Department of Paediatrics and Child Health

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Browsing Department of Paediatrics and Child Health by browse.metadata.advisor "Donald, Kirsten"

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    A systematic review of cerebral palsy in African paediatric populations
    (Stellenbosch : Stellenbosch University, 2022-09) Murugasen, Serini; Springer, Priscilla; Donald, Kirsten; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. Obstetrics and Gynaecolog.
    ENGLISH ABSTRACT: Introduction Most knowledge on cerebral palsy (CP) comes from studies of North American and European populations. Translating this information into African contexts is difficult and flawed due to the dearth of information on CP in the region. Objective To review the literature on the prevalence, aetiology, co-morbidities, therapies and functional outcomes of African children with CP over a 20-year period. Methods PubMed, SCOPUS and Web of Science databases were searched for original research on children with CP aged <18 years published from 2000-2020. 1452 articles underwent a primary and secondary survey against explicit inclusion and exclusion criteria, with the final 58 articles reviewed by all 3 authors prior to quality assessment and data extraction. Results Prevalence of CP ranged from 0.8-10 per 1000 children, with most studies reporting a prevalence of 2-3 per 1000 children, but with concerns around case identification and undercounting. Almost half these children had identifiable risk factors in the perinatal period but up to 26% had no identifiable risk factor. Hypoxic ischaemic encephalopathy and kernicterus were important risk factors for CP in Africa. Spasticity was the most common clinical subtype and up to two-thirds of children with CP had at least one co-morbidity. Hospital-based populations had a larger proportion of more severely impaired children compared to the community, but all children had a disproportionately low level of access to assistive devices or rehabilitation services. Children with CP showed functional improvement with interventions compared to controls. Caregivers struggle significantly with multiple barriers to accessing services. Conclusion The true prevalence of CP in Africa remains uncertain, but African children have a different risk factor profile and higher levels of impairment and co-morbidities compared to the global North. Significant barriers prevent these children from accessing optimal care.