A population-based study of the prevalence of Cerebral Palsy in Uganda has revealed some shocking results. The study was done in low-income, as well as middle-income countries, with the motives of examining the prevalence, subtypes, and functional impairments caused due to this disease.
Cerebral palsy is one of the most common motor disorder caused in childhood. The disorder is characterized by sensory, as well as cognitive dysfunctions, along with some other medical conditions. There are four main types of this condition including non-spastic cerebral palsy, athetoid cerebral palsy, ataxic cerebral palsy and mixed cerebral palsy.
As per the national cerebral palsy population-based studies in the USA, Australia, and Europe, the prevalence of this condition is around 1.8 to 2.3 cases per 1000 children.
The population-based study was conducted in a rural eastern district of Uganda in three stages using a cross-sectional method in children aged between 2 to 17 years. A team diagnosed the condition and studied the subtypes, motor functions (as per the GMFCS, Gross Motor Function Classification System), and the presumed injury time for each kid.
The information regarding additional cases of the condition was derived from the informants of the village. The prevalence of crude, as well as adjusted cerebral palsy, was estimated.
To rule out the findings, the data from 1, March 2015 to 30 June 2015 was used. Screening of 31,756 children was done to confirm that 86 (19 percent) of 442 children screened positive in 1st screening stage. The crude prevalence was about 2.7 (95 percent CI 2.2 to 3.3) per thousand children. It increased to 2.9 (2.4 to 3.6) per thousand children after attrition adjustment). In older children (8 to 17 years) the prevalence of this condition was lower as compared to the children less than 8 years of age. Triangulation added eleven children to cohort.
According to the study, the most common subtype of cerebral palsy was spastic unilateral cerebral palsy. It was followed by bilateral cerebral palsy. 27% (14 of 51 children) between 2 to 7 years had severe cerebral palsy as compared to 12% (5 of 42 children) between 8 to 17 years. 2% (2 out of 97) were born preterm. In 25% (24 out of 97) children post-neonatal events caused cerebral palsy.
The entire study suggested that the prevalence of cerebral palsy was higher in rural areas of Uganda as compared to the HICs or high-income countries. In HICs the prevalence of cerebral palsy was 1.8 to 2.3 cases per thousand children. Children less than 8 years of age were susceptible to severe cerebral palsy as compared to older children. Fewer older kids as compared to younger kids with the condition showed high mortality in severe cases. Fewer preterm-born children showed low preterm survival.
In Uganda, 5 times more children than HICs having post-neonatal cerebral palsy suggested that seizure and cerebral malaria were the major risk factors.
The funding was done by the Swedish Research Council, Promobilia.