Prevalence and risk factors of neurological impairment among children aged 6–9 years: from population based cross sectional study in western Kenya

BMC Pediatrics

Sumihisa Honda¹  Mohamed Karama⁴  Satoshi Kaneko²  Yoshito Kawakatsu³ 

[1] Graduate school of Biomedical science, Nagasaki University, Nagasaki, Japan;NUITM-KEMRI project, Nairobi, Kenya; , Postal Address: 852-8523 1-12-4, Sakamoto, Nagasaki-city, Nagasaki, Japan;Centre of Public Health Research, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya

关键词: Risk factor;    Kenya;    Pediatric;    Neuroepidemiology;    Disability;   

Others  :  1170600
DOI  :  10.1186/1471-2431-12-186

 received in 2012-05-17, accepted in 2012-11-28,  发布年份 2012

【 摘 要 】

Background

The burden of disability is more severe among children in low income countries. Moreover, the number of children with disabilities (CWDs) in sub-Saharan Africa is predicted to increase with reduction in child mortality. Although the issue on CWDs is important in sub-Saharan Africa, there are few researches on risk factors of disabilities. The purpose of this study was to evaluate the risk factors of neurological impairment (NI) among children in western Kenya.

Methods

The present study was conducted in Mbita district (which has high HIV infectious prevalence), Kenya from April 2009 to December 2010. The study consisted of two phases. In phase 1, the Ten Question Questionnaire (TQQ) was administered to all 6362 caregivers of children aged 6–9 years. In phase two, all 413 children with TQQ positive and a similar number of controls (n=420) which were randomly selected from children with TQQ negative were examined for physical and cognitive status. In addition, a structured questionnaire was also conducted to their caregivers.

Results

The prevalence was estimated to be 29/1000. Among the types of impairments, cognitive impairment was the most common (24/1000), followed by physical impairment (5/1000). In multivariate analysis, having more than five children [adjusted odds ratio (AOR): 2.85; 95%IC: 1.25 – 6.49; p=0.013], maternal age older than 35 years old [AOR: 2.31; 95%IC: 1.05 – 5.07; p=0.036] were significant factors associated with NI. In addition, monthly income under 3000 ksh [AOR: 2.79; 95%IC: 1.28 – 6.08; p=0.010] and no maternal tetanus shot during antenatal care [AOR: 5.17; 95%IC: 1.56 – 17.14; p=0.007] were also significantly related with having moderate/severe neurological impairment.

Conclusion

It was indicated that increasing coverage of antenatal care including maternal tetanus shot and education of how to take care of neonatal children to prevent neurological impairment are important.

【 授权许可】

   
2012 Kawakatsu et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]WHO: [http:/ / www.who.int/ healthinfo/ global_burden_disease/ 2004_report_update/ en/ index.html] webciteThe global burden of disease: 2004 update, Part3 Disease incidence,prevalence and disability. World Health Organization; 2004.
• [2]Kaosar Afsana AA-s, Abbas B, et al.: The state of health in Bangladesh 2006: challenges of achieving equity in health. Bangladesh: Health Watch; 2007.
• [3]Murray CJ, Lopez AD: Quantifying disability: data, methods and results. Bull World Health Organ 1994, 72(3):481-494.
• [4]Obama MT, Dongmo L, Nkemayim C, Mbede J, Hagbe P: Stroke in children in Yaounde, Cameroon. Indian Pediatr 1994, 31(7):791-795.
• [5]Durkin MS, Khan NZ, Davidson LL, Huq S, Munir S, Rasul E, et al.: Prenatal and postnatal risk factors for mental retardation among children in Bangladesh. Am J Epidemiol 2000, 152(11):1024-1033.
• [6]Sommer A, West KP Jr: The duration of the effect of vitamin A supplementation [2]. Am J Public Health 1997, 87(3):467-468.
• [7]Hetzel BS: Iodine deficiency disorders (IDD) and their eradication. Lancet 1983, 2(8359):1126-1129.
• [8]Roncagliolo M, Garrido M, Walter T, Peirano P, Lozoff B: Evidence of altered central nervous system development in infants with iron deficiency anemia at 6 mo: Delayed maturation of auditory brainstem responses. Am J Clin Nutr 1998, 68(3):683-690.
• [9]Gottlieb MJM CA, Claudia C, Durkin MS: Child disability screening, nutrition, and early learning in 18 countries with low and middle incomes: data from the third round of UNICEF's Multiple Indicator Cluster Survey (2005–06). Lancet 2009, 374:1831-1839.
• [10]Durkin M: THE EPIDEMIOLOGY OF DEVELOPMENTAL DISABILITIES IN LOW-INCOME COUNTRIES. MENTAL RETARDATION AND DEVELOPMENTAL DISABILITIES 2002, 8:206-211.
• [11]Ellis M, Manandhar N, Shrestha PS, Shrestha L, Manandhar DS, Costello AMDL: Outcome at 1 year of neonatal encephalopathy in Kathmandu, Nepal. Dev Med Child Neurol 1999, 41(10):689-695.
• [12]Mung'ala-Odera V, Meehan R, Njuguna P, Mturi N, Alcock KJ, Newton CRJC: Prevalence and risk factors of neurological disability and impairment in children living in rural Kenya. Int J Epidemiol 2006, 35(3):683-688.
• [13]Durkin MS, Schupf N, Stein ZA: Epidemiology of mental retardation. Fetal and Neonatal Neurology and Neurosurgery. Third edition. 2001, 799-818.
• [14]Milaat WA, Ghabrah TM, Al-Bar HMS, Abalkhail BA, Kordy MN: Population-based survey of childhood disability in Eastern Jeddah using the ten questions tool. Disabil Rehabil 2001, 23(5):199-203.
• [15]Carter JA, Ross AJ, Neville BGR, Obiero E, Katana K, Mung'ala-Odera V, et al.: Developmental impairments following severe falciparum malaria in children. Tropical Med Int Health 2005, 10(1):3-10.
• [16]Omondi D, Ogol C, Otieno S, Macharia I: Parental awareness of hearing impairment in their school-going children and healthcare seeking behaviour in Kisumu district, Kenya. Int J Pediatr Otorhinolaryngol 2007, 71(3):415-423.
• [17]V. Mung’ala-Odera SW, Meehan R, Otieno GO, Njuguna P, Mturi N, Edwards T, Neville BG, Newton CRJC: Prevalence, incidence and risk factors of epilepsy in older children in rural Kenya. Seizure 2008, 17:396-404.
• [18]Kello AB, Gilbert C: Causes of severe visual impairment and blindness in children in schools for the blind in Ethiopia. Br J Ophthalmol 2003, 87(5):526-530.
• [19]Fitaw Y, Boersma MFJ: Prevalence and impact of disability in north-western Ethiopia. Disabil Rehabil 2006, 28(15):949-953.
• [20]Central Bureau of Statistics GoK: Geographic dimension of well being in Kenya: a constituency level profile, volume II. 2006.
• [21]KDHS: 2008–09 Kenya demographic and health survey. 2010.
• [22]Kaneko Satoshi JK, Kiche I, Wanyua S, Goto K, Tanaka J, Changoma M, Mwangangi M, Karama M, Moji K, Shimada M: Health and demoraphic surveillance system (HDSS) in the western and coastal areas of Kenya: an inflastructure for epidemiologic studies in africa. J Epidemiol 2012. Under publishing
• [23]Naing L, Winn T, Rusli BN: Practical issue in calculating the sample size for prevalence survey. Arch Orofac Sci 2006, 1:9-14.
• [24]Zaman SS, Khan NZ, Islam S, Banu S, Dixit S, Shrout P, et al.: Validity of the 'Ten Questions' for screening serious childhood disability: results from urban Bangladesh. Int J Epidemiol 1990, 19(3):613-20.
• [25]Durkin MS, Davidson LL, Desai P, Hasan ZM, Khan N, Shrout PE, et al.: Validity of the Ten Questions screen for childhood disability: Results from population-based studies in Bangladesh, Jamaica, and Pakistan. Epidemiology 1994, 5(3):283-9.
• [26]Singhi P, Kumar M, Malhi P, Kumar R: Utility of the WHO ten questions screen for disability detection in a rural community - The North Indian experience. J Trop Pediatr 2007, 53(6):383-7.
• [27]Mung'ala-Odera V, Meehan R, Njuguna P, Mturi N, Alcock K, Carter JA, et al.: Validity and reliability of the 'Ten Questions' Questionnaire for detecting moderate to severe neurological impairment in children aged 6–9 years in rural Kenya. Neuroepidemiology 2004, 23(1–2):67-72.
• [28]Seidel HM, Ball J, Dains J, Benedict GW: Mosby's physical examination handbook. 2006.
• [29]Pointer JS: Recognition versus resolution: a comparison of visual acuity results using Two alternative test chart optotype. J Optometry 2008, 1:65-70.
• [30]Survey NHaNE: AUDIOMETRY PROCEDURES MANUAL. 2003.
• [31]Baddeley A, Gardner JM, Graham-Mcgrgor S: Cross-cultural cognition: Developing tests for developing countries. Applied Cognitive Psychology 1995, 9(7):S173-S195.
• [32]Glanzer: Storage mechamsms in recall: The psychology of learning and motivation; advances in research and theory. New York Academic Press; 1972.
• [33]Akaike H: A new look at the statistical model identification. IEEE Trans Automatic Control 1974, 19(6):716-23.
• [34]Muga E: Screening for disability in a community: the 'ten questions' screen for children, in Bondo, Kenya. Afr Health Sci 2003, 3(1):33-9.
• [35]Couper J: Prevalence of childhood disability in rural KwaZulu-Natal. South African Medical J 2002, 92(7):549-52.
• [36]Biritwum RB, Devres JP, Ofosu-Amaah S, Marfo C, Essah ER: Prevalence of children with disabilities in central region, Ghana. West Afr J Med 2001, 20(3):249-55.
• [37]Thorburn M, Desai P, Paul TJ, Malcolm L, Durkin M, Davidson L: Identification of childhood disability in Jamaica: evaluation of the ten question screen. Int J Rehabil Res 1992, 15(3):262-70.
• [38]Durkin MS, Hasan ZM, Hasan KZ: The ten questions screen for childhood disabilities: Its uses and limitations in Pakistan. J Epidemiol Community Health 1995, 49(4):431-6.
• [39]Annegers JF, Rocca WA: Causes of epilepsy: contributions of the rochester epidemiology project. Mayo Clin Proc 1996, 71(6):570-5.
• [40]Carter JA, Neville BGR, White S, Ross AJ, Otieno G, Mturi N, et al.: Increased prevalence of epilepsy associated with severe falciparum malaria in children. Epilepsia 2004, 45(8):978-81.
• [41]Newton CR, Garcia HH: Epilepsy in poor regions of the world. Lancet 2012, 380(9848):1193-201.
• [42]Bhalla D, Chea K, Hun C, Vannareth M, Huc P, Chan S, et al.: Population-based study of epilepsy in cambodia associated factors, measures of impact, stigma, quality of life, knowledge-attitude-practice, and treatment gap. PLoS One 2012, 7(10):e46296.
• [43]Benedicte Ingstad LG: see me, and do not forget me people with disabilities in Kenya. Kenya: World Bank; 2007:1-68.
• [44]Sida: Children and adults with disabilities - Publications - Sida. 2009.
• [45]Perry H, Robison N, Chavez D, Taja O, Hilari C, Shanklin D, et al.: The census-based, impact-oriented approach: Its effectiveness in promoting child health in Bolivia. Health Policy Plan 1998, 13(2):140-51.
• [46]ADC: [http://www.entwicklung.at/uploads/media/Focus_Disabilities_May2011.pdf] webciteFocus: Persons with Disabilities in ADC. Austrian Development Agency, the operationalional unit of of the Austrian Development Cooperation Information and Communication; 2011.
• [47]Alaa Shukrallah NH, Abdel-Hamid K: Prevention, early detection and management of childhood disabilities association for health and environmental development. 2004.
• [48]Barlow JL, Mung'Ala-Odera V, Gona J, Newton CRJC: Brain damage after neonatal tetanus in a rural Kenyan hospital. Trop Med Int Health 2001, 6(4):305-8.
• [49]OLUSEGUN J, ADEBAMI GAO, JOSHUA A, OWA , OYEKU A: OYELAMI Maternal factors in the etiology of fetal malnutrition in Nigeria. Pediatrics Int 2007, 49:150-5.
• [50]Rahman MM, Abidin S: Factors affecting neonatal mortality in Bangladesh. J Heal Manag 2010, 12(2):137-52.
• [51]FD O¨z¨rA, Yavuz T, Yıldız S: Antenatal and delivery risk factors and prevalence of cerebral palsy in Duzce (Turkey). Brain Dev 2007, 29:39-42.
• [52]Mwaniki MK, Atieno M, Lawn JE, Newton CRJC: Long-term neurodevelopmental outcomes after intrauterine and neonatal insults: A systematic review. Lancet 2012, 379(9814):445-52.