regional data will be compared. ETHICS AND DISSEMINATION Individual CP registers have applied ethics approval from respective national human research ethics committees (HREC) and/or institutional review boards prior to the establishment and inclusion into the LATAM-CPR. Ethical approval for LATAM-CPR has already been obtained from the HREC in the two countries that started (Argentina and Mexico). Findings will be disseminated and will be made publicly available through peer-reviewed publications, conference presentations and social media communications.
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Affiliation(s)
- Maria de Las Mercedes Ruiz Brunner
- Instituto de Investigaciones en Ciencias de la Salud (INICSA), CONICET-UNC, Cordoba, Argentina
- Instituto de Investigaciones Clínicas y Epidemiológicas (INICyE), Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Cordoba, Argentina
| | - Israt Jahan
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia
- Cerebral Palsy Program, CSF Global, Dhaka, Bangladesh
- Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh
| | - Eduardo Cuestas
- Instituto de Investigaciones en Ciencias de la Salud (INICSA), CONICET-UNC, Cordoba, Argentina
- Instituto de Investigaciones Clínicas y Epidemiológicas (INICyE), Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Cordoba, Argentina
| | - Maria Elisabeth Cieri
- Instituto de Investigaciones en Ciencias de la Salud (INICSA), CONICET-UNC, Cordoba, Argentina
- Instituto de Investigaciones Clínicas y Epidemiológicas (INICyE), Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Cordoba, Argentina
| | - Johana Escobar Zuluaga
- Instituto de Investigaciones en Ciencias de la Salud (INICSA), CONICET-UNC, Cordoba, Argentina
- Instituto de Investigaciones Clínicas y Epidemiológicas (INICyE), Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Cordoba, Argentina
| | - Ana Laura Condinanzi
- Instituto de Investigaciones en Ciencias de la Salud (INICSA), CONICET-UNC, Cordoba, Argentina
- Instituto de Investigaciones Clínicas y Epidemiológicas (INICyE), Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Cordoba, Argentina
| | - Federico Sanchez
- Instituto de Investigaciones en Ciencias de la Salud (INICSA), CONICET-UNC, Cordoba, Argentina
- Instituto de Investigaciones Clínicas y Epidemiológicas (INICyE), Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Cordoba, Argentina
| | - Sarah McIntyre
- Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Hayley Smithers-Sheedy
- Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Mohammad Muhit
- Cerebral Palsy Program, CSF Global, Dhaka, Bangladesh
- Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh
| | - Nadia Badawi
- Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, New South Wales, Australia
- Grace Centre for Newborn Care, Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Raul Díaz
- Comité de Educación, Academia Mexicana de Parálisis Cerebral y Trastornos del Neurodesarrollo, Ciudad de México, Mexico
| | - Agripina Diaz
- Comité de Educación, Academia Mexicana de Parálisis Cerebral y Trastornos del Neurodesarrollo, Ciudad de México, Mexico
| | - Jorge Carranza
- Comité de Educación, Academia Mexicana de Parálisis Cerebral y Trastornos del Neurodesarrollo, Ciudad de México, Mexico
| | - Claudia Durán
- Comité de Educación, Academia Mexicana de Parálisis Cerebral y Trastornos del Neurodesarrollo, Ciudad de México, Mexico
| | - Carlos Alberto Quintero Valencia
- Departamento de Rehabilitación, Facultad de Medicina de la Universidad de Antioquia, Antoquia, Colombia
- Unidad de Rehabilitación para Niños, Comité de Rehabilitación de Antioquia, Medellín, Colombia
| | - Mariana Melaragno
- Docencia e Investigación, Fundación Teletón Argentina, Buenos Aires, Argentina
| | - Gulam Khandaker
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia
- Cerebral Palsy Program, CSF Global, Dhaka, Bangladesh
- Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh
- Central Queensland Public Health Unit, Central Queensland University, Rockhampton, New South Wales, Australia
- Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
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Garne E, Goldsmith S, Barisic I, Braz P, Dakovic I, Gibson C, Hansen M, Hoei-Hansen CE, Hollung SJ, Klungsøyr K, Smithers-Sheedy H, Virella D, Badawi N, Watson L, McIntyre S. Severe Congenital Heart Defects and Cerebral Palsy. J Pediatr 2023; 262:113617. [PMID: 37473991 DOI: 10.1016/j.jpeds.2023.113617] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/08/2023] [Accepted: 07/12/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVE To report the prevalence of cerebral palsy (CP) in children with severe congenital heart defects (sCHD) and the outcome/severity of the CP. METHODS Population-based, data linkage study between CP and congenital anomaly registers in Europe and Australia. The EUROCAT definition of severe CHD (sCHD) was used. Linked data from 4 regions in Europe and 2 in Australia were included. All children born in the regions from 1991 through 2009 diagnosed with CP and/or sCHD were included. Linkage was completed locally. Deidentified linked data were pooled for analyses. RESULTS The study sample included 4989 children with CP and 3684 children with sCHD. The total number of livebirths in the population was 1 734 612. The prevalence of CP was 2.9 per 1000 births (95% CI, 2.8-3.0) and the prevalence of sCHD was 2.1 per 1000 births (95% CI, 2.1-2.2). Of children with sCHD, 1.5% (n = 57) had a diagnosis of CP, of which 35 (61%) children had prenatally or perinatally acquired CP (resulting from a brain injury at ≤28 days of life) and 22 (39%) children had a postneonatal cause (a brain injury between 28 days and 2 years). Children with CP and sCHD more often had unilateral spastic CP and more intellectual impairments than children with CP without congenital anomalies. CONCLUSIONS In high-income countries, the proportion of children with CP is much higher in children with sCHD than in the background population. The severity of disease in children with CP and sCHD is milder compared with children with CP without congenital anomalies.
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Affiliation(s)
- Ester Garne
- Department of Pediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark.
| | - Shona Goldsmith
- Cerebral Palsy Alliance Research Institute, Specialty of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, Australia
| | - Ingeborg Barisic
- Children's Hospital Zagreb, Center of Excellence for Reproductive and Regenerative Medicine, Medical School University of Zagreb, Zagreb, Croatia
| | - Paula Braz
- National Registry of Congenital Anomalies, Department of Epidemiology, National Health Institute Dr Richardo Jorge, Lisbon, Portugal
| | - Ivana Dakovic
- Children's Hospital, Medical School, University of Zagreb, Zagreb, Croatia
| | - Catherine Gibson
- South Australian Birth Defects Register, Women's and Children's Hospital, Women's and Children's Health Network, Adelaide, South Australia, Australia
| | - Michele Hansen
- Western Australian Register of Developmental Anomalies, Department of Health Western Australia, Perth, Australia; Telethon Kids Institute, the University of Western Australia, Perth, Australia
| | - Christina E Hoei-Hansen
- Department of Pediatrics, University Hospital Rigshospitalet and Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Sandra Julsen Hollung
- Norwegian Quality and Surveillance Registry for Cerebral Palsy, Vestfold Hospital Trust, Tønsberg, Norway
| | - Kari Klungsøyr
- Department of Global Public Health and Primary Care, University of Bergen, Norway, and Division of Mental and Physical Health, Norwegian Institute of Public Health, Bergen, Norway
| | - Hayley Smithers-Sheedy
- Cerebral Palsy Alliance Research Institute, Specialty of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, Australia
| | - Daniel Virella
- National Registry for Surveillance of Cerebral Palsy, Department of Epidemiology, National Health Institute Dr Richardo Jorge, Lisbon, Portugal
| | - Nadia Badawi
- Cerebral Palsy Alliance Research Institute, Specialty of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, Australia; Grace Center for Newborn Intensive Care, Children's Hospital at Westmead, Sydney, Australia
| | - Linda Watson
- Western Australian Register of Developmental Anomalies, Department of Health Western Australia, Perth, Australia
| | - Sarah McIntyre
- Cerebral Palsy Alliance Research Institute, Specialty of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, Australia
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Lingam R, Smithers-Sheedy H, Hodgson S, Hutchinson K, Meyers Morris T, Hu N, Nassar N, Schroeder EA, Rana R, Dickins E, Bula K, Zurynski Y. Evaluation of RuralkidsGPS; A Novel Integrated Paediatric Care Coordination Model of Care in Rural Australia - a Mixed-Methods Study Protocol. Int J Integr Care 2023; 23:10. [PMID: 38020416 PMCID: PMC10668883 DOI: 10.5334/ijic.7008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 10/31/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction The Kids Guided Personalised Service (KidsGPS) is an integrated model of care coordination for children and young people (CYP) living with medical complexity. After successful implementation in an urban setting, the model of care will be rolled-out at scale to four rural regions in New South Wales, Australia to establish RuralKidsGPS. This paper describes the approach and methods for the outcome and implementation evaluation of RuralKidsGPS. Description The evaluation aims to assess health, economic and implementation outcomes and processes whilst identifying barriers and enablers to inform future rollouts. Measures of health service utilisation (primary outcome), child health related quality of life and parent/carer experiences will be assessed. The implementation evaluation will occur alongside the outcomes evaluation and is underpinned by the Consolidated Framework for Implementation Research and informed by validated quantitative measures and qualitative interviews with patients, families, healthcare providers and service managers. An economic analysis will determine incremental cost effectiveness ratios for the new model of care using health service utilisation data. Conclusion RuralKidsGPS, if effective, has the potential to improve equity of access to integrated care for CYP and their families and this protocol may inform other evaluations of similar models of care delivered at scale.
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Affiliation(s)
- Raghu Lingam
- Population Child Health Research Group, School of Women’s and Children’s Health, University of New South Wales, Sydney, NSW, Australia
- The Sydney Children’s Hospitals Network, Sydney, NSW, Australia
| | - Hayley Smithers-Sheedy
- Population Child Health Research Group, School of Women’s and Children’s Health, University of New South Wales, Sydney, NSW, Australia
| | | | - Karen Hutchinson
- Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Tammy Meyers Morris
- Population Child Health Research Group, School of Women’s and Children’s Health, University of New South Wales, Sydney, NSW, Australia
- Department of Community Paediatrics, Sydney Children’s Hospital, Randwick, NSW, Australia
| | - Nan Hu
- Population Child Health Research Group, School of Women’s and Children’s Health, University of New South Wales, Sydney, NSW, Australia
| | - Natasha Nassar
- Child Population and Translational Health Research, Children’s Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Elizabeth-Ann Schroeder
- Macquarie University Centre for the Health Economy, Australian Institute of Health Innovation, Macquarie University, Sydney NSW 2113, Australia
| | - Rezwanul Rana
- Macquarie University Centre for the Health Economy, Australian Institute of Health Innovation, Macquarie University, Sydney NSW 2113, Australia
| | - Emma Dickins
- The Sydney Children’s Hospitals Network, Sydney, NSW, Australia
| | - Kirsten Bula
- The Sydney Children’s Hospitals Network, Sydney, NSW, Australia
| | - Yvonne Zurynski
- Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
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Honan I, Waight E, Bratel J, Given F, Badawi N, McIntyre S, Smithers-Sheedy H. Emotion Regulation Is Associated with Anxiety, Depression and Stress in Adults with Cerebral Palsy. J Clin Med 2023; 12:jcm12072527. [PMID: 37048620 PMCID: PMC10094904 DOI: 10.3390/jcm12072527] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/15/2023] [Accepted: 03/21/2023] [Indexed: 03/30/2023] Open
Abstract
Emotion regulation difficulties are associated with many neurological conditions and negatively impact daily function. Yet little is known about emotion regulation in adults with cerebral palsy (CP). Our aim was to investigate emotion regulation in adults with CP and its relationship with condition-related and/or socio-demographic factors. In a cross-sectional study of adults with CP, participants completed a survey containing the Difficulties in Emotion Regulation Scale (DERS), Depression Anxiety and Stress Scale-21 (DASS-21), and socio-demographic and condition-related questions. Descriptive statistics, chi-squared and Mann–Whitney tests were performed. Of the 42 adults with CP (x31.5 years, SD13.5) that were tested, 38 had within normal limits DERS total scores; however, a significantly higher proportion of participants experienced elevated scores (i.e., more difficulties with emotion regulation) than would be expected in the general population across five of the six DERs subdomains. Moderate–extremely severe depression and anxiety symptoms were reported by 33% and 60% of participants, respectively. The DERS total scores for participants with elevated depression, anxiety, and stress scores were significantly higher than the DERS totals score for those without elevated depression, anxiety, and stress scores. DERS and DASS-21 scores did not differ significantly by condition-related nor socio-demographic characteristics. In conclusion, emotion regulation difficulties were associated with elevated symptoms of depression and anxiety, which were overrepresented in the adults with CP participating in this study.
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Smithers-Sheedy H, Swinburn K, Waight E, King R, Hui L, Jones CA, Daly K, Rawlinson W, Mcintyre S, Webb A, Badawi N, Bowen A, Britton PN, Palasanthiran P, Lainchbury A, Shand A. eLearning significantly improves maternity professionals' knowledge of the congenital cytomegalovirus prevention guidelines. Aust N Z J Obstet Gynaecol 2022; 62:445-452. [PMID: 35348198 PMCID: PMC9541485 DOI: 10.1111/ajo.13500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 10/17/2021] [Accepted: 01/29/2022] [Indexed: 11/29/2022]
Abstract
Aims Cytomegalovirus (CMV) is a preventable cause of neurodevelopmental disability. Australian guidelines recommend that pregnant women are informed about CMV to reduce their risk of infection; however, less than 10% of maternity health professionals routinely provide prevention advice. The aim was to develop and evaluate the effectiveness of an eLearning course for midwives to improve knowledge and confidence about CMV. Materials and Methods Participants undertaking the course between March and November 2020 were invited to complete an evaluation questionnaire: before the course (T1), immediately after (T2) and three months post completion (T3). A linear mixed model was used to evaluate change in participant scores; P < 0.05 was considered statistically significant. Results Midwives (316/363, 87%), midwifery students (29/363, 8%) and nurses (18/363, 5%) participated. At T1 80% indicated they had not received education about CMV. Total adjusted mean scores for questionnaires completed between T1 (n = 363) and T2 (n = 238) increased significantly (from 17.2 to 22.8, P < 0.001). Limited available T3 scores (n = 27) (−1.7, P < 0.001), while lower than T2, remained higher than at T1 (+3.6, P < 0.001). Participants’ awareness of CMV information resources improved from 10 to 97% from T1 to T2. Confidence in providing CMV advice increased from 6 to 95% between T1 and T2 (P < 0.001) and was maintained at T3. Almost all (99%) participants indicated they would recommend the course to colleagues. Conclusion Participants who completed the eLearning course had significantly improved knowledge and confidence in providing advice about CMV. Programs targeting other maternity health professionals should be considered, to further support the implementation of the congenital CMV prevention guidelines.
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Affiliation(s)
- Hayley Smithers-Sheedy
- Cerebral Palsy Alliance Research Institute, Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia
| | - Katherine Swinburn
- Cerebral Palsy Alliance Research Institute, Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia
| | - Emma Waight
- Cerebral Palsy Alliance Research Institute, Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia
| | - Ruth King
- Nursing and Midwifery Office, ACT Health, Canberra, ustralian Capital Territory, Australia
| | - Lisa Hui
- Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia
| | - Cheryl A Jones
- Department of Infectious Diseases and Microbiology, The Children's Hospital at Westmead and Sydney Medical School, The University of Sydney, Westmead, New South Wales, Australia
| | - Kate Daly
- CMV Australia, Normanhurst, New South Wales, Australia
| | - William Rawlinson
- NSW Health Pathology Randwick, Level 4 Campus Centre, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Sarah Mcintyre
- Cerebral Palsy Alliance Research Institute, Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia
| | - Annabel Webb
- Cerebral Palsy Alliance Research Institute, Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia
| | - Nadia Badawi
- Cerebral Palsy Alliance Research Institute, Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia.,The Grace Centre for Newborn Intensive Care, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Asha Bowen
- Department of Infectious Diseases, Perth Children's Hospital, Nedlands, Western Australia, Australia
| | - Philip N Britton
- Department of Infectious Diseases and Microbiology, The Children's Hospital at Westmead and Sydney Medical School, The University of Sydney, Westmead, New South Wales, Australia
| | - Pamela Palasanthiran
- Department of Immunology and Infectious Disease, Sydney Children's Hospitals Network, School of Women's and Child Health, University of New South Wales, Randwick, New South Wales, Australia
| | - Anne Lainchbury
- Royal Hospital for Women, Randwick, Western Australia, Australia
| | - Antonia Shand
- Royal Hospital for Women, Randwick, Western Australia, Australia.,Child Population and Translational Health Research, Children's Hospital at Westmead, Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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Jahan I, Sultana R, Muhit M, Akbar D, Karim T, Al Imam MH, Das MC, Smithers-Sheedy H, McIntyre S, Badawi N, Khandaker G. Nutrition Interventions for Children with Cerebral Palsy in Low- and Middle-Income Countries: A Scoping Review. Nutrients 2022; 14:nu14061211. [PMID: 35334869 PMCID: PMC8951851 DOI: 10.3390/nu14061211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/03/2022] [Accepted: 03/04/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Malnutrition is substantially higher among children with cerebral palsy (CP) in low- and middle-income countries (LMICs) when compared with the general population. Access to appropriate interventions is crucial for better management of malnutrition and nutritional outcomes of those children. We aimed to review the existing evidence on nutrition interventions for children with CP in LMICs. Methods: Online databases, i.e., PubMed and Scopus, and Google Scholar were searched up to 10 January 2022, to identify peer-reviewed publications/evidence on LMIC focused nutritional management guidelines/interventions. Following title screening and abstract review, full articles that met the inclusion/exclusion criteria were retained for data charting. Information about the study characteristics, nutrition interventions, and their effectiveness were extracted. Descriptive data were reported. Results: Eight articles published between 2008 and 2019 were included with data from a total of n = 252 children with CP (age range: 1 y 0 m–18 y 7 m, 42% female). Five studies followed experimental design; n = 6 were conducted in hospital/clinic/center-based settings. Four studies focused on parental/caregiver training; n = 2 studies had surgical interventions (i.e., gastrostomy) and n = 1 provided neurodevelopmental therapy feeding intervention. Dietary modification as an intervention (or component) was reported in n = 5 studies and had better effect on the nutritional outcomes of children with CP compared to interventions focused on feeding skills or other behavioral modifications. Surgical interventions improved nutritional outcomes in both studies; however, none documented any adverse consequences of the surgical interventions. Conclusion: There is a substantial knowledge gap on nutrition interventions for children with CP in LMICs. This hinders the development of best practice guidelines for the nutritional management of children with CP in those settings. Findings suggest interventions directly related to growth/feeding of children had a better outcome than behavioral interventions. This should be considered in planning of nutrition-focused intervention or comprehensive services for children with CP in LMICs.
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Affiliation(s)
- Israt Jahan
- CSF Global, Dhaka 1213, Bangladesh; (I.J.); (R.S.); (M.M.); (T.K.); (M.H.A.I.); (M.C.D.)
- Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka 1212, Bangladesh
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD 4701, Australia
| | - Risad Sultana
- CSF Global, Dhaka 1213, Bangladesh; (I.J.); (R.S.); (M.M.); (T.K.); (M.H.A.I.); (M.C.D.)
- Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka 1212, Bangladesh
| | - Mohammad Muhit
- CSF Global, Dhaka 1213, Bangladesh; (I.J.); (R.S.); (M.M.); (T.K.); (M.H.A.I.); (M.C.D.)
- Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka 1212, Bangladesh
| | - Delwar Akbar
- School of Business and Law, Central Queensland University, Rockhampton, QLD 4701, Australia;
| | - Tasneem Karim
- CSF Global, Dhaka 1213, Bangladesh; (I.J.); (R.S.); (M.M.); (T.K.); (M.H.A.I.); (M.C.D.)
- Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka 1212, Bangladesh
- Specialty of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, NSW 2145, Australia
- Cerebral Palsy Alliance, Sydney Medical School, The University of Sydney, Camperdown, NSW 2006, Australia; (H.S.-S.); (S.M.); (N.B.)
| | - Mahmudul Hassan Al Imam
- CSF Global, Dhaka 1213, Bangladesh; (I.J.); (R.S.); (M.M.); (T.K.); (M.H.A.I.); (M.C.D.)
- Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka 1212, Bangladesh
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD 4701, Australia
- Central Queensland Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, QLD 4700, Australia
| | - Manik Chandra Das
- CSF Global, Dhaka 1213, Bangladesh; (I.J.); (R.S.); (M.M.); (T.K.); (M.H.A.I.); (M.C.D.)
- Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka 1212, Bangladesh
| | - Hayley Smithers-Sheedy
- Cerebral Palsy Alliance, Sydney Medical School, The University of Sydney, Camperdown, NSW 2006, Australia; (H.S.-S.); (S.M.); (N.B.)
| | - Sarah McIntyre
- Cerebral Palsy Alliance, Sydney Medical School, The University of Sydney, Camperdown, NSW 2006, Australia; (H.S.-S.); (S.M.); (N.B.)
| | - Nadia Badawi
- Cerebral Palsy Alliance, Sydney Medical School, The University of Sydney, Camperdown, NSW 2006, Australia; (H.S.-S.); (S.M.); (N.B.)
- Grace Centre for Newborn Intensive Care, The Children’s Hospital at Westmead, Sydney Children’s Hospital Network, Westmead, NSW 2145, Australia
| | - Gulam Khandaker
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD 4701, Australia
- Specialty of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, NSW 2145, Australia
- Central Queensland Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, QLD 4700, Australia
- Correspondence: ; Tel.: +61-7-49206989
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Smithers-Sheedy H, Khandaker G, Raynes-Greenow C, Flack L, Britton PN, McIntyre S, Badawi N, Burgner D, Galea C, Jones CA. The long-term burden of congenital cytomegalovirus: Hospitalisation and mortality in a population-based matched cohort study. Eur J Paediatr Neurol 2022; 37:82-86. [PMID: 35151079 DOI: 10.1016/j.ejpn.2022.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 01/05/2022] [Accepted: 01/29/2022] [Indexed: 11/28/2022]
Abstract
AIM Congenital cytomegalovirus (cCMV) infection can result in considerable morbidity and mortality. However, the impact of cCMV on health system utilisation beyond infancy is poorly defined. Here we sought to describe the burden of cCMV health service use and mortality using linked population-based datasets. METHODS The design was a matched cohort study using record-linked administrative datasets. Participants included all children aged 0-15 years identified through the New South Wales (NSW), Australia, Admitted Patient Data Collection who were hospitalised with an admission code for cCMV infection between 2001 and 2011. Participants were then matched by age, sex and birth postcode quintile using Socio-Economic Indexes for Area, to children randomly selected from the NSW Perinatal Data Collection, excluding those with central nervous system infections or cerebral palsy. We calculated rate ratios (RR) for hospital admissions adjusted for preterm birth, the median length of stay, cost weights of admission and odds ratio (OR) for deaths. RESULTS There were 130 children with cCMV matched to 2672 children. Neonates (aged <1 month) with cCMV had twice the rate of admissions (RR 2.4 95%CI 2.0, 2.8) and children aged ≥ 5yr to < 15yrs with cCMV almost eight times the rate of admissions (RR 7.8 95%CI 5.1, 11.5). Children with cCMV had significantly higher cost weights of admissions and an increased risk of mortality (OR 18.4 95%CI 7.8, 43.6). CONCLUSION Throughout childhood, children with cCMV had higher rates of hospital admissions, higher admission cost weights and an increased risk of mortality compared with matched peers without cCMV.
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Affiliation(s)
- Hayley Smithers-Sheedy
- Cerebral Palsy Alliance Research Institute, & Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia.
| | - Gulam Khandaker
- Central Queensland Hospital and Health Service, Rockhampton, Queensland, Australia
| | - Camille Raynes-Greenow
- Sydney School of Public Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Lloyd Flack
- Cerebral Palsy Alliance Research Institute, & Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia
| | - Philip N Britton
- Cerebral Palsy Alliance Research Institute, & Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia; Sydney Institute for Infectious Diseases, The University of Sydney, Sydney, New South Wales, Australia; Sydney Children's Hospital Network (The Children's Hospital at Westmead), Westmead, New South Wales, Australia
| | - Sarah McIntyre
- Cerebral Palsy Alliance Research Institute, & Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia
| | - Nadia Badawi
- Cerebral Palsy Alliance Research Institute, & Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia; Sydney Children's Hospital Network (The Children's Hospital at Westmead), Westmead, New South Wales, Australia
| | - David Burgner
- The Department of Paediatrics, University of Melbourne Parkville, Victoria, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Claire Galea
- Cerebral Palsy Alliance Research Institute, & Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia; Sydney Children's Hospital Network (The Children's Hospital at Westmead), Westmead, New South Wales, Australia
| | - Cheryl A Jones
- Cerebral Palsy Alliance Research Institute, & Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia; Sydney Institute for Infectious Diseases, The University of Sydney, Sydney, New South Wales, Australia; Sydney Children's Hospital Network (The Children's Hospital at Westmead), Westmead, New South Wales, Australia
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10
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Jahan I, Muhit M, Hardianto D, Laryea F, Chhetri AB, Smithers-Sheedy H, McIntyre S, Badawi N, Khandaker G. Epidemiology of cerebral palsy in low- and middle-income countries: preliminary findings from an international multi-centre cerebral palsy register. Dev Med Child Neurol 2021; 63:1327-1336. [PMID: 34031872 DOI: 10.1111/dmcn.14926] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/15/2021] [Indexed: 12/11/2022]
Abstract
AIM To describe the epidemiology of cerebral palsy (CP) in children from low- and middle-income countries (LMICs) using data from the Global Low- and Middle-Income Country CP register (GLM-CPR). METHOD The GLM-CPR is a multi-country initiative that combines and compares data from children with CP (<18y) in LMICs. Children with CP are registered after detailed neurodevelopmental assessment by a multidisciplinary medical team using a harmonized protocol. Data are collected on agreed core variables. Descriptive analyses are completed to report findings from participating countries. RESULTS Between January 2015 and May 2019, 2664 children were recruited from Bangladesh, Nepal, Indonesia, and Ghana (mean age [SD] at assessment: 7y 8mo [4y 8mo], 95% confidence interval 7y 6mo-7y 11mo; male [n=1615] 60.6%, female [n=1049] 39.4%). Overall, 86.6% children acquired CP prenatally and perinatally (e.g. preterm birth, birth asphyxia, neonatal encephalopathy). Median age at CP diagnosis was 3 years. Moreover, 79.2% children had spastic CP and 73.3% were classified in Gross Motor Function Classification System levels III to V. Notably, 47.3% of children never received rehabilitation services (median age at receiving rehabilitation services was 3y; 12.7% received assistive devices) and 75.6% of school-age children had no access to education. INTERPRETATION Population-based data show that the proportion of severe cases of CP is very high in LMICs. Children with CP in LMICs lack access to rehabilitation and educational services and a large proportion of children have potentially preventable risk factors, for example, birth asphyxia and neonatal infections. Delayed diagnosis, severe motor impairments, and lack of rehabilitation in most children call for urgent action to identify preventive opportunities and promote early diagnosis and intervention for children with CP in LMICs. What this paper adds The proportion of severe cases of cerebral palsy (CP) is very high in rural low- and middle-income countries (LMICs). Children with CP in LMICs lack access to rehabilitation and educational services. A large proportion of children with CP in LMICs have potentially preventable risk factors.
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Affiliation(s)
- Israt Jahan
- CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development, University of South Asia, Dhaka, Bangladesh.,School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia
| | - Mohammad Muhit
- CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development, University of South Asia, Dhaka, Bangladesh
| | | | | | | | - Hayley Smithers-Sheedy
- Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.,Cerebral Palsy Alliance Research Institute, The University of Sydney, Sydney, NSW, Australia
| | - Sarah McIntyre
- Cerebral Palsy Alliance Research Institute, The University of Sydney, Sydney, NSW, Australia
| | - Nadia Badawi
- Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.,Cerebral Palsy Alliance Research Institute, The University of Sydney, Sydney, NSW, Australia
| | - Gulam Khandaker
- CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development, University of South Asia, Dhaka, Bangladesh.,School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia.,Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.,Central Queensland Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, QLD, Australia
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11
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Lansdown K, Irving M, Mathieu Coulton K, Smithers-Sheedy H. A scoping review of oral health outcomes for people with cerebral palsy. Spec Care Dentist 2021; 42:232-243. [PMID: 34706111 DOI: 10.1111/scd.12671] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 10/10/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Good oral health is important for good overall health. Studies have reported poorer oral health outcomes for people with cerebral palsy, but there has been no synthesis of the evidence surrounding this and, there are no clear oral health recommendations for people with cerebral palsy globally. This review synthesizes the existing knowledge base on oral health in people with cerebral palsy and provides recommendations for future research. METHODS A scoping review was conducted to assess the current literature. Databases were searched using relevant search terms. Study outcomes were synthesized according to their reported outcomes. RESULTS One hundred seventy three studies were included in this review. Children with cerebral palsy have an increased risk for dental caries and untreated caries. Higher saliva osmolality is a major contributor to increased dental caries. People with cerebral palsy are more likely to experience tooth wear and bruxism. Children and their care-givers have poor oral health related quality of life. There is a large unmet need for oral healthcare in this group. There is no suggested plan for the prevention of poor oral health for this group. A high number of studies included related to research is conducted in low- and middle-income countries, care should be taken in applying results outside this context. There is a lack of research conducted in people with cerebral palsy, 18 years and over. CONCLUSION There is a higher risk for poor oral health in people with cerebral palsy and there is a large unmet need to dental care in this group. This study highlights the need for further research to focus on adults with cerebral palsy and an of understanding the oral health care outcomes in the context of settings. The authors recommend the inclusion of classification systems and the integration of disability inclusive language in future studies.
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Affiliation(s)
- Karen Lansdown
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Michelle Irving
- School of Public Health, Faculty of Medicine and Health, Menzies Centre for Health Policy, University of Sydney, Camperdown, Australia
| | - Kimberly Mathieu Coulton
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Hayley Smithers-Sheedy
- Cerebral Palsy Alliance Research Institute, Sydney Medical School, The University of Sydney, Sydney, Australia
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12
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Waight E, Swinburn K, Shand A, Hui L, Daly K, Rawlinson W, Jones C, Badawi N, Smithers-Sheedy H. 319Congenital cytomegalovirus education, translation and prevention. Int J Epidemiol 2021. [DOI: 10.1093/ije/dyab168.688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Focus of Presentation
Congenital cytomegalovirus (CMV) is a known cause of sensorineural hearing loss, cerebral palsy and other disabilities. International consensus guidelines (2017) and the Australasian Society of Infectious Diseases (2014) recommend all pregnant women be provided with information on CMV and strategies to reduce their risk of infection. Here we describe the multifaceted strategies implemented to date to promote uptake of these guidelines.
Findings
At policy level, we influenced national clinical practice standards through input into new CMV prevention recommendations by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists and Department of Health, which sparked state public health campaigns. At the intervention level, we presented hospital in-services, podcasts and webinars and developed an e-learning course for midwives. In collaboration with the Department of Health >11,000 pamphlets were disseminated to NSW GPs. At the community level, we developed patient information and media resources. During a recent month-long campaign, our cCMV video had >62,000 views, CMV content on social media had >1.4M total impressions, >77,000 total engagements and >200,000 viewed CMV awareness pieces via television/radio/print.
Conclusions/Implications
Implementation of congenital CMV practice guidelines provide an important opportunity to prevent neurodevelopmental disability. Collaborations between families, clinicians, researchers, professional bodies and health departments are essential to drive translation.
Key messages
A multifaceted approach in implementing congenital CMV practice guidelines gives the opportunity to reach numerous stakeholders including policymakers, health professionals and expectant mothers.
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Affiliation(s)
- Emma Waight
- Cerebral Palsy Alliance, Camperdown, Australia
- Sydney Medical School, The University of Sydney, Camperdown, Australia
| | - Katherine Swinburn
- Cerebral Palsy Alliance, Camperdown, Australia
- Sydney Medical School, The University of Sydney, Camperdown, Australia
| | - Antonia Shand
- Royal Hospital for Women, Randwick, Australia
- Sydney Medical School, The University of Sydney, Camperdown, Australia
| | - Lisa Hui
- Royal Children's Hospital, Parkville, Australia
- University of Melbourne, Parkville, Australia
| | | | - William Rawlinson
- Prince of Wales Hospital, Randwick, Australia
- University of New South Wales, Randwick, Australia
| | - Cheryl Jones
- Sydney Medical School, The University of Sydney, Camperdown, Australia
| | - Nadia Badawi
- Cerebral Palsy Alliance, Camperdown, Australia
- Sydney Medical School, The University of Sydney, Camperdown, Australia
| | - Hayley Smithers-Sheedy
- Cerebral Palsy Alliance, Camperdown, Australia
- Sydney Medical School, The University of Sydney, Camperdown, Australia
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Al Imam MH, Jahan I, Das MC, Muhit M, Smithers-Sheedy H, McIntyre S, Badawi N, Khandaker G. Population-based surveillance of children with cerebral palsy enables early diagnosis and intervention. Dev Med Child Neurol 2021; 63:883-884. [PMID: 33719074 DOI: 10.1111/dmcn.14861] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 02/25/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Mahmudul Hassan Al Imam
- CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh.,School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia
| | - Israt Jahan
- CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh.,School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia
| | - Manik Chandra Das
- CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh
| | - Mohammad Muhit
- CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh
| | - Hayley Smithers-Sheedy
- Cerebral Palsy Alliance, Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia
| | - Sarah McIntyre
- Cerebral Palsy Alliance, Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia
| | - Nadia Badawi
- Cerebral Palsy Alliance, Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia.,Grace Centre for Newborn Intensive Care, Sydney Children's Hospital Network, Westmead, New South Wales, Australia
| | - Gulam Khandaker
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia.,Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.,Central Queensland Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, Queensland, Australia
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14
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Sellier E, Goldsmith S, McIntyre S, Perra O, Rackauskaite G, Badawi N, Fares A, Smithers-Sheedy H. Cerebral palsy in twins and higher multiple births: a Europe-Australia population-based study. Dev Med Child Neurol 2021; 63:712-720. [PMID: 33533028 DOI: 10.1111/dmcn.14827] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/11/2020] [Indexed: 11/26/2022]
Abstract
AIM To describe the birth prevalence, temporal trends, and clinical outcomes of twins, triplets, or quadruplets with cerebral palsy (CP). METHOD This was a cross-sectional study using data for twins, triplets, and quadruplets with prenatally or perinatally acquired CP and pooled from the Surveillance of Cerebral Palsy in Europe network (born 1992-2009) and Australian Cerebral Palsy Register (born 1993-2009). Children were at least 4 years old at time of registration. Children born in regions with population ascertainment and available denominator data were included in prevalence calculations (n=1033 twins, 81 triplets, and 11 quadruplets). Clinical data from children registered in all participating registers were described, including 2163 twins (56% male), 187 triplets (59% male), and 20 quadruplets (45% male). RESULTS The birth prevalence of CP was higher with increasing plurality (twins 6.5 per 1000 live births [95% confidence interval {CI} 6.1-6.9], triplets 17.1 [95% CI 13.6-21.2], quadruplets 50.7 [95% CI 25.6-88.9]); however, prevalence by gestational age was similar across all pluralities. Between 1992-1994 and 2007-2009, prevalence of CP among twins declined (p=0.001) but prevalence of CP among triplets did not change significantly over time (p=0.55). The distributions of Gross Motor Function Classification System, epilepsy, and impairments of intellect, vision, and hearing were similar regardless of plurality. INTERPRETATION The data combined from two CP register networks indicated that triplets and quadruplets had increased risk of CP compared to twins. The higher prevalence of CP in triplets and quadruplets is due to their higher risk of preterm birth. Prevalence of CP among twins significantly declined in Europe and Australia. Clinical outcomes were similar for all multiple births.
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Affiliation(s)
- Elodie Sellier
- Université Grenoble Alpes, CNRS, Grenoble INP, CHU Grenoble Alpes, TIMC-IMAG, Grenoble, France.,RHEOP, Grenoble, France
| | - Shona Goldsmith
- Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Sarah McIntyre
- Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia
| | | | - Gija Rackauskaite
- Child and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Nadia Badawi
- Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia.,Grace Centre for Newborn Intensive Care, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Asma Fares
- Pôle Santé Publique, Département de l'Information Médicale CHU Grenoble Alpes, Grenoble, France
| | - Hayley Smithers-Sheedy
- Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia
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Al Imam MH, Jahan I, Das MC, Muhit M, Smithers-Sheedy H, McIntyre S, Badawi N, Khandaker G. Rehabilitation status of children with cerebral palsy in Bangladesh: Findings from the Bangladesh Cerebral Palsy Register. PLoS One 2021; 16:e0250640. [PMID: 33939721 PMCID: PMC8092763 DOI: 10.1371/journal.pone.0250640] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 04/08/2021] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE The objective of this study was to assess the rehabilitation status and factors associated with rehabilitation service utilisation among children with cerebral palsy (CP) in Bangladesh. MATERIALS AND METHODS This is a population-based surveillance study conducted among children with CP registered in the Bangladesh CP Register (BCPR), the first population-based register of children with CP aged <18 years (y) in Bangladesh. Children with CP were identified from the community using the key informant method and underwent a detailed neurodevelopmental assessment. Socio-demographic, clinical and rehabilitation status were documented. Unadjusted and adjusted analyses with a 95% confidence interval (CI) were used to identify potential predictors of rehabilitation service uptake. RESULTS Between January 2015 and December 2019, 2852 children with CP were registered in the BCPR (mean (standard deviation, SD) age: 7 y 8 months (mo) (4 y 7 mo), 38.5% female). Of these, 50.2% had received rehabilitation services; physiotherapy was the most common type of service (90.0%). The mean (SD) age at commencement of rehabilitation services was 3 y 10 mo (3 y 1 mo). The odds of not receiving rehabilitation was significantly higher among female children (adjusted odds ratio (aOR) 1.3 [95% CI: 1.0-1.7], children whose mothers were illiterate and primary level completed (aOR 2.1 [95% CI: 1.4-3.1] and aOR 1.5 [95% CI: 1.1-2.1], respectively), fathers were illiterate (aOR 1.9 [95% CI: 1.3-2.8]), had a monthly family income ~US$ 59-118 (aOR: 1.8 [95% CI: 1.2-2.6]), had hearing impairment (aOR: 2.3 [95% CI: 1.5-3.5]) and motor severity (i.e. Gross Motor Function Classification System level III (aOR: 0.6 [95% CI: 0.3-0.9]) and level V (aOR: 0.4 [95% CI: 0.2-0.7])). CONCLUSIONS Rehabilitation status was poor among the majority of the children with CP in the BCPR cohort, limiting their opportunities for functional improvement. A community-based rehabilitation model focusing on socio-demographic and clinical characteristics should be a public health priority in Bangladesh.
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Affiliation(s)
- Mahmudul Hassan Al Imam
- CSF Global, Dhaka, Bangladesh
- Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia
| | - Israt Jahan
- CSF Global, Dhaka, Bangladesh
- Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia
| | - Manik Chandra Das
- CSF Global, Dhaka, Bangladesh
- Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh
| | - Mohammad Muhit
- CSF Global, Dhaka, Bangladesh
- Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh
| | - Hayley Smithers-Sheedy
- Cerebral Palsy Alliance, Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia
| | - Sarah McIntyre
- Cerebral Palsy Alliance, Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia
| | - Nadia Badawi
- Cerebral Palsy Alliance, Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia
- Grace Centre for Newborn Intensive Care, Sydney Children’s Hospital Network, Westmead, New South Wales, Australia
| | - Gulam Khandaker
- CSF Global, Dhaka, Bangladesh
- Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh
- Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
- Central Queensland Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, Queensland, Australia
- * E-mail:
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May P, Smithers-Sheedy H, Muhit M, Cumming R, Jones C, Booy R, Badawi N, Khandaker G. Immunisation Status of Children with Cerebral Palsy in Rural Bangladesh: Results from the Bangladesh Cerebral Palsy Register (BCPR). Infect Disord Drug Targets 2021; 20:318-322. [PMID: 30360749 DOI: 10.2174/1871526518666181024101002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Revised: 09/14/2018] [Accepted: 09/16/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND Cerebral palsy (CP) is the most common cause of physical disability in childhood, with an estimated 17 million cases worldwide. There is limited data concerning the general health of this population and the immunisation status of children with CP is largely unknown. OBJECTIVE We aimed to assess the immunisation status of children with CP in rural Bangladesh and determine the predictors of non-immunisation. METHODS This study is part of the Bangladesh CP Register (BCPR) study; a population based CP register commenced in January 2015 in the Shahjadpur sub-district of Bangladesh. As part of BCPR registration, all children with CP in the catchment area were assessed by a paediatrician and their clinical and immunisation history were collected. RESULTS Between January and December 2015, 615 children with CP were registered on the BCPR. The median age of the children was 7.5 years, and 38.5% were female. 91.7% of those children had a BCG vaccine scar (as an objective marker for immunisation at birth). However, only 43.2% reported to have received the rubella vaccine during the 2014 national rubella immunisation campaign. Timing of CP diagnosis was found to be an independent predictor for immunisation uptake; those diagnosed before the age of 3 were more likely to have received the rubella vaccine (95% confidence interval [CI] 1.6 - 4.3, odds ratio [OR] 2.6, p <0.0001). CONCLUSIONS To the best of our knowledge, this is the first paper to use a formal CP register to examine the relationship between CP and immunisation status in a low or middle income country like Bangladesh. Our data suggest that more than half of children with CP in rural Bangladesh did not receive immunisation during a recent national campaign.
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Affiliation(s)
- P May
- School of Public Health, Sydney Medical School, University of Sydney, Sydney, Australia
| | - H Smithers-Sheedy
- Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, Australia,Cerebral Palsy Alliance Research Institute, University of Sydney, Sydney, Australia
| | - M Muhit
- Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh,CSF Global, Dhaka, Bangladesh
| | - R Cumming
- School of Public Health, Sydney Medical School, University of Sydney, Sydney, Australia
| | - C Jones
- Dept of Paediatrics, University of Melbourne, Parkville, Melbourne, Australia,Dept of Infectious Diseases, Royal Children’s Hospital Melbourne, Melbourne, Australia,Murdoch Childrens Research Institute, Parkville, Melbourne, Australia
| | - R Booy
- Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, Australia,National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Sydney, Australia
| | - N Badawi
- Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, Australia,Cerebral Palsy Alliance Research Institute, University of Sydney, Sydney, Australia
| | - G Khandaker
- Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, Australia,Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh,CSF Global, Dhaka, Bangladesh,Public Health Unit, Central Queensland Hospital and Health Service, Queensland, Australia
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Midgley G, Smithers-Sheedy H, McIntyre S, Badawi N, Keogh J, Jones CA. Congenital Cytomegalovirus Prevention, Awareness and Policy Recommendations - A Scoping Study. Infect Disord Drug Targets 2021; 20:291-302. [PMID: 30306881 DOI: 10.2174/1871526518666181009093725] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 08/25/2018] [Accepted: 09/14/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND Congenital cytomegalovirus (cCMV) is known to cause childhood deafness, neurodevelopmental disability and death. Simple hygiene precautions are effective in reducing maternal risk of CMV infection. OBJECTIVE To review i) awareness of CMV infection and available primary prevention strategies both in the community and amongst health professionals ii) available cCMV information sources in the literature, grey literature and published professional guidelines. METHODS Scoping study to i) identify literature pertaining to cCMV awareness amongst parents and health professionals using MedLine and CINAHL databases via EBSCO ii) review one high income country's guidelines and recommendations regarding cCMV infection and pregnancy (example country Australia) iii) grey literature for parental information. RESULTS Worldwide awareness of cCMV and of available prevention strategies amongst women and health professionals are poor. Findings internationally suggest at least half of maternity care health professionals do not routinely provide advice to women regarding simple hygiene precautions that can reduce their risk of infection during pregnancy. Though information resources regarding cCMV are available, they are frequently not included within general healthy pregnancy advice and require individuals to search for 'congenital cytomegalovirus'. CONCLUSION cCMV is a preventable cause of serious congenital disability and death. Prevention opportunities are being missed because most women are not aware of cCMV or how to reduce their risk of infection in pregnancy, in part due to poor health professional awareness. New strategies to disseminate cCMV information to the community and to support health professionals to embed cCMV advice within routine pregnancy counselling is required.
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Affiliation(s)
- Georgia Midgley
- University of Notre Damn Australia, Sydney Campus, School of Medicine, Sydney, NSW, Australia
| | - Hayley Smithers-Sheedy
- Cerebral Palsy Alliance, The University of Sydney, Sydney, NSW, Australia,Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Sarah McIntyre
- Cerebral Palsy Alliance, The University of Sydney, Sydney, NSW, Australia,Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Nadia Badawi
- Cerebral Palsy Alliance, The University of Sydney, Sydney, NSW, Australia,Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia,The Grace Centre for Newborn Care, The Children’s Hospital at Westmead, Sydney, Sydney, NSW, Australia
| | - John Keogh
- The University of Sydney, Sydney Adventist Hospital, Sydney, NSW, Australia
| | - Cheryl A Jones
- Dept of Paediatrics, University of Melbourne, Parkville, Melbourne, Australia,Dept of Infectious Diseases, Royal Children’s Hospital Melbourne, Melbourne, Australia,Murdoch Children’s Research Institute, Parkville, Melbourne, Australia
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18
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Goldsmith S, McIntyre S, Scott H, Himmelmann K, Smithers-Sheedy H, Andersen GL, Blair E, Badawi N, Garne E. Congenital anomalies in children with postneonatally acquired cerebral palsy: an international data linkage study. Dev Med Child Neurol 2021; 63:421-428. [PMID: 33432582 DOI: 10.1111/dmcn.14805] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/08/2020] [Indexed: 11/30/2022]
Abstract
AIM To describe the major congenital anomalies present in children with postneonatally acquired cerebral palsy (CP), and to compare clinical outcomes and cause of postneonatally acquired CP between children with and without anomalies. METHOD Data were linked between total population CP and congenital anomaly registers in five European and three Australian regions for children born 1991 to 2009 (n=468 children with postneonatally acquired CP; 255 males, 213 females). Data were pooled and children classified into mutually exclusive categories based on type of congenital anomaly. The proportion of children with congenital anomalies was calculated. Clinical outcomes and cause of postneonatally acquired CP were compared between children with and without anomalies. RESULTS Major congenital anomalies were reported in 25.6% (95% confidence interval [CI] 21.7-29.9) of children with postneonatally acquired CP. Cardiac anomalies, often severe, were common and present in 14.5% of children with postneonatally acquired CP. Clinical outcomes were not more severe in children with congenital anomalies than those without anomalies. Cause of postneonatally acquired CP differed with the presence of congenital anomalies, with cerebrovascular accidents predominating in the anomaly group. Congenital anomalies were likely associated with cause of postneonatally acquired CP in 77% of children with anomalies. INTERPRETATION In this large, international study of children with postneonatally acquired CP, congenital anomalies (particularly cardiac anomalies) were common. Future research should determine specific causal pathways to postneonatally acquired CP that include congenital anomalies to identify opportunities for prevention. WHAT THIS PAPER ADDS One-quarter of children with postneonatally acquired cerebral palsy (CP) have a major congenital anomaly. Cardiac anomalies, often severe, are the most common anomalies. Causes of postneonatally acquired CP differ between children with and without congenital anomalies.
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Affiliation(s)
- Shona Goldsmith
- Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Sarah McIntyre
- Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Heather Scott
- South Australian Birth Defects Register, Women's and Children's Hospital, Women's and Children's Health Network, Adelaide, South Australia, Australia
| | - Kate Himmelmann
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Regional Rehabilitation Centre for Children and Adolescents, Queen Silvia's Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Hayley Smithers-Sheedy
- Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Guro L Andersen
- Cerebral Palsy Registry of Norway, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Eve Blair
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Nadia Badawi
- Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia.,Grace Centre for Newborn Intensive Care, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Ester Garne
- Paediatric Department, Hospital Lillebaelt Kolding, Kolding, Denmark
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Goldsmith S, Mcintyre S, Andersen GL, Gibson C, Himmelmann K, Blair E, Badawi N, Smithers-Sheedy H, Garne E. Congenital anomalies in children with pre- or perinatally acquired cerebral palsy: an international data linkage study. Dev Med Child Neurol 2021; 63:413-420. [PMID: 32578204 DOI: 10.1111/dmcn.14602] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 04/16/2020] [Accepted: 05/11/2020] [Indexed: 02/06/2023]
Abstract
AIM To describe the frequency and types of major congenital anomalies present in children with pre- or perinatally acquired cerebral palsy (CP), and compare clinical outcomes for children with and without anomalies. METHOD This multi-centre total population collaborative study between Surveillance of Cerebral Palsy in Europe, Australian Cerebral Palsy Register, and European Surveillance of Congenital Anomalies (EUROCAT) involved six European and three Australian regions. Data were linked between each region's CP and congenital anomaly register for children born between 1991 and 2009, and then pooled. Children were classified into mutually exclusive categories based on type of anomaly. Proportions of children with congenital anomalies were calculated, and clinical outcomes compared between children with and without anomalies. RESULTS Of 8201 children with CP, 22.8% (95% confidence interval [CI] 21.9, 23.8) had a major congenital anomaly. Isolated cerebral anomalies were most common (45.2%), with a further 8.6% having both cerebral and non-cerebral anomalies. Cardiac anomalies only were described in 10.5% of children and anomalies associated with syndromes were also reported: genetic (8.0%), chromosomal (5.7%), and teratogenic (3.0%). Clinical outcomes were more severe for children with CP and congenital anomalies, particularly cerebral anomalies. INTERPRETATION This large, international study reports major congenital anomalies in nearly one-quarter of children with pre- or perinatally acquired CP. Future research must focus on aetiological pathways to CP that include specific patterns of congenital anomalies. WHAT THIS PAPER ADDS Congenital anomalies were reported in 23% of children with pre- or perinatally acquired cerebral palsy. A higher proportion of children born at or near term had anomalies. The most common type of anomalies were isolated cerebral anomalies. Clinical outcomes were more severe for children with congenital anomalies (particularly cerebral).
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Affiliation(s)
- Shona Goldsmith
- Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, Australia
| | - Sarah Mcintyre
- Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, Australia
| | - Guro L Andersen
- Cerebral Palsy Registry of Norway, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Catherine Gibson
- South Australian Birth Defects Register, Women's and Children's Hospital, Women's and Children's Health Network, Adelaide, South Australia, Australia
| | - Kate Himmelmann
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Regional Rehabilitation Centre for Children and Adolescents, Queen Silvia's Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Eve Blair
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Nadia Badawi
- Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, Australia.,Grace Centre for Newborn Intensive Care, Children's Hospital at Westmead, Sydney, Australia
| | - Hayley Smithers-Sheedy
- Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, Australia
| | - Ester Garne
- Paediatric Department, Hospital Lillebaelt Kolding, Kolding, Denmark
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Smithers-Sheedy H. The Singapore Cerebral Palsy Registry: An important new resource for cerebral palsy research. Ann Acad Med Singap 2021; 50:109-110. [PMID: 33733252 DOI: 10.47102/annals-acadmedsg.202161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
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Lewis SA, Shetty S, Wilson BA, Huang AJ, Jin SC, Smithers-Sheedy H, Fahey MC, Kruer MC. Insights From Genetic Studies of Cerebral Palsy. Front Neurol 2021; 11:625428. [PMID: 33551980 PMCID: PMC7859255 DOI: 10.3389/fneur.2020.625428] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 12/16/2020] [Indexed: 12/11/2022] Open
Abstract
Cohort-based whole exome and whole genome sequencing and copy number variant (CNV) studies have identified genetic etiologies for a sizable proportion of patients with cerebral palsy (CP). These findings indicate that genetic mutations collectively comprise an important cause of CP. We review findings in CP genomics and propose criteria for CP-associated genes at the level of gene discovery, research study, and clinical application. We review the published literature and report 18 genes and 5 CNVs from genomics studies with strong evidence of for the pathophysiology of CP. CP-associated genes often disrupt early brain developmental programming or predispose individuals to known environmental risk factors. We discuss the overlap of CP-associated genes with other neurodevelopmental disorders and related movement disorders. We revisit diagnostic criteria for CP and discuss how identification of genetic etiologies does not preclude CP as an appropriate diagnosis. The identification of genetic etiologies improves our understanding of the neurobiology of CP, providing opportunities to study CP pathogenesis and develop mechanism-based interventions.
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Affiliation(s)
- Sara A Lewis
- Pediatric Movement Disorders Program, Barrow Neurological Institute, Phoenix Children's Hospital, Phoenix, AZ, United States.,Departments of Child Health, Neurology, and Cellular & Molecular Medicine and Program in Genetics, University of Arizona College of Medicine, Phoenix, AZ, United States
| | - Sheetal Shetty
- Pediatric Movement Disorders Program, Barrow Neurological Institute, Phoenix Children's Hospital, Phoenix, AZ, United States.,Departments of Child Health, Neurology, and Cellular & Molecular Medicine and Program in Genetics, University of Arizona College of Medicine, Phoenix, AZ, United States
| | - Bryce A Wilson
- Pediatric Movement Disorders Program, Barrow Neurological Institute, Phoenix Children's Hospital, Phoenix, AZ, United States.,Departments of Child Health, Neurology, and Cellular & Molecular Medicine and Program in Genetics, University of Arizona College of Medicine, Phoenix, AZ, United States
| | - Aris J Huang
- Programs in Neuroscience and Molecular & Cellular Biology, School of Life Sciences, Arizona State University, Tempe, AZ, United States
| | - Sheng Chih Jin
- Department of Genetics, Washington University School of Medicine, St. Louis, MO, United States
| | - Hayley Smithers-Sheedy
- Cerebral Palsy Alliance, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Michael C Fahey
- Department of Paediatrics, Monash University, Melbourne, VIC, Australia
| | - Michael C Kruer
- Pediatric Movement Disorders Program, Barrow Neurological Institute, Phoenix Children's Hospital, Phoenix, AZ, United States.,Departments of Child Health, Neurology, and Cellular & Molecular Medicine and Program in Genetics, University of Arizona College of Medicine, Phoenix, AZ, United States.,Programs in Neuroscience and Molecular & Cellular Biology, School of Life Sciences, Arizona State University, Tempe, AZ, United States
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Jahan I, Al Imam MH, Karim T, Muhit M, Hardianto D, Das MC, Smithers-Sheedy H, Badawi N, Khandaker G. Epidemiology of cerebral palsy in Sumba Island, Indonesia. Dev Med Child Neurol 2020; 62:1414-1422. [PMID: 32686098 DOI: 10.1111/dmcn.14616] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 05/15/2020] [Accepted: 05/15/2020] [Indexed: 11/28/2022]
Abstract
AIM To define the epidemiology, clinical characteristics, and rehabilitation status of children with cerebral palsy (CP) in Sumba Island, Indonesia. METHOD A community-based key informant method survey among children (aged <18y) with CP was conducted between March and August 2017. Children with suspected CP underwent detailed neurodevelopmental assessment by a multidisciplinary medical team. Socio-demographic characteristics, aetiology, motor type, motor severity, associated impairments, educational, and rehabilitation status were documented. RESULTS There were 130 children with clinically confirmed CP. The mean age at assessment was 8 years 11 months and 43.8% (n=57) of the children were female. The mean age at CP diagnosis was 6 years 5 months. Of these children, 46.9% (n=61) had post-neonatally acquired CP, most frequently because of vaccine-preventable infectious encephalopathy (73.8%, n=45). In total, 80.8% (n=105) had a predominantly spastic motor type of CP and 83.8% (n=109) were classified in Gross Motor Functional Classification System levels III to V. A total of 77.7% (n=101) had at least one associated impairment (speech 77.5%, intellectual 29.2%, visual 13.8%, hearing 20.0%, and epilepsy 13.5%). And 66.2% (n=86) had never received rehabilitation services. INTERPRETATION Post-neonatally acquired CP was common in this setting. Addressing preventable post-neonatally acquired risk factors for CP should be a public health priority. Earlier identification and diagnosis of CP would also provide new opportunities for early intervention and targeted rehabilitation services.
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Affiliation(s)
- Israt Jahan
- CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development, University of South Asia, Dhaka, Bangladesh.,School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia
| | - Mahmudul Hassan Al Imam
- CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development, University of South Asia, Dhaka, Bangladesh.,School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia
| | - Tasneem Karim
- CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development, University of South Asia, Dhaka, Bangladesh.,Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.,Cerebral Palsy Alliance Research Institute, The University of Sydney, Sydney, NSW, Australia
| | - Mohammad Muhit
- CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development, University of South Asia, Dhaka, Bangladesh
| | | | - Manik Chandra Das
- CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development, University of South Asia, Dhaka, Bangladesh
| | - Hayley Smithers-Sheedy
- Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.,Cerebral Palsy Alliance Research Institute, The University of Sydney, Sydney, NSW, Australia
| | - Nadia Badawi
- Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.,Cerebral Palsy Alliance Research Institute, The University of Sydney, Sydney, NSW, Australia
| | - Gulam Khandaker
- CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development, University of South Asia, Dhaka, Bangladesh.,School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia.,Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.,Central Queensland Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, QLD, Australia
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Shepherd E, Mcintyre S, Smithers-Sheedy H, Ashwood P, Sullivan TR, Te Velde A, Doyle LW, Makrides M, Middleton P, Crowther CA. Linking data from a large clinical trial with the Australian Cerebral Palsy Register. Dev Med Child Neurol 2020; 62:1170-1175. [PMID: 32383806 DOI: 10.1111/dmcn.14556] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/01/2020] [Indexed: 11/27/2022]
Abstract
AIM To link data from a large maternal perinatal trial with the Australian Cerebral Palsy Register (ACPR) to identify children with cerebral palsy (CP). METHOD Deidentified data from the Australasian Collaborative Trial of Magnesium Sulphate (ACTOMgSO4 ) and the ACPR were linked. Children born from 1996 to 2000 at Australian hospitals who survived and had 2-year paediatric assessments were included. Children identified with CP in: (1) both the ACTOMgSO4 (2y) and the ACPR (5y), (2) the ACTOMgSO4 only, and (3) the ACPR only were compared. RESULTS We included 913 children (492 males, 421 females; mean gestational age at birth 27.8wks [standard deviation 2.1wks]; range 23.0-40.0wks). Eighty-four children received a CP diagnosis: 35 by the ACTOMgSO4 and the ACPR, 29 by the ACTOMgSO4 only, and 20 by the ACPR only. The ACTOMgSO4 diagnosed 76.2% (95% confidence interval [CI] 65.9-84.1) and the ACPR identified 65.5% (95% CI 54.7-74.9). Children born in states/territories with long-standing versus more recently established registers were more likely to be included on the ACPR (p<0.05). INTERPRETATION Linking deidentified perinatal trial data with the ACPR was achieved. Limitations of both strategies for identifying children with CP in this era (late 1990s and early 2000s) probably explain many of the differences observed, and inform future linkage studies and evaluations of CP-preventive interventions. WHAT THIS PAPER ADDS Randomized trial data were linked with the Australian Cerebral Palsy Register. Trial (2y) and register (up to 5y) diagnoses of cerebral palsy (CP) differed. States with long-standing registers were more likely to include children with CP.
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Affiliation(s)
- Emily Shepherd
- SA Health and Medical Research Institute, Adelaide, SA, Australia.,Discipline of Obstetrics and Gynaecology, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
| | - Sarah Mcintyre
- Cerebral Palsy Alliance, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, NSW, Australia.,Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Hayley Smithers-Sheedy
- Cerebral Palsy Alliance, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, NSW, Australia.,Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Pat Ashwood
- Discipline of Obstetrics and Gynaecology, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
| | - Thomas R Sullivan
- SA Health and Medical Research Institute, Adelaide, SA, Australia.,School of Public Health, The University of Adelaide, Adelaide, SA, Australia
| | - Anna Te Velde
- Cerebral Palsy Alliance, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, NSW, Australia.,Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Lex W Doyle
- Victorian Infant Brain Studies, The Murdoch Children's Research Institute, Melbourne, Vic, Australia.,Neonatal Services, Royal Women's Hospital, Melbourne, Vic, Australia.,Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Vic, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Vic, Australia
| | - Maria Makrides
- SA Health and Medical Research Institute, Adelaide, SA, Australia.,Discipline of Paediatrics, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
| | - Philippa Middleton
- SA Health and Medical Research Institute, Adelaide, SA, Australia.,Discipline of Obstetrics and Gynaecology, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
| | - Caroline A Crowther
- Discipline of Obstetrics and Gynaecology, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia.,Liggins Institute, The University of Auckland, Auckland, New Zealand
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Manlongat E, Mcintyre S, Smithers-Sheedy H, Trivedi A, Muhit M, Badawi N, Khandaker G. Congenital anomalies in children with cerebral palsy in rural Bangladesh. Dev Med Child Neurol 2020; 62:463-469. [PMID: 31903557 DOI: 10.1111/dmcn.14456] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/29/2019] [Indexed: 12/21/2022]
Abstract
AIM To determine the proportion of children with cerebral palsy (CP) who had major congenital anomalies, describe the types of disorders, and report on the children's functional outcomes. METHOD Data were extracted from the Bangladesh Cerebral Palsy Register (BCPR). Descriptive analyses were conducted on children with CP and major congenital anomalies. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to measure the association between major congenital anomalies, clinical severity, and presence of comorbidities. RESULTS Between January 2015 and December 2016, 726 children with CP were newly registered with the BCPR (277 females, 449 males; mean age [SD] at registration 90mo [54mo], 4mo-18y). Seventy-eight children (11%) had a major congenital anomaly. Neurological (86%) and musculoskeletal congenital anomalies (10%) were the most common. Microcephaly was the most common congenital anomaly (83%). The odds of severe functional motor limitations (OR=2.4, 95% CI=1.9-2.9), epilepsy (OR=1.6, 95% CI=1.1-2.1), visual impairment (OR=2.6, 95% CI=2.0-3.2), presence of strabismus (OR=3.9, 95% CI=3.8-4.4), hearing (OR=1.2, 95% CI=0.6-1.9), speech (OR=5.4, 95% CI=4.6-6.2), and intellectual impairments (OR=2.3, 95% CI=1.8-2.8) were higher in children with congenital anomalies compared to children without. INTERPRETATION The proportion of children with major congenital anomalies in the BCPR (11%) was lower than that identified in higher-income countries. This may be because of differences in how congenital anomalies are diagnosed as well as the impact of survival bias. In Bangladesh, children with CP and major congenital anomalies are more likely to have severe functional motor limitations and associated comorbidities. WHAT THIS PAPER ADDS Eleven per cent of children with cerebral palsy (CP) in Bangladesh had major congenital anomalies. Neurological and musculoskeletal congenital anomalies were the most common. Severe functional motor limitations and associated comorbidities were more common in children presenting with CP and major congenital anomalies.
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Affiliation(s)
- Ellen Manlongat
- Grace Centre for Newborn Intensive Care, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Sarah Mcintyre
- Cerebral Palsy Alliance Research Institute, The University of Sydney, Camperdown, NSW, Australia
| | - Hayley Smithers-Sheedy
- Cerebral Palsy Alliance Research Institute, The University of Sydney, Camperdown, NSW, Australia.,The University of Sydney Children's Hospital Westmead Clinical School, Sydney, NSW, Australia
| | - Amit Trivedi
- Grace Centre for Newborn Intensive Care, The Children's Hospital at Westmead, Westmead, NSW, Australia.,The University of Sydney Children's Hospital Westmead Clinical School, Sydney, NSW, Australia
| | - Mohammad Muhit
- CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development, University of South Asia, Dhaka, Bangladesh
| | - Nadia Badawi
- Grace Centre for Newborn Intensive Care, The Children's Hospital at Westmead, Westmead, NSW, Australia.,Cerebral Palsy Alliance Research Institute, The University of Sydney, Camperdown, NSW, Australia.,The University of Sydney Children's Hospital Westmead Clinical School, Sydney, NSW, Australia
| | - Gulam Khandaker
- The University of Sydney Children's Hospital Westmead Clinical School, Sydney, NSW, Australia.,CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development, University of South Asia, Dhaka, Bangladesh.,Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, QLD, Australia
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25
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Britton PN, Walker K, McMullan B, Galea C, Burrell R, Morgan B, Honan I, Teutsch S, Smithers-Sheedy H, Fairbairn N, Mattick R, Hutchinson D, Jones CA. Early Life Parechovirus Infection Neurodevelopmental Outcomes at 3 Years: A Cohort Study. J Pediatr 2020; 219:111-117.e1. [PMID: 32005541 DOI: 10.1016/j.jpeds.2019.12.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 10/30/2019] [Accepted: 12/12/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate the long-term developmental and behavioral outcomes in an established cohort of children hospitalized as infants with human parechovirus (HPeV) infection and sepsis-like illness. STUDY DESIGN The HPeV cohort was composed of children 3 years of age after HPeV infection and hospitalization in early infancy that occurred during a well-documented HPeV genotype 3 outbreak in Australia. We assessed neurodevelopmental and behavioral outcomes using the Bayley Scales of Infant and Toddler Development-III and the Child Behavior Checklist. We compared their outcomes with a subsample of healthy control infants drawn from the independently sampled Triple B Pregnancy Cohort Study. RESULTS Fifty children, with a mean age of 41 months, were followed for 3 years after hospital admission with HPeV infection. There were 47 children whose original illness was fever without source or sepsis-like illness and 3 who had encephalitis. All children in the HPeV cohort showed age-specific development within the population normal range on the Bayley Scales of Infant and Toddler Development-III. There was no difference in developmental attainment compared with 107 healthy control infants after adjusting for measured confounders. The HPeV cohort showed higher average scores on the Child Behavior Checklist and a higher frequency of clinical range scores compared with healthy controls. CONCLUSIONS Although HPeV sepsis-like illness did not result in neurodevelopmental delay at 3 years of age, it was associated with increased behavioral problems compared with healthy controls. The behavioral problems reached a clinical threshold in a minority of children. Results inform clinical management and planning for children after severe HPeV infection in infancy.
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Affiliation(s)
- Philip N Britton
- Discipline of Child and Adolescent Health and Marie Bashir Institute Faculty of Medicine and Health, University of Sydney, Sydney, Australia; Department of Infectious Diseases and Microbiology, The Children's Hospital at Westmead, Sydney Children's Hospitals Network, Sydney, Australia.
| | - Karen Walker
- Discipline of Child and Adolescent Health and Marie Bashir Institute Faculty of Medicine and Health, University of Sydney, Sydney, Australia; Grace Centre for Newborn Intensive Care, The Children's Hospital at Westmead, Sydney Children's Hospitals Network, Sydney, Australia; The George Institute for Global Health, Sydney, Australia
| | - Brendan McMullan
- Department of Immunology and Infectious Diseases, Sydney Children's Hospital, Randwick, Sydney Children's Hospitals Network, Sydney, Australia; School of Women's and Children's Health, University of New South Wales, Sydney, Australia
| | - Claire Galea
- Cerebral Palsy Alliance, The University of Sydney, Sydney, Australia
| | - Rebecca Burrell
- Discipline of Child and Adolescent Health and Marie Bashir Institute Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Bronte Morgan
- Discipline of Child and Adolescent Health and Marie Bashir Institute Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Ingrid Honan
- Discipline of Child and Adolescent Health and Marie Bashir Institute Faculty of Medicine and Health, University of Sydney, Sydney, Australia; Cerebral Palsy Alliance, The University of Sydney, Sydney, Australia
| | - Suzy Teutsch
- Discipline of Child and Adolescent Health and Marie Bashir Institute Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Hayley Smithers-Sheedy
- Discipline of Child and Adolescent Health and Marie Bashir Institute Faculty of Medicine and Health, University of Sydney, Sydney, Australia; Cerebral Palsy Alliance, The University of Sydney, Sydney, Australia
| | - Natalie Fairbairn
- Grace Centre for Newborn Intensive Care, The Children's Hospital at Westmead, Sydney Children's Hospitals Network, Sydney, Australia
| | - Richard Mattick
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Delyse Hutchinson
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia; Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia; Murdoch Children's Research Institute, Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Australia
| | - Cheryl A Jones
- Discipline of Child and Adolescent Health and Marie Bashir Institute Faculty of Medicine and Health, University of Sydney, Sydney, Australia; Department of Infectious Diseases and Microbiology, The Children's Hospital at Westmead, Sydney Children's Hospitals Network, Sydney, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Australia
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Sellier E, McIntyre S, Smithers-Sheedy H, Platt MJ. European and Australian Cerebral Palsy Surveillance Networks Working Together for Collaborative Research. Neuropediatrics 2020; 51:105-112. [PMID: 31910452 DOI: 10.1055/s-0039-3402003] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
AIMS This study aims to describe and compare goals and methods, characteristics of children with cerebral palsy (CP), and to compare prevalence of CP in the Surveillance of Cerebral Palsy in Europe (SCPE) and the Australian Cerebral Palsy Register (ACPR). METHODS This study compares the objectives of the two networks and their working practices; key documents from both above-mentioned networks were used. Children included in the comparison of the descriptive profile and prevalence measures were born between 1993 and 2009 for Australian data and between 1980 and 2003 for SCPE. RESULTS SCPE contributed 10,756 cases and ACPR 6,803. There were similar distributions of motor type, severity, and gestational age groups, except for the proportion of the lowest gestational age category (range, 20-27 weeks) which was twice higher in the ACPR (13 vs. 7%). Associated impairment proportions were also similar except for severe vision impairment which was more than twice as high in SCPE as in the ACPR (11 vs. 4%), but most likely due to a subtle difference in definitions. Prevalence rates were comparable at the same time point in the different groups of birth weight, and declined over time, except for the moderately low birth weight in ACPR. CONCLUSION Two CP networks representing two continents have compared their major characteristics to facilitate the comparison across their study populations. These characteristics proved to be similar with only marginal differences. This gives additional strength to the observation in both networks that CP prevalence is decreasing which is of great importance for families and health care systems.
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Affiliation(s)
- Elodie Sellier
- Université Grenoble Alpes, CNRS, Grenoble INP, CHU Grenoble, France.,Registre du Handicap de l'Enfant et Observatoire Périnatal, Grenoble, France
| | - Sarah McIntyre
- Cerebral Palsy Alliance, The University of Sydney, Sydney, New South Wales, Australia.,Discipline of Child and Adolescent Health, Sydney Medical School, the University of Sydney, New South Wales, Australia
| | - Hayley Smithers-Sheedy
- Cerebral Palsy Alliance, The University of Sydney, Sydney, New South Wales, Australia.,Discipline of Child and Adolescent Health, Sydney Medical School, the University of Sydney, New South Wales, Australia
| | - Mary Jane Platt
- Norwich Medical School, University of East Anglia, Norwich, Norfolk, United Kingdom
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Jahan I, Karim T, Das MC, Muhit M, Mcintyre S, Smithers-Sheedy H, Badawi N, Khandaker G. Mortality in children with cerebral palsy in rural Bangladesh: a population-based surveillance study. Dev Med Child Neurol 2019; 61:1336-1343. [PMID: 31081134 DOI: 10.1111/dmcn.14256] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/15/2019] [Indexed: 02/06/2023]
Abstract
AIM To determine the mortality rate, immediate cause of death (CoD), and predictors of death in children with cerebral palsy (CP) in rural Bangladesh. METHOD We carried out a prospective population-based surveillance study of children with CP aged 0 to 18 years registered with the Bangladesh Cerebral Palsy Register (BCPR) between January 2015 and December 2016, with subsequent follow-up until December 2017. Verbal autopsy was applied to assign immediate CoD. Crude mortality rates, hazard ratios of death, and survival probabilities were estimated. RESULTS Twenty-nine of the 678 children in the BCPR died during the study period, resulting in a crude mortality rate of 19.5 per 1000 person-years of observation (total follow-up duration 1486.8 person-years; mean 2y [standard deviation 6mo]). The leading immediate CoD was meningitis (n=9) and pneumonia (n=8). Survival probability and hazard ratio of death was significantly associated with age, Gross Motor Functional Classification System level, and associated impairments. Severe underweight and/or severe stunting was significantly overrepresented among deceased children than others in the cohort (p<0.05) when compared with the World Health Organization reference population. INTERPRETATION The majority of deaths were due to potentially preventable causes. The life expectancy of these children could have been extended by ensuring primary healthcare and nutritional supplementation. WHAT THIS PAPER ADDS Mortality rate in children with cerebral palsy (CP) in rural Bangladesh is 19.5 per 1000 person-years. The majority of children with CP died from potentially preventable and treatable conditions. Motor severity, associated impairments, and malnutrition make children with CP vulnerable to premature death in rural Bangladesh.
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Affiliation(s)
- Israt Jahan
- CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh
| | - Tasneem Karim
- CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh.,Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Manik Chandra Das
- CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh
| | - Mohammad Muhit
- CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh
| | - Sarah Mcintyre
- Cerebral Palsy Alliance Research Institute, The University of Sydney, Sydney, New South Wales, Australia
| | - Hayley Smithers-Sheedy
- Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.,Cerebral Palsy Alliance Research Institute, The University of Sydney, Sydney, New South Wales, Australia
| | - Nadia Badawi
- Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.,Cerebral Palsy Alliance Research Institute, The University of Sydney, Sydney, New South Wales, Australia
| | - Gulam Khandaker
- CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh.,Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.,Central Queensland Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, Queensland, Australia
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Karim T, Al Imam MH, Golland P, Khan AI, Hossain I, Smithers-Sheedy H, Badawi N, Muhit M, Khandaker G. Hip dysplasia among children with spastic cerebral palsy in rural Bangladesh. BMC Musculoskelet Disord 2019; 20:494. [PMID: 31656186 PMCID: PMC6815374 DOI: 10.1186/s12891-019-2805-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 08/30/2019] [Indexed: 12/05/2022] Open
Abstract
Background Hip dysplasia is common among children with cerebral palsy (CP), particularly in spastic CP. It can result in pain, reduced function and quality of life. However, the burden of hip dysplasia among children with CP in llow-and middle-income countries (LMICs) like Bangladesh is unknown. We aimed to define the burden of hip dysplasia among children with spastic CP in Bangladesh. Methods This study includes a subset of the Bangladesh CP Register (BCPR) study cohort who were registered between January and March 2015. The BCPR is a population-based surveillance of children with CP (aged < 18 years) operating in a northern sub-district (Shahjadpur; child population ~ 226,114) of Bangladesh. Community-based key informant’s method (KIM) survey conducted to identify children with CP in the surveillance area. A diagnosis of CP was made based on clinical history and examination by the study physicians and physiotherapist. Study participants had an antero-posterior (AP) X-ray of their pelvis. The degree of subluxation was assessed by calculating the migration percentage (MP). Results During the study period, 196 children with CP were registered, 144 had spastic CP. 40 children with spastic CP (80 hips) had pelvic X-Rays (mean age 9.4 years, range 4.0–18.0 years) and 32.5% were female. Gross Motor Function Classification System (GMFCS) showed 37.5% (n = 15) with GMFCS level I-II and 62.5% (n = 25) with GMFCS level III-V. Twenty percent (n = 8) of the children had hip subluxation (MP: 33–80%). Osteopenic changes were found in 42.5% (n = 17) children. Conclusions To the best of our knowledge this is one of the first studies exploring hip dysplasia among children with spastic CP in Bangladesh. Our findings reflect that hip dysplasia is common among children with spastic CP. Introduction of hip surveillance programmes is imperative for prevention of secondary complications, reduced function and poor quality of life among these children.
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Affiliation(s)
- Tasneem Karim
- CSF Global, Dhaka, Bangladesh. .,Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh. .,Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, Australia. .,Cerebral Palsy Alliance Research Institute, The University of Sydney, Sydney, Australia.
| | - Mahmudul Hassan Al Imam
- CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh
| | - Prue Golland
- Cerebral Palsy Alliance Research Institute, The University of Sydney, Sydney, Australia
| | - Aynul Islam Khan
- CSF Global, Dhaka, Bangladesh.,Singair Upazilla Health Complex, Singair, Manikganj, Bangladesh
| | - Iqbal Hossain
- Radiology and Imaging Department, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
| | | | - Nadia Badawi
- Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, Australia.,Cerebral Palsy Alliance Research Institute, The University of Sydney, Sydney, Australia
| | - Mohammad Muhit
- CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh
| | - Gulam Khandaker
- CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh.,Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, Australia.,Central Queensland Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, Queensland, Australia
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29
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Jahan I, Muhit M, Hardianto D, Karim T, Al Imam MH, Das MC, Smithers-Sheedy H, Badawi N, Khandaker G. Nutritional status of children with cerebral palsy in remote Sumba Island of Indonesia: a community-based key informants study. Disabil Rehabil 2019; 43:1819-1828. [PMID: 31656105 DOI: 10.1080/09638288.2019.1676833] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
AIM To assess the burden and underlying factors of malnutrition among children with cerebral palsy (CP) in the remote Sumba Island, Indonesia. METHODS This is a community-based key informant (KI) method survey of children with CP in the southwest regency of Sumba Island, Indonesia (child population∼152 471). Children with suspected CP identified by trained community volunteers (KIs) underwent a detailed neurodevelopmental assessment by a multidisciplinary medical assessment team to confirm diagnosis of CP. Anthropometric measurements were taken, z scores were calculated, and nutritional status was determined following the World Health Organization guideline. Descriptive analyses were performed, multivariable linear regression model was fitted to identify potential predictors of malnutrition. RESULTS One hundred and thirty children with CP aged <18 years were included in the study. The majority were severely underweight (78.8%) and severely stunted (85.9%). Severe malnutrition was overrepresented among young children, children who had spastic tri/quadriplegia, Gross Motor Function Classification System levels III-V, had at least one associated impairment, speech impairment and/or swallowing difficulties. Age and presence of visual impairment were found to be significantly associated with weight-for-age z score (i.e., underweight) whereas, epilepsy was significantly associated with the height-for-age z score (i.e., stunting) when adjusted for other covariates. CONCLUSIONS The substantial-high burden of malnutrition among children with CP in remote Sumba Island highlights their vulnerability to poor health-related outcomes. There is an urgent need for nutritional rehabilitation services to avert such consequences among children with CP in low and middle-income countries like Indonesia.Implications for rehabilitationMalnutrition among children with cerebral palsy (CP) is alarmingly high in the remote Sumba island of Indonesia.Children with severe gross motor function limitations or spastic tri/quadriplegia had the most severe malnutrition.There is an urgent need for rehabilitation services including nutrition and feeding interventions for children with CP in low and middle-income countries like Indonesia.
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Affiliation(s)
- Israt Jahan
- CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh
| | - Mohammad Muhit
- CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh
| | | | - Tasneem Karim
- CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh.,Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Mahmudul Hassan Al Imam
- CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh
| | - Manik Chandra Das
- CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh
| | - Hayley Smithers-Sheedy
- Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, Australia.,Cerebral Palsy Alliance Research Institute, The University of Sydney, Sydney, Australia
| | - Nadia Badawi
- Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, Australia.,Cerebral Palsy Alliance Research Institute, The University of Sydney, Sydney, Australia
| | - Gulam Khandaker
- CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh.,Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, Australia.,Central Queensland Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, Australia
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30
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Lansdown K, Smithers-Sheedy H, Mathieu Coulton K, Irving M. Oral health outcomes for people with cerebral palsy: a scoping review protocol. ACTA ACUST UNITED AC 2019; 17:2551-2558. [PMID: 31313707 DOI: 10.11124/jbisrir-2017-004037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE This review aims to systematically map the literature reporting on oral health outcomes experienced by people with cerebral palsy. INTRODUCTION At present, there are no documented systematic reviews reporting on oral health outcomes for people of all ages with cerebral palsy. Subsequently, there are no clear guidelines, frameworks or detailed oral health recommendations for people with cerebral palsy. Considering the importance of oral health on general well-being and quality of life, it is important that it is not overlooked when focusing on patient-centered care for people with cerebral palsy. INCLUSION CRITERIA Studies that focus on oral health, including dental diagnosis, trauma and/or treatment, facial pain, saliva, and sleep apnea, and/or make statements regarding oral health pertaining to cerebral palsy will be considered for inclusion inthis scoping review. METHODS This review will be conducted in accordance with the guidelines outlined by JBI methodology for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). Articles published in any language will be considered for inclusion, with no restriction on publication date. The search databases will include the Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, Scopus, Embase and Dentistry and Oral Science. A search of gray literature will also be conducted. Extracted data relevant to the scoping review will be performed by two reviewers.
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Affiliation(s)
- Karen Lansdown
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Hayley Smithers-Sheedy
- Cerebral Palsy Alliance Research Institute, Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Kimberly Mathieu Coulton
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Michelle Irving
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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31
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MacLennan AH, Lewis S, Moreno-De-Luca A, Fahey M, Leventer RJ, McIntyre S, Ben-Pazi H, Corbett M, Wang X, Baynam G, Fehlings D, Kurian MA, Zhu C, Himmelmann K, Smithers-Sheedy H, Wilson Y, Ocaña CS, van Eyk C, Badawi N, Wintle RF, Jacobsson B, Amor DJ, Mallard C, Pérez-Jurado LA, Hallman M, Rosenbaum PJ, Kruer MC, Gecz J. Genetic or Other Causation Should Not Change the Clinical Diagnosis of Cerebral Palsy. J Child Neurol 2019; 34:472-476. [PMID: 30963790 PMCID: PMC6582263 DOI: 10.1177/0883073819840449] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
High throughput sequencing is discovering many likely causative genetic variants in individuals with cerebral palsy. Some investigators have suggested that this changes the clinical diagnosis of cerebral palsy and that these individuals should be removed from this diagnostic category. Cerebral palsy is a neurodevelopmental disorder diagnosed on clinical signs, not etiology. All nonprogressive permanent disorders of movement and posture attributed to disturbances that occurred in the developing fetal and infant brain can be described as "cerebral palsy." This definition of cerebral palsy should not be changed, whatever the cause. Reasons include stability, utility and accuracy of cerebral palsy registers, direct access to services, financial and social support specifically offered to families with cerebral palsy, and community understanding of the clinical diagnosis. Other neurodevelopmental disorders, for example, epilepsy, have not changed the diagnosis when genomic causes are found. The clinical diagnosis of cerebral palsy should remain, should prompt appropriate genetic studies and can subsequently be subclassified by etiology.
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Affiliation(s)
- Alastair H. MacLennan
- Robinson Research Institute, University of Adelaide, Adelaide, Australia,Alastair H. MacLennan, MD, The Robinson Research Institute, 55 King William Rd, North Adelaide, South Australia 5064, Australia.
| | - Sara Lewis
- Barrow Neurological Institute, Phoenix Children’s Hospital and Departments of Child Health, Cellular & Molecular Medicine, Neurology and Genetics, University of Arizona College of Medicine, Phoenix, AZ, USA
| | | | - Michael Fahey
- Department of Paediatrics, Monash University, Melbourne, Victoria, Australia
| | - Richard J. Leventer
- Department of Neurology Royal Children’s Hospital, Murdoch Children’s Research Institute and University of Melbourne Department of Paediatrics, Melbourne, Victoria, Australia
| | - Sarah McIntyre
- Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent Health, University of Sydney, New South Wales, Australia
| | - Hilla Ben-Pazi
- Pediatric Movement Disorders, Neuropediatric Unit, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Mark Corbett
- Adelaide Medical School & Robinson Research Institute, University of Adelaide, Adelaide, Australia
| | - Xiaoyang Wang
- Department of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Department of Pediatrics, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China,Henan Provincial Key Laboratory of Child Brain Injury, Zhengzhou, China
| | - Gareth Baynam
- Western Australian Register of Developmental Anomalies and Genetic Services of Western Australia, Western Australian Department of Health, Perth, Western Australia
| | - Darcy Fehlings
- Holland Bloorview Kids Rehabilitation Hospital, Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Manju A. Kurian
- Developmental Neurosciences, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Changlian Zhu
- Henan Key Laboratory of Child Brain Injury, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China,Center for Brain Repair and Rehabilitation, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Kate Himmelmann
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Hayley Smithers-Sheedy
- Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent Health, University of Sydney, New South Wales, Australia
| | - Yana Wilson
- Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent Health, University of Sydney, New South Wales, Australia
| | - Carlos Santos Ocaña
- Andalusian Center for Developmental Biology-CABD, CIBERER-ISCIII and University Pablo de Olavide, Sevilla, Spain
| | - Clare van Eyk
- Adelaide Medical School & Robinson Research Institute, University of Adelaide, Adelaide, Australia
| | - Nadia Badawi
- Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent Health, University of Sydney, New South Wales, Australia
| | - Richard F. Wintle
- Centre for Applied Genomics and Program in Genetics and Genome Biology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Bo Jacobsson
- Department of Obstetrics and Gynecology, Sahlgrenska Academy, Gothenburg University, Sweden,Department of Genetics and Bioinformatics, Domain of Health Data and Digitalisation, Institute of Public Health, Oslo, Norway
| | - David J. Amor
- University of Melbourne Department of Paediatrics and Murdoch Children’s Research Institute, Melbourne, Australia
| | - Carina Mallard
- Henan Key Laboratory of Child Brain Injury, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China,Center for Brain Repair and Rehabilitation, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Luis A. Pérez-Jurado
- Women’s and Children´s Hospital, South Australian Health and Medical Research Institute, University of Adelaide, Australia,Universitat Pompeu Fabra, IMIM-Hospital del Mar and CIBERER-ISCIII, Barcelona, Spain
| | - Mikko Hallman
- Department of Children and Adolescents, Oulu University Hospital, Oulu, Finland,PEDEGO Research Unit, Medical Research Center Oulu, University of Oulu, Oulu, Finland
| | - Peter J. Rosenbaum
- CanChild Centre for Childhood Disability Research, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Michael C. Kruer
- Barrow Neurological Institute, Phoenix Children’s Hospital and Departments of Child Health, Cellular & Molecular Medicine, Neurology and Genetics, University of Arizona College of Medicine, Phoenix, AZ, USA
| | - Jozef Gecz
- Adelaide Medical School & Robinson Research Institute, University of Adelaide, Adelaide, Australia
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Woolfenden S, Galea C, Smithers-Sheedy H, Blair E, Mcintyre S, Reid S, Delacy M, Badawi N. Impact of social disadvantage on cerebral palsy severity. Dev Med Child Neurol 2019; 61:586-592. [PMID: 30221759 DOI: 10.1111/dmcn.14026] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/27/2018] [Indexed: 12/27/2022]
Abstract
AIM To investigate the impact of socio-economic disadvantage on indicators of cerebral palsy (CP) severity - motor impairment, intellectual disability, and the presence of severe comorbidities - in children with CP in Australia. METHOD Data from the Australian Cerebral Palsy Register were analysed. Socio-economic disadvantage was assessed using maternal age, maternal country of birth, and a measure of neighbourhood socio-economic status (SES) at the time of the child's birth. Descriptive bivariate analysis, trend analysis, risk ratios, and mediation analysis were undertaken to examine the impact of disadvantage on the indicators of CP severity. RESULTS A socio-economic gradient was demonstrated with an increasing proportion of children with non-ambulant status, at least moderate intellectual disability, and the presence of severe comorbidities (having epilepsy, functional blindness, bilateral deafness, and/or no verbal communication) with decreasing neighbourhood SES, adolescent motherhood, and maternal minority ethnicity. INTERPRETATION In Australia, socio-economic disadvantage at birth impacts adversely on CP severity at age 5 years. By identifying that socio-economically disadvantaged children with CP are at greater risk of more severe functional outcomes, we can inform targeted interventions at the family and neighbourhood level to reduce these inequities for children with CP. WHAT THIS PAPER ADDS Socio-economic disadvantage is associated with increased severity of cerebral palsy functional outcomes. This encompasses low neighbourhood socio-economic status, adolescent motherhood, and maternal minority ethnicity.
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Affiliation(s)
- Sue Woolfenden
- Department of Community Child Health, Sydney Children's Hospitals Network, Sydney, NSW, Australia.,School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia
| | - Claire Galea
- Cerebral Palsy Alliance, The University of Sydney, Sydney, NSW, Australia.,Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Hayley Smithers-Sheedy
- Cerebral Palsy Alliance, The University of Sydney, Sydney, NSW, Australia.,Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Eve Blair
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | - Sarah Mcintyre
- Cerebral Palsy Alliance, The University of Sydney, Sydney, NSW, Australia.,Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Sue Reid
- Developmental Disability and Rehabilitation Research, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Michael Delacy
- Queensland Cerebral Palsy Register, CPL - Choice, Passion, Life, Brisbane, QLD, Australia
| | - Nadia Badawi
- Cerebral Palsy Alliance, The University of Sydney, Sydney, NSW, Australia.,Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.,The Grace Centre for Newborn Care, The Children's Hospital at Westmead, Sydney, NSW, Australia
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Khandaker G, Muhit M, Karim T, Smithers-Sheedy H, Novak I, Jones C, Badawi N. Epidemiology of cerebral palsy in Bangladesh: a population-based surveillance study. Dev Med Child Neurol 2019; 61:601-609. [PMID: 30394528 DOI: 10.1111/dmcn.14013] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/13/2018] [Indexed: 12/11/2022]
Abstract
AIM To examine the prevalence, clinical characteristics, and risk factors of cerebral palsy (CP) in children in Bangladesh. METHOD The Bangladesh CP Register is an ongoing population-based surveillance database of children with CP from a geographically defined area in Bangladesh. Cases were defined based on Surveillance of CP in Europe and Australian CP Register criteria after clinical assessments and identification by the key informant's method. RESULTS In total, 726 children with CP were identified between January 2015 and December 2016. Mean age was 7 years 7 months (standard deviation [SD] 4y 6mo; range: 4.8mo-18y; median 7y 1.2mo; 61.8% male, 38.2% female). Mean age at CP diagnosis was 5 years 2 months (SD 3.8). Observed prevalence was 3.4 per 1000 children (95% confidence interval [CI]: 3.2-3.7), resulting in an estimated 233 514 children (95% CI: 219 778-254 118) with CP in Bangladesh. The majority (79.6%) had spastic CP. Altogether, 79.6% of the children with CP had at least one associated impairment (speech 67.6%, intellectual 39.0%, epilepsy 23.7%, visual 10.2%, and hearing 10.2%). In total, 78.2% never received rehabilitation. INTERPRETATION In Bangladesh, the burden of CP is high, and diagnosis is substantially delayed, limiting opportunities for early intervention. There is a lack of available services and the majority of the children had preventable risk factors. WHAT THIS PAPER ADDS Prevalence of cerebral palsy (CP) is 3.4 per 1000 children in rural Bangladesh. There are an estimated 233 514 children with CP in Bangladesh. The majority have potentially preventable risk factors. Diagnosis of CP is delayed, limiting opportunities for early intervention. There is a lack of available services for children with CP in rural Bangladesh.
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Affiliation(s)
- Gulam Khandaker
- Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh.,Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, Queensland, Australia
| | - Mohammad Muhit
- CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh
| | - Tasneem Karim
- Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh
| | - Hayley Smithers-Sheedy
- Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,Cerebral Palsy Alliance Research Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Iona Novak
- Cerebral Palsy Alliance Research Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Cheryl Jones
- Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,Marie Bashir Institute for Infectious Diseases and Biosecurity (MBI), University of Sydney, Sydney, New South Wales, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Nadia Badawi
- Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,Cerebral Palsy Alliance Research Institute, University of Sydney, Sydney, New South Wales, Australia
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Galea C, Mcintyre S, Smithers-Sheedy H, Reid SM, Gibson C, Delacy M, Watson L, Goldsmith S, Badawi N, Blair E. Cerebral palsy trends in Australia (1995-2009): a population-based observational study. Dev Med Child Neurol 2019; 61:186-193. [PMID: 30187914 DOI: 10.1111/dmcn.14011] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/13/2018] [Indexed: 11/29/2022]
Abstract
AIM To investigate trends in birth prevalence of cerebral palsy (CP) overall and by gestational age, and examine the distribution of motor type, spastic topography, and severity using Australian CP Register data from 1995 to 2009. METHOD Prenatal and perinatal CP data were collated from state/territory CP registers. Birth prevalence estimates per 1000 live births and per 1000 neonatal survivors (NNS) were calculated in five epochs. Data from three state registers with population-level ascertainment were used to investigate birth prevalence trends by gestational age using Poisson regression. Distribution of motor type, spastic topography, and moderate to severe disability (IQ≤50 and/or Gross Motor Function Classification System levels III-V) were evaluated within birthweight categories. RESULTS Birth prevalence of CP varied across population-level states but within each state declined significantly over time (p<0.05). Birth prevalence per 1000 neonatal survivors declined amongst children born before 28 weeks (South Australia, Victoria p<0.001) and those born at or after 37 weeks (Victoria p<0.001, Western Australia p<0.002). Across Australia the percentage of children with bilateral spastic CP declined amongst those born less than 1000g. The percentage of children with moderate to severe disability decreased (48%-34%, p<0.001). INTERPRETATION Birth prevalence of CP declined. Encouragingly, the percentage of children with CP whose disability was moderate to severe also decreased. WHAT THIS PAPER ADDS Birth prevalence of cerebral palsy (CP) differed but declined across Australian states (1995-2009). Australian CP birth prevalence declined significantly amongst children born before 28 weeks and those born at or after 37 weeks. The percentage of children with moderate to severe disability decreased.
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Affiliation(s)
- Claire Galea
- Cerebral Palsy Alliance, The University of Sydney, Sydney, NSW, Australia.,Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Sarah Mcintyre
- Cerebral Palsy Alliance, The University of Sydney, Sydney, NSW, Australia.,Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Hayley Smithers-Sheedy
- Cerebral Palsy Alliance, The University of Sydney, Sydney, NSW, Australia.,Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Susan M Reid
- Developmental Disability and Rehabilitation Research, Murdoch Children's Research Institute, Parkville, VIC, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Catherine Gibson
- South Australian Birth Defects Register, Women's and Children's Hospital, Women's and Children's Health Network, Adelaide, SA, Australia
| | | | - Linda Watson
- Department of Health Western Australia, Perth, WA, Australia
| | - Shona Goldsmith
- Cerebral Palsy Alliance, The University of Sydney, Sydney, NSW, Australia.,Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Nadia Badawi
- Cerebral Palsy Alliance, The University of Sydney, Sydney, NSW, Australia.,Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.,The Grace Centre for Newborn Care, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Eve Blair
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
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Akhter R, Hassan NMM, Martin EF, Muhit M, Smithers-Sheedy H, Badawi N, Khandaker G. Caries experience and oral health-related quality of life (OHRQoL) of children and adolescents with cerebral palsy in a low-resource setting. BMC Oral Health 2019; 19:15. [PMID: 30646890 PMCID: PMC6332610 DOI: 10.1186/s12903-018-0704-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 12/26/2018] [Indexed: 11/17/2022] Open
Abstract
Background Children with complex neurodevelopmental disabilities such as cerebral palsy (CP), have a higher risk of dental disease related at least in part to greater difficulties in performing and maintaining effective oral hygiene and oral care practices. However, to date, there are very few studies that have considered the impact of dental disease on the Oral Health-Related Quality of Life (OHRQoL) of children and adolescents with cerebral palsy. This study aimed to investigate the association between dental caries experience and oral health related quality of life (OHRQoL) among children and adolescents with cerebral palsy in a low-resource setting (Bangladesh). Methods A total of 90 children and adolescents with CP, 2–17 years old (median age 10 years; 37.8% female and 62.2% male) were randomly selected from the Bangladesh Cerebral Palsy Register (BCPR) The decayed, missing and filled teeth (dmft/DMFT) index was used to measure caries experience. Child Perceptions Questionnaire (CPQ) and Family Impact Scale (FIS) were used to assess oral health–related quality of life (OHRQoL). Binary logistic regression was used to investigate factors that may contribute to dental caries experience. Results Dental caries were observed among 55.6% of the participants. After adjusting for age and gender, binary logistic regression analysis showed that dental caries experience was significantly associated with those who had teeth/mouth pain (rate ratio 7.3; P = 0.02), food caught between teeth (rate ratio: 6.4; P = 0.02), difficulty in eating and drinking (rate ratio 5.9; p = 0.02) and those who felt frequently upset (rate ratio: 54.7; P = 0.02). Conclusion In this study, we found that children and adolescents with CP in a low-resource setting had high dental caries experience and that dental caries had a negative impact on OHRQoL amongst these participants and their parents/caregivers. Health care professionals should be aware of the importance of dental health and oral hygiene in this population. These findings highlight the need for oral health promotion programs for children and adolescents with CP in these settings to reduce pain and to improve quality of life.
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Affiliation(s)
- Rahena Akhter
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, C24 Westmead Hospital, Level 1 WCOH, Westmead, NSW, 2145, Australia.
| | | | - Elizabeth F Martin
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, C24 Westmead Hospital, Level 1 WCOH, Westmead, NSW, 2145, Australia
| | - Mohammad Muhit
- CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh
| | - Hayley Smithers-Sheedy
- Cerebral Palsy Alliance Research Institute, The University of Sydney, Allambie Heights, NSW, Australia.,The Children's Hospital at Westmead Clinical School, The University of Sydney, Westmead, NSW, Australia
| | - Nadia Badawi
- Cerebral Palsy Alliance Research Institute, The University of Sydney, Allambie Heights, NSW, Australia.,The Children's Hospital at Westmead Clinical School, The University of Sydney, Westmead, NSW, Australia
| | - Gulam Khandaker
- CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh.,The Children's Hospital at Westmead Clinical School, The University of Sydney, Westmead, NSW, Australia.,Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, Queensland, Australia
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Goldsmith S, Garcia Jalon G, Badawi N, Blair E, Garne E, Gibson C, McIntyre S, Scott H, Smithers-Sheedy H, Andersen GL. Comprehensive investigation of congenital anomalies in cerebral palsy: protocol for a European-Australian population-based data linkage study (The Comprehensive CA-CP Study). BMJ Open 2018; 8:e022190. [PMID: 30037879 PMCID: PMC6059266 DOI: 10.1136/bmjopen-2018-022190] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 05/17/2018] [Accepted: 06/07/2018] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION Cerebral palsy (CP), an umbrella term for non-progressive conditions of cerebral origin resulting in motor impairments, is collectively the most common cause of physical disability in childhood. Cerebral and/or non-cerebral congenital anomalies are present in 15%-40% of children with CP. In order to identify effective prevention strategies for this substantial proportion of CP, a comprehensive understanding of the epidemiology of these congenital anomalies is required. International collaboration is needed, as previous attempts have fallen short due to a lack of power, since the anomalies are individually rare and CP comprises many clinical descriptions. The aim of this study is to generate new knowledge about the aetiologies of CP through a focused investigation into the role of congenital anomalies. METHODS AND ANALYSIS This collaborative, population-based data linkage study includes nine geographic regions (six in Europe, three in Australia) served by both congenital anomaly and CP registers. Register data for children with CP (both with and without congenital anomalies) and children with specific congenital anomalies (without CP) born between 1991 and 2009 will be linked and de-identified within each region. The resulting linked data sets will be quality assured, recoded, harmonised and then pooled into one data set. Analysis of the combined data set will include: frequencies/proportions of congenital anomalies and outcomes (type of CP, severity, impairments); descriptive analyses comparing timing of congenital anomaly development and brain injury/abnormality responsible for CP; ORs to calculate the odds of CP following a specific congenital anomaly; and identification of anomalies on causal pathways to CP. ETHICS AND DISSEMINATION Ethics approval for this collaborative study, The Comprehensive CA-CP Study, has been obtained from the Cerebral Palsy Alliance Human Research Ethics Committee (EC00402). Study findings will be disseminated at conferences and published in peer-reviewed journals, and recommendations will be made regarding the collection and classification of congenital anomaly data by CP registers.
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Affiliation(s)
- Shona Goldsmith
- Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Guiomar Garcia Jalon
- Northern Ireland Cerebral Palsy Register, School of Nursing and Midwifery, Queen’s University Belfast, Royal Group of Hospitals, Belfast, UK
| | - Nadia Badawi
- Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia
- Grace Centre for Newborn Care, The Children’s Hospital at Westmead, Sydney, New South Wales, Australia
| | - Eve Blair
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Ester Garne
- Paediatric Department, Hospital Lillebaelt Kolding, Kolding, Denmark
| | - Catherine Gibson
- South Australian Birth Defects Register, Women’s and Children’s Hospital, Women’s and Children’s Health Network, Adelaide, South Australia, Australia
| | - Sarah McIntyre
- Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Heather Scott
- South Australian Birth Defects Register, Women’s and Children’s Hospital, Women’s and Children’s Health Network, Adelaide, South Australia, Australia
| | - Hayley Smithers-Sheedy
- Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Guro L Andersen
- The Cerebral Palsy Register of Norway, Vestfold Hospital Trust, Tønsberg, Norway
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Jahan I, Muhit M, Karim T, Smithers-Sheedy H, Novak I, Jones C, Badawi N, Khandaker G. What makes children with cerebral palsy vulnerable to malnutrition? Findings from the Bangladesh cerebral palsy register (BCPR). Disabil Rehabil 2018; 41:2247-2254. [PMID: 29658318 DOI: 10.1080/09638288.2018.1461260] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Purpose: To assess the nutritional status and underlying risk factors for malnutrition among children with cerebral palsy in rural Bangladesh. Materials and methods: We used data from the Bangladesh Cerebral Palsy Register; a prospective population based surveillance of children with cerebral palsy aged 0-18 years in a rural subdistrict of Bangladesh (i.e., Shahjadpur). Socio-demographic, clinical and anthropometric measurements were collected using Bangladesh Cerebral Palsy Register record form. Z scores were calculated using World Health Organization Anthro and World Health Organization AnthroPlus software. Results: A total of 726 children with cerebral palsy were registered into the Bangladesh Cerebral Palsy Register (mean age 7.6 years, standard deviation 4.5, 38.1% female) between January 2015 and December 2016. More than two-third of children were underweight (70.0%) and stunted (73.1%). Mean z score for weight for age, height for age and weight for height were -2.8 (standard deviation 1.8), -3.1 (standard deviation 2.2) and -1.2 (standard deviation 2.3) respectively. Moderate to severe undernutrition (i.e., both underweight and stunting) were significantly associated with age, monthly family income, gross motor functional classification system and neurological type of cerebral palsy. Conclusions: The burden of undernutrition is high among children with cerebral palsy in rural Bangladesh which is augmented by both poverty and clinical severity. Enhancing clinical nutritional services for children with cerebral palsy should be a public health priority in Bangladesh. Implications for Rehabilitation Population-based surveillance data on nutritional status of children with cerebral palsy in Bangladesh indicates substantially high burden of malnutrition among children with CP in rural Bangladesh. Children with severe form of cerebral palsy, for example, higher Gross Motor Function Classification System (GMFCS) level, tri/quadriplegic cerebral palsy presents the highest proportion of severe malnutrition; hence, these vulnerable groups should be focused in designing nutrition intervention and rehabilitation programs. Disability inclusive and focused nutrition intervention programme need to be kept as priority in national nutrition policies and nutrition action plans specially in low- and middle-income countries. Community-based management of malnutrition has the potential to overcome this poor nutritional scenario of children with disability (i.e., cerebral palsy). The global leaders such as World Health Organization, national and international organizations should take this in account and conduct further research to develop nutritional guidelines for this vulnerable group of population.
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Affiliation(s)
- Israt Jahan
- a CSF Global , Dhaka , Bangladesh.,b Asian Institute of Disability and Development (AIDD) , University of South Asia , Dhaka , Bangladesh
| | - Mohammad Muhit
- a CSF Global , Dhaka , Bangladesh.,b Asian Institute of Disability and Development (AIDD) , University of South Asia , Dhaka , Bangladesh
| | - Tasneem Karim
- a CSF Global , Dhaka , Bangladesh.,b Asian Institute of Disability and Development (AIDD) , University of South Asia , Dhaka , Bangladesh
| | - Hayley Smithers-Sheedy
- c Cerebral Palsy Alliance Research Institute , University of Sydney , Sydney , Australia.,d Discipline of Child and Adolescent Health , Sydney Medical School, University of Sydney , Sydney , Australia
| | - Iona Novak
- c Cerebral Palsy Alliance Research Institute , University of Sydney , Sydney , Australia
| | - Cheryl Jones
- e Marie Bashir Institute for Infectious Diseases and Biosecurity (MBI) , University of Sydney , Sydney , Australia.,f Department of Paediatrics , The University of Melbourne , Parkville , Australia
| | - Nadia Badawi
- c Cerebral Palsy Alliance Research Institute , University of Sydney , Sydney , Australia.,d Discipline of Child and Adolescent Health , Sydney Medical School, University of Sydney , Sydney , Australia
| | - Gulam Khandaker
- a CSF Global , Dhaka , Bangladesh.,b Asian Institute of Disability and Development (AIDD) , University of South Asia , Dhaka , Bangladesh.,d Discipline of Child and Adolescent Health , Sydney Medical School, University of Sydney , Sydney , Australia
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Smithers-Sheedy H, Raynes-Greenow C, Badawi N, Fernandez MA, Kesson A, McIntyre S, Leung KC, Jones CA. Congenital Cytomegalovirus Among Children With Cerebral Palsy. Obstet Gynecol Surv 2017. [DOI: 10.1097/01.ogx.0000520631.42677.1c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Akhter R, Hassan NMM, Martin EF, Muhit M, Haque MR, Smithers-Sheedy H, Jones C, Badawi N, Khandaker G. Risk factors for dental caries among children with cerebral palsy in a low-resource setting. Dev Med Child Neurol 2017; 59:538-543. [PMID: 27935024 DOI: 10.1111/dmcn.13359] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/02/2016] [Indexed: 11/28/2022]
Abstract
AIM To describe the oral health status and investigate factors affecting dental caries experience among children with cerebral palsy (CP) in rural Bangladesh. METHOD A cross-sectional study was conducted among children with CP who are part of the Bangladesh Cerebral Palsy Register (BCPR) study. Caries experience was measured by identifying decayed, missing, and filled teeth for deciduous and permanent teeth (dmft/DMFT). Clinical periodontal index, body mass index, oral hygiene behaviour, masticatory ability, and dietary habits were recorded. CP motor types and severity of functional mobility (Gross Motor Function Classification System [GMFCS]) were assessed. RESULTS Of 90 children with CP (mean age 9y 7mo, range 2-17y, 37.8% female and 62.2% male), 35% of 2 to 6 year olds, and 70% of 7 to 11 year olds (p=0.014) experienced caries (dmft+DMFT>0). The mean values (standard deviation [SD]) of dmft and DMFT were 2.46 (3.75) and 0.72 (1.79) respectively. After adjusting for age and sex, binary logistic regression analysis showed a significant relationship with dental caries for children who had quadriplegia (odds ratio [OR] 5.56, p=0.035), tooth cleaning less than one time/day (OR 0.08, p=0.016), using toothpowder or charcoal for cleaning (OR 7.63, p=0.015), and snacking between meals more than one time/day (OR 6.93, p=0.012). INTERPRETATION Early oral health preventive care is required for children with CP because dental caries is highly prevalent in these children.
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Affiliation(s)
- Rahena Akhter
- Faculty of Dentistry, University of Sydney, Westmead, NSW, Australia
| | | | | | - Mohammad Muhit
- CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development, University of South Asia, Dhaka, Bangladesh
| | | | | | - Cheryl Jones
- The Children's Hospital at Westmead Clinical School, University of Sydney, Westmead, NSW, Australia.,Marie Bashir Institute of Emerging Infection and Biosecurity, University of Sydney, Sydney, NSW, Australia
| | - Nadia Badawi
- Cerebral Palsy Alliance Research Institute, Sydney, NSW, Australia.,The Children's Hospital at Westmead Clinical School, University of Sydney, Westmead, NSW, Australia
| | - Gulam Khandaker
- Department of Public Health, University of South Asia, Dhaka, Bangladesh.,The Children's Hospital at Westmead Clinical School, University of Sydney, Westmead, NSW, Australia.,Marie Bashir Institute of Emerging Infection and Biosecurity, University of Sydney, Sydney, NSW, Australia
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Smithers-Sheedy H, Raynes-Greenow C, Badawi N, Fernandez MA, Kesson A, McIntyre S, Leung KC, Jones CA. Congenital Cytomegalovirus among Children with Cerebral Palsy. J Pediatr 2017; 181:267-271.e1. [PMID: 27816221 DOI: 10.1016/j.jpeds.2016.10.024] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 09/26/2016] [Accepted: 10/06/2016] [Indexed: 01/06/2023]
Abstract
OBJECTIVES To determine the proportion of children with cerebral palsy (CP) and cytomegalovirus (CMV) DNA detected retrospectively in their newborn screening cards (NBSC), to compare the proportion of children with CMV DNA in their NBSC across spastic subtypes of CP, and to compare the sex and other characteristics of children with CP and CMV detected on their NSBC with those in whom CMV DNA was not detected. STUDY DESIGN Retrospective observational study. Data were extracted from patient records on children with CP (birth years 1996-2014) from 2 Australian state CP registers and state-wide paediatric rehabilitation services with consent. NBSCs were retrospectively analyzed for CMV DNA by nested polymerase chain reaction (PCR) using primers against gB. Positive samples were validated using real time PCR for CMV UL83. RESULTS Of 401 children recruited, 323 (80.5%) had an available NBSC. Of these, 31 (9.6%; 95% CI, 6.8-13.3) tested positive for CMV DNA by nested PCR for CMV gB, of whom 28 (8.7%; 95% CI, 6.1-12.2) also had CMV DNA detected by real-time PCR for CMV UL83. Detection of CMV DNA was significantly associated with epilepsy, but not with clinical or epidemiologic characteristics, including sex and pattern of spasticity. CONCLUSIONS CMV viremia in the newborn period, indicating congenital CMV infection, is highly prevalent among children with CP. Further research is needed to investigate the mechanisms and contribution of congenital CMV to the causal pathways to CP.
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Affiliation(s)
- Hayley Smithers-Sheedy
- Marie Bashir Institute for Infectious Diseases and Biosecurity, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia; The Children's Hospital at Westmead, Westmead, New South Wales, Australia; Cerebral Palsy Alliance, Sydney Medical School, The University of SydneySydney, New South Wales, Australia
| | | | - Nadia Badawi
- The Children's Hospital at Westmead, Westmead, New South Wales, Australia; Cerebral Palsy Alliance, Sydney Medical School, The University of SydneySydney, New South Wales, Australia
| | - Marian A Fernandez
- Marie Bashir Institute for Infectious Diseases and Biosecurity, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia; The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Alison Kesson
- Marie Bashir Institute for Infectious Diseases and Biosecurity, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia; The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Sarah McIntyre
- Cerebral Palsy Alliance, Sydney Medical School, The University of SydneySydney, New South Wales, Australia; Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Kin-Chuen Leung
- The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Cheryl A Jones
- Marie Bashir Institute for Infectious Diseases and Biosecurity, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia; The Children's Hospital at Westmead, Westmead, New South Wales, Australia.
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Khandaker G, Raynes-Greenow C, Smithers-Sheedy H, Booy R, Menzies R, Jones C. Mortality from Herpes Simplex Virus (HSV) Infection in Australian Children, 1999-2011 Using National Datasets. Infect Disord Drug Targets 2016; 14:89-92. [PMID: 25019231 DOI: 10.2174/1871526514666140714084934] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 06/11/2014] [Accepted: 06/13/2014] [Indexed: 11/22/2022]
Abstract
BACKGROUND This study examines national childhood HSV mortality data in Australia from 1999-2011. This information is important to better understand the disease burden of HSV in early life and to formulate public health interventions. METHODS Retrospective analysis of Australian Bureau of Statistics (ABS) national mortality data from 1999- 2011 in children aged <15 years who died with specific ICD-10 codes for HSV infection listed as an underlying or contributing cause. RESULTS Twenty nine HSV-associated deaths in children aged <15 years from 1999-2011 were identified (0.05 per 100,000 children; 95% CI 0.04-0.06), 16 in the first month of life (0.45 per 100,000 live births; 95% CI 0.23- 0.67). Among those, 20 were males and 9 were females (p=0.04). The majority of deaths (69%) occurred in infants aged <12 months and most in infants aged <1 month (55%). HSV-associated death in infants aged < 1 month of age accounted for 0.15% of all neonatal deaths for 1999-2011 in Australia. A downward trend in HSV-associated neonatal mortality was observed between 1999 and 2011 (p=0.52). During the study period, mortality from HSV infections in Australian children resulted in an estimated 2,275 age-adjusted years of potential life lost. CONCLUSIONS This data confirms reported findings from active surveillance of a downward trend in mortality rate from HSV infection in infants aged < 1 month in Australia over this period. Ongoing surveillance is required to confirm this observation.
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Affiliation(s)
- Gulam Khandaker
- Centre for Perinatal Infection Research, The Children's Hospital at Westmead, Cnr Hawkesbury Rd and Hainsworth St, Locked Bag 4001, Westmead, NSW 2145, Australia.
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McIntyre S, Blair E, Goldsmith S, Badawi N, Gibson C, Scott H, Smithers-Sheedy H. Congenital anomalies in cerebral palsy: where to from here? Dev Med Child Neurol 2016; 58 Suppl 2:71-5. [PMID: 26762782 DOI: 10.1111/dmcn.13015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/31/2015] [Indexed: 11/29/2022]
Abstract
Proportions of cases of cerebral palsy (CP) with congenital anomalies recorded in Australian CP registers range from 15% to 40%. The anomalies seen in CP are extremely variable. We have identified that CP registers often do not have quality data on congenital anomalies, necessitating linkage with congenital anomaly registers. However, a lack of unified processes and definitions in congenital anomaly registers and data collections means that linkages are complex, need to be carefully planned, and limitations acknowledged. Historically in CP research, congenital anomalies have been classified by International Classification of Disease codes, then combined into brain and other major and minor anomalies. Systems have been developed to classify congenital anomalies into aetiologically related groups, but such a classification has yet to be trialled in CP. It is anticipated that primary prevention of a small proportion of cases of CP is possible through the primary prevention of congenital anomalies, especially those due to teratogens. Owing to the anticipated low prevalence of each subgroup, global collaboration will be required to further these lines of enquiry.
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Affiliation(s)
- Sarah McIntyre
- Cerebral Palsy Alliance, The University of Sydney, Sydney, NSW, Australia.,Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | - Eve Blair
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | - Shona Goldsmith
- Cerebral Palsy Alliance, The University of Sydney, Sydney, NSW, Australia
| | - Nadia Badawi
- Cerebral Palsy Alliance, The University of Sydney, Sydney, NSW, Australia.,Telethon Kids Institute, University of Western Australia, Perth, WA, Australia.,Grace Centre for Newborn Care, Sydney Children's Hospital Network, Sydney, NSW, Australia
| | - Catherine Gibson
- South Australian Birth Defects Register, Women's and Children's Hospital, Women's and Children's Health Network, Adelaide, SA, Australia
| | - Heather Scott
- South Australian Birth Defects Register, Women's and Children's Hospital, Women's and Children's Health Network, Adelaide, SA, Australia
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Goldsmith S, McIntyre S, Smithers-Sheedy H, Blair E, Cans C, Watson L, Yeargin-Allsopp M. An international survey of cerebral palsy registers and surveillance systems. Dev Med Child Neurol 2016; 58 Suppl 2:11-7. [PMID: 26781543 PMCID: PMC4837944 DOI: 10.1111/dmcn.12999] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/20/2015] [Indexed: 01/31/2023]
Abstract
AIM To describe cerebral palsy (CP) surveillance programmes and identify similarities and differences in governance and funding, aims and scope, definition, inclusion/exclusion criteria, ascertainment and data collection, to enhance the potential for research collaboration. METHOD Representatives from 38 CP surveillance programmes were invited to participate in an online survey and submit their data collection forms. Descriptive statistics were used to summarize information submitted. RESULTS Twenty-seven surveillance programmes participated (25 functioning registers, two closed owing to lack of funding). Their aims spanned five domains: resource for CP research, surveillance, aetiology/prevention, service planning, and information provision (in descending order of frequency). Published definitions guided decision making for the definition of CP and case eligibility for most programmes. Consent, case identification, and data collection methods varied widely. Ten key data items were collected by all programmes and a further seven by at least 80% of programmes. All programmes reported an interest in research collaboration. INTERPRETATION Despite variability in methodologies, similarities exist across programmes in terms of their aims, definitions, and data collected. These findings will facilitate harmonization of data and collaborative research efforts, which are so necessary on account of the heterogeneity and relatively low prevalence of CP.
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Affiliation(s)
- Shona Goldsmith
- Cerebral Palsy Alliance, The University of Sydney, Sydney, NSW, Australia
| | - Sarah McIntyre
- Cerebral Palsy Alliance, The University of Sydney, Sydney, NSW, Australia,Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | | | - Eve Blair
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | - Christine Cans
- RHEOP–ThEMAS - Centre Hospitalier Universitaire de Grenoble, Grenoble Université, Grenoble, France
| | - Linda Watson
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia,Department of Health Western Australia, Perth, WA, Australia
| | - Marshalyn Yeargin-Allsopp
- Developmental Disabilities Branch, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Smithers-Sheedy H, McIntyre S, Gibson C, Meehan E, Scott H, Goldsmith S, Watson L, Badawi N, Walker K, Novak I, Blair E. A special supplement: findings from the Australian Cerebral Palsy Register, birth years 1993 to 2006. Dev Med Child Neurol 2016; 58 Suppl 2:5-10. [PMID: 26762930 DOI: 10.1111/dmcn.13026] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/16/2015] [Indexed: 11/30/2022]
Abstract
AIM To briefly outline the strengths and limitations of cerebral palsy (CP) registers, and to report on findings of the Australian Cerebral Palsy Register (ACPR) pertaining to a population cohort of children with CP. METHOD De-identified data were extracted from the ACPR for people with CP in birth years 1993 to 2006, from South Australia, Victoria, and Western Australia. Live birth prevalence of CP was estimated and risk factors described. RESULTS The overall birth prevalence of CP (including those whose CP was postneonatally acquired) for the 1993 to 2006 birth cohort was 2.1 per 1000 live births (95% confidence interval [CI] 2.0-2.2). Excluding cases with a known postneonatal cause, the birth prevalence for pre/perinatally acquired CP was 2.0 per 1000 live births (95% CI 1.9-2.1). A downward trend in rates of CP in those born extremely preterm was evident over at least three consecutive periods across all three regions. Most (58.6%) children were born at term (≥ 37 wks). Male sex, early gestational age, low birthweight, and multiple birth were risk factors for CP. INTERPRETATION Overall rates of CP did not change during this period. The proportion of those with CP born extremely preterm decreased. The ACPR Group will investigate whether this pattern continues when data pertaining to the next birth cohort for all three regions becomes available.
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Affiliation(s)
- Hayley Smithers-Sheedy
- Cerebral Palsy Alliance, The University of Sydney, Sydney, NSW, Australia.,Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, NSW, Australia
| | - Sarah McIntyre
- Cerebral Palsy Alliance, The University of Sydney, Sydney, NSW, Australia
| | - Catherine Gibson
- South Australian Birth Defects Register, Women's and Children's Hospital, Women's and Children's Health Network, Adelaide, SA, Australia
| | - Elaine Meehan
- Developmental Disability and Rehabilitation Research, Murdoch Childrens Research Institute, Melbourne, VIC, Australia
| | - Heather Scott
- South Australian Birth Defects Register, Women's and Children's Hospital, Women's and Children's Health Network, Adelaide, SA, Australia
| | - Shona Goldsmith
- Cerebral Palsy Alliance, The University of Sydney, Sydney, NSW, Australia.,Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, NSW, Australia
| | - Linda Watson
- Department of Health Western Australia, Perth, WA, Australia
| | - Nadia Badawi
- Cerebral Palsy Alliance, The University of Sydney, Sydney, NSW, Australia.,Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, NSW, Australia.,The Grace Centre for Newborn Care, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Karen Walker
- Cerebral Palsy Alliance, The University of Sydney, Sydney, NSW, Australia.,The Grace Centre for Newborn Care, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Iona Novak
- Cerebral Palsy Alliance, The University of Sydney, Sydney, NSW, Australia
| | - Eve Blair
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
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DeLacy MJ, Louca C, Smithers-Sheedy H, McIntyre S. Change in residential remoteness during the first 5 years of life in an Australian cerebral palsy cohort. Dev Med Child Neurol 2016; 58 Suppl 2:60-5. [PMID: 26857827 DOI: 10.1111/dmcn.13013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/16/2015] [Indexed: 11/29/2022]
Abstract
AIM To determine if families of children with cerebral palsy living in Australia move to less remote areas between birth and 5 years. METHOD Children on the Australian Cerebral Palsy Register (n=3399) born 1996 to 2005, were assigned a remoteness value for family residence at birth and 5 years using a modification of the Australian Statistical Geography Standard. Each value at birth was subtracted from the value at 5 years yielding a positive difference if they moved more remotely, negative difference if they moved less remotely and a value of zero if they did not move or moved to an equally remote residence. RESULTS The small net increase in remoteness across this cohort was non-significant (p=0.43). Fifty-seven per cent of families changed postcode but only 20% changed remoteness, 11% more remotely, and 9% less remotely. There was a small trend for families with a child with more impaired gross motor function (Gross Motor Function Classification System levels IV and V) to move to a less remote area. INTERPRETATION This cohort of families with children with cerebral palsy did not appear to move to less remote areas by age 5 years. Remoteness at birth and level of gross motor function seem to have little effect.
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Affiliation(s)
- Michael J DeLacy
- Queensland Cerebral Palsy Register, CPL - Choice, Passion, Life, Brisbane, QLD, Australia
| | - Christalla Louca
- Queensland Cerebral Palsy Register, CPL - Choice, Passion, Life, Brisbane, QLD, Australia
| | | | - Sarah McIntyre
- Cerebral Palsy Alliance, The University of Sydney, Sydney, NSW, Australia.,Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
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Abstract
Isolated strabismus does not significantly impair visual functionality and has traditionally been considered a primarily cosmetic defect of little importance. However, even in the absence of strabismus amblyopia, manifest strabismus and its non-surgical treatments can render the person less socially acceptable, creating a barrier to participation and resulting in psychosocial disadvantage that has been documented in the typically developing population. The Australian Cerebral Palsy Register traditionally recorded strabismus only if it were not accompanied by visual impairment; however, even these data indicate that the proportion of cerebral palsy registrants with strabismus is many times higher than in comparable population samples, compounding their challenges to achieve participation. It is therefore inappropriate to continue to consider strabismus as merely a cosmetic defect, but one that deserves surgical correction early in life.
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Affiliation(s)
- Eve Blair
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
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Affiliation(s)
- Hayley Smithers-Sheedy
- Cerebral Palsy Alliance Research Institute - The Children's Hospital at Westmead Clinical School, University of Sydney, Westmead, NSW, Australia
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Smithers-Sheedy H, Raynes-Greenow C, Badawi N, Reid SM, Meehan E, Gibson CS, Dale RC, Jones CA. Neuroimaging findings in a series of children with cerebral palsy and congenital cytomegalovirus infection. Infect Disord Drug Targets 2015; 14:185-90. [PMID: 25809629 DOI: 10.2174/1871526515999150320154858] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 11/21/2014] [Accepted: 11/25/2014] [Indexed: 11/22/2022]
Abstract
UNLABELLED Congenital cytomegalovirus (cCMV) is a contributing cause of neurodevelopmental disabilities including cerebral palsy (CP). In this case series we reviewed the neuroimaging findings of children with CP and cCMV infection in the context of the children's clinical profile. PARTICIPANTS Children with CP and laboratory confirmed cCMV (n=12) reported to the Australian CP Register, born in South Australia and Victoria, 1993-2006, with magnetic resonance imaging (MRI) and/or computerized tomography (CT) report available. Clinical details and neuroimaging findings were tabulated and compared to published literature. Children in this series were mostly born at term (n=8), with symptoms or signs of cCMV (n=10) and had spastic quadriplegia (n=9), epilepsy (n=8), intellectual deficit (n=12), communication (n=10) and hearing impairments (n=9). All but one had abnormal neuroimaging findings reported on MRI or CT (n=11): most commonly brain malformations including disorders of neuronal migration (n=10), such as lissencephaly, pachygyria and polymicrogyria, and cerebellar hypoplasia (n=5). Other findings included ventricular dilatation (n=8), calcifications (n=7) and white matter abnormalities (n=6). This study suggests that brain malformations, calcifications, ventricular dilatation and cerebellar hypoplasia are common neuroimaging patterns in children with CP and cCMV infection. The presence of these findings should prompt investigations for congenital cytomegalovirus.
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Affiliation(s)
| | | | | | | | | | | | | | - Cheryl A Jones
- Children's Hospital at Westmead, Locked Bag 4001, Westmead NSW 2145 Australia.
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Khandaker G, Smithers-Sheedy H, Islam J, Alam M, Jung J, Novak I, Booy R, Jones C, Badawi N, Muhit M. Bangladesh Cerebral Palsy Register (BCPR): a pilot study to develop a national cerebral palsy (CP) register with surveillance of children for CP. BMC Neurol 2015; 15:173. [PMID: 26407723 PMCID: PMC4582618 DOI: 10.1186/s12883-015-0427-9] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 09/11/2015] [Indexed: 11/29/2022] Open
Abstract
Background The causes and pathogenesis of cerebral palsy (CP) are all poorly understood, particularly in low- and middle-income countries (LMIC). There are gaps in knowledge about CP in Bangladesh, especially in the spheres of epidemiological research, intervention and service utilization. In high-income countries CP registers have made substantial contributions to our understanding of CP. In this paper, we describe a pilot study protocol to develop, implement, and evaluate a CP population register in Bangladesh (i.e., Bangladesh Cerebral Palsy Register - BCPR) to facilitate studies on prevalence, severity, aetiology, associated impairments and risk factors for CP. Methods/Design The BCPR will utilise a modified version of the Australian Cerebral Palsy Register (ACPR) on a secured web-based platform hosted by the Cerebral Palsy Alliance Research Institute, Australia. A standard BCPR record form (i.e., data collection form) has been developed in consultation with local and international experts. Using this form, the BPCR will capture information about maternal health, birth history and the nature of disability in all children with CP aged <18 years. The pilot will be conducted in the Shahjadpur sub-district of Sirajgonj district in the northern part of Bangladesh. There are 296 villages in Shahjadpur, a total population of 561,076 (child population ~ 226,114), an estimated 70,998 households and 12,117 live births per annum. Children with CP will be identified by using the community based Key Informants Method (KIM). Data from the completed BPCR record together with details of assessment by a research physician will be entered into an online data repository. Discussion Once implemented, BCPR will be, to the best of our knowledge, the first formalised CP register from a LMIC. Establishment of the BCPR will enable estimates of prevalence; facilitate clinical surveillance and promote research to improve the care of individuals with CP in Bangladesh.
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Affiliation(s)
- Gulam Khandaker
- The Children's Hospital at Westmead (Clinical School), The University of Sydney, Locked Bag 4001, Westmead, NSW, 2145, Australia.
| | - Hayley Smithers-Sheedy
- Cerebral Palsy Alliance Research Institute, The University of Sydney, Westmead, Australia.
| | - Johurul Islam
- Child Sight Foundation (CSF), House 9, Flat A1& B3, Road 2/1, Banani, Dhaka, 1213, Bangladesh.
| | - Monzurul Alam
- Child Sight Foundation (CSF), House 9, Flat A1& B3, Road 2/1, Banani, Dhaka, 1213, Bangladesh.
| | - Jenny Jung
- School of Public Health, Sydney Medical School, The University of Sydney, Westmead, Australia.
| | - Iona Novak
- Cerebral Palsy Alliance Research Institute, The University of Sydney, Westmead, Australia.
| | - Robert Booy
- National Centre for Immunisation Research and Surveillance (NCIRS) and The University of Sydney, Westmead, Australia.
| | - Cheryl Jones
- The Children's Hospital at Westmead and the Marie Bashir Institute, University of Sydney, Westmead, Australia.
| | - Nadia Badawi
- Cerebral Palsy Alliance Research Institute and the Children's Hospital at Westmead, Westmead, Australia.
| | - Mohammad Muhit
- Child Sight Foundation (CSF) and University of South Asia, House 9, Flat A1& B3, Road 2/1, Banani, Dhaka, 1213, Bangladesh.
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Smithers-Sheedy H, Raynes-Greenow C, Badawi N, Khandaker G, Menzies R, Jones CA. Cytomegalovirus-related childhood mortality in Australia 1999-2011. J Paediatr Child Health 2015; 51:901-5. [PMID: 25872417 DOI: 10.1111/jpc.12896] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/04/2015] [Indexed: 11/30/2022]
Abstract
AIM Cytomegalovirus (CMV) is an important cause of congenital infection, which can result in neonatal deaths or contribute to deaths in later childhood. Post-natally acquired CMV is a less common cause of disease and mortality, and only in preterm infants or immunocompromised children. Here we sought to describe CMV as a direct or secondary contributor to childhood mortality in Australia. METHOD We searched national mortality data sets between1999 and 2011 for cases <15 years with CMV recorded as an underlying or contributing cause of death. RESULTS Eighty-three CMV-associated deaths in children <15 years were identified (0.2 cases per 100 000 <15 years; 95% confidence interval 0.16-0.24). Childhood deaths associated with CMV were evenly distributed between males and females, and the majority (n = 57; 68%) occurred in children less than 12 months of age, with 22 cases <1 month of age. Over the 13-year study period, the mortality rate remained stable and CMV resulted in an estimated age-adjusted 5925 years of potential life lost. CONCLUSIONS CMV makes a small but important contribution to childhood mortality in Australia. Most CMV-related deaths occurred in infants <12 months of age. These infant deaths may be an indirect marker of the burden of severe intrauterine CMV disease given the natural history of this infection.
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Affiliation(s)
- Hayley Smithers-Sheedy
- Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.,Centre for Perinatal Infection Research, Grace Centre for Newborn Care, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.,Cerebral Palsy Alliance Research Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Camille Raynes-Greenow
- Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.,Centre for Perinatal Infection Research, Grace Centre for Newborn Care, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Nadia Badawi
- Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.,Centre for Perinatal Infection Research, Grace Centre for Newborn Care, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.,Cerebral Palsy Alliance Research Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Gulam Khandaker
- Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.,Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, New South Wales, Australia.,Centre for Perinatal Infection Research, Grace Centre for Newborn Care, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.,National Centre for Immunisation Research and Surveillance (NCIRS), The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Robert Menzies
- Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.,National Centre for Immunisation Research and Surveillance (NCIRS), The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Cheryl A Jones
- Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.,Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, New South Wales, Australia.,Centre for Perinatal Infection Research, Grace Centre for Newborn Care, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.,National Centre for Immunisation Research and Surveillance (NCIRS), The Children's Hospital at Westmead, Sydney, New South Wales, Australia
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