Thembi J Katangwe, Mariana Kruger, Ronald van Toorn, Jeanetta van Zyl, Sandile Ndlovu, Regan Solomons, Kirsten A Donald
{"title":"Paediatric cerebral palsy in South Africa: Prevention and care gaps at hospital level.","authors":"Thembi J Katangwe, Mariana Kruger, Ronald van Toorn, Jeanetta van Zyl, Sandile Ndlovu, Regan Solomons, Kirsten A Donald","doi":"10.4102/ajod.v13i0.1449","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Population-based data show high proportions of severe cases of cerebral palsy (CP) in resource-poor regions such as sub-Saharan Africa, where most children have potentially preventable risk factors (factors that may increase the likelihood of CP occurrence but can be mitigated through medical interventions).</p><p><strong>Objectives: </strong>This study aimed to describe the demographic and clinical profile of children living with CP accessing services at Tygerberg Hospital over a period of 10 years (2010-2020), identify the potential gaps in care (proportion of individuals in a country requiring but not receiving suboptimal or inadequate care), and comparison with a similar study at the same centre two decades ago.</p><p><strong>Method: </strong>This 10-year retrospective study investigated causes and morbidities in children with CP, attending a central hospital in the Western Cape, South Africa.</p><p><strong>Results: </strong>A total of 613 children with CP were identified. Perinatal causes were predominant, especially in 57.7% (<i>n</i> = 354) of the cohort: perinatal asphyxia (41.1%) and preterm birth (16.6%). Postnatal causes constituted 15.2% (<i>n</i> = 93), which included tuberculous meningitis (3.6%) and bacterial meningitis (3.6%). The most common complications were intellectual impairment (61.8%; <i>n</i> = 379); epilepsy (30.8%; <i>n</i> = 189) and visual impairment (54.7%; <i>n</i> = 234). A third of the cohort had severe CP, classified as Gross Motor Function Classification System IV and V (38%).</p><p><strong>Conclusion: </strong>Most of the previously documented main drivers of CP are still present and the implementation of healthcare prevention strategies remains inadequate.</p><p><strong>Contribution: </strong>This study provides longitudinal evidence to confirm that CP in a South African setting is associated with a high burden of potentially preventable causes.</p>","PeriodicalId":45606,"journal":{"name":"African Journal of Disability","volume":"13 ","pages":"1449"},"PeriodicalIF":1.3000,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538225/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"African Journal of Disability","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4102/ajod.v13i0.1449","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Population-based data show high proportions of severe cases of cerebral palsy (CP) in resource-poor regions such as sub-Saharan Africa, where most children have potentially preventable risk factors (factors that may increase the likelihood of CP occurrence but can be mitigated through medical interventions).
Objectives: This study aimed to describe the demographic and clinical profile of children living with CP accessing services at Tygerberg Hospital over a period of 10 years (2010-2020), identify the potential gaps in care (proportion of individuals in a country requiring but not receiving suboptimal or inadequate care), and comparison with a similar study at the same centre two decades ago.
Method: This 10-year retrospective study investigated causes and morbidities in children with CP, attending a central hospital in the Western Cape, South Africa.
Results: A total of 613 children with CP were identified. Perinatal causes were predominant, especially in 57.7% (n = 354) of the cohort: perinatal asphyxia (41.1%) and preterm birth (16.6%). Postnatal causes constituted 15.2% (n = 93), which included tuberculous meningitis (3.6%) and bacterial meningitis (3.6%). The most common complications were intellectual impairment (61.8%; n = 379); epilepsy (30.8%; n = 189) and visual impairment (54.7%; n = 234). A third of the cohort had severe CP, classified as Gross Motor Function Classification System IV and V (38%).
Conclusion: Most of the previously documented main drivers of CP are still present and the implementation of healthcare prevention strategies remains inadequate.
Contribution: This study provides longitudinal evidence to confirm that CP in a South African setting is associated with a high burden of potentially preventable causes.
期刊介绍:
The African Journal of Disability, the official journal of CRS, AfriNEAD and CEDRES, introduce and discuss issues and experiences relating to and supporting the act of better understanding the interfaces between disability, poverty and practices of exclusion and marginalisation. Its articles yield new insight into established human development practices, evaluate new educational techniques and disability research, examine current cultural and social discrimination, and bring serious critical analysis to bear on problems shared across the African continent. Emphasis is on all aspects of disability particularity in the developing African context. This includes, amongst others: -disability studies as an emerging field of public health enquiry -rehabilitation, including vocational and community-based rehabilitation -community development and medical issues related to disability and poverty -disability-related stigma and discrimination -inclusive education -legal, policy, human rights and advocacy issues related to disability -the role of arts and media in relation to disability -disability as part of global Sustainable Development Goals transformation agendas -disability and postcolonial issues -globalisation and cultural change in relation to disability -environmental and climate-related issues linked to disability -disability, diversity and intersections of identity -disability and the promotion of human development.