Prevalence of Cerebral Palsy among Children Aged 2 to 5 Years in a Rural District in Sri Lanka: A Population-Based Study

Abstract

Abstract Objective  The objective of this study is to estimate the prevalence of cerebral palsy (CP) in the 2- to 5-year age group in a rural setting in Sri Lanka and describe the type, topography, severity, functional status of CP, and associated comorbidities. Design and Patients  A population-based, cross-sectional study was conducted in the district of Ampara, which represents a typical rural setting in Sri Lanka. A house-to-house survey was performed in 60 geographically defined areas to screen 2- to 5-year-old children for motor disability or any developmental delay. Those who were positive underwent face-to-face interviews for confirmation of the diagnosis of CP. This was followed by an evaluation of the features of the CP. Results  A total of 1,090 children aged 2 to 5 years were screened for CP. Among them, there were four children with confirmed CP, resulting in an overall prevalence of 3.7 per 1,000 children aged 2 to 5 years (95% confidence interval [CI]: 1.0, 9.4%). Male dominance was noted (75%). The most common single type of CP was spastic (75%). The other was of the mixed type (25%). A severe level of disability (level V) based on gross motor function and manual ability and communication function was seen in 75% of cases. The two most common comorbidities were cerebral visual impairment (75%) and epilepsy (50%). Gastrointestinal-related problems (75%) and contractures (75%) were the most common complications. Conclusion  The burden of CP is relatively high among children in rural settings in Sri Lanka in comparison to reported rates in developed countries. However, these rates are comparable to reported rates from similar rural settings in other regional countries. The majority suffered from a severe degree of impairment.