Predictors of school attendance among children with cerebral palsy in Bangladesh.

IF 3.8 2区医学 Q1 CLINICAL NEUROLOGY

Developmental Medicine and Child Neurology Pub Date : 2024-10-27 DOI:10.1111/dmcn.16136

Mahmudul Hassan Al Imam, Israt Jahan, Genevieve Perrins, Mohammad Muhit, Nadia Badawi, Gulam Khandaker

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Abstract

Aim: To determine school attendance and its predictors among children with cerebral palsy (CP) in Bangladesh using population-based data.

Method: This study utilized data from the Bangladesh Cerebral Palsy Register (BCPR), a population-based register of children with CP aged less than 18 years in Bangladesh. Sociodemographic, clinical, and educational data were documented, and descriptive statistics and multivariate regression analyses were used to identify potential predictors of school attendance.

Results: Between January 2015 and January 2019, 2725 children with CP were registered into BCPR of which 1582 were school-aged children (i.e. aged 6-18 years). The majority of those children had not attended school (73.9%); 50% (n = 239) children in Gross Motor Function Classification System (GMFCS) levels I to II did not attend schools. Adjusted odds ratios (OR) showed significantly higher odds of school attendance among children whose mothers had completed secondary education or higher (adjusted OR: 2.2; 95% confidence interval [CI]: 1.2-4.0) and received rehabilitation (adjusted OR: 2.1; 95% CI: 1.4-3.1). Conversely, lower odds of school attendance were observed among children aged 15 to 18 years (adjusted OR: 0.4; 95% CI: 0.2-0.8), those with bilateral CP (adjusted OR: 0.5; 95% CI: 0.3-0.8), GMFCS levels III to V (adjusted OR: 0.3; 95% CI: 0.2-0.5), Manual Ability Classification System levels III to V (adjusted OR: 0.5; 95% CI: 0.4-0.8), and speech impairment (adjusted OR: 0.3; 95% CI: 0.2-0.6).

Interpretation: A large number of children with CP in Bangladesh, including half of those with milder forms, do not attend schools. These findings underscore a deficiency in awareness and support, encompassing the provision of resources and trained teachers, highlighting the necessity for policy-level changes. Sociodemographic and clinical predictors should be taken into account when devising educational programmes to enhance school attendance for children with CP in Bangladesh.

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孟加拉国脑瘫儿童入学率的预测因素。

目的：利用基于人口的数据确定孟加拉国脑瘫（CP）儿童的入学率及其预测因素：本研究利用了孟加拉国脑瘫登记册（BCPR）中的数据，该登记册是孟加拉国 18 岁以下脑瘫儿童的人口登记册。研究记录了社会人口学、临床和教育数据，并使用描述性统计和多变量回归分析来确定入学率的潜在预测因素：2015年1月至2019年1月期间，共有2725名患有CP的儿童在BCPR登记，其中1582名为学龄儿童（即6-18岁）。这些儿童中的大多数（73.9%）没有上过学；50%（n = 239）粗大运动功能分级系统（GMFCS）I级至II级的儿童没有上学。调整后的几率比（OR）显示，母亲完成中学或以上教育（调整后的几率比：2.2；95% 置信区间[CI]：1.2-4.0）并接受康复治疗（调整后的几率比：2.1；95% 置信区间：1.4-3.1）的儿童入学几率明显更高。相反，15 至 18 岁儿童（调整 OR：0.4；95% CI：0.2-0.8）、双侧 CP 儿童（调整 OR：0.5；95% CI：0.3-0.8）、GMFCS III 级儿童（调整 OR：0.5；95% CI：0.3-0.4）和接受康复治疗的儿童（调整 OR：1.2-4.0）的入学率较低。8）、GMFCS III 至 V 级（调整 OR：0.3；95% CI：0.2-0.5）、徒手能力分类系统 III 至 V 级（调整 OR：0.5；95% CI：0.4-0.8）和语言障碍（调整 OR：0.3；95% CI：0.2-0.6）：解释：孟加拉国有大量患有先天性脑瘫的儿童没有上学，其中包括半数病情较轻的儿童。这些研究结果表明，在提供资源和训练有素的教师等方面，人们的认识和支持存在不足，因此有必要在政策层面做出改变。在制定教育计划以提高孟加拉国脊髓灰质炎儿童的入学率时，应考虑到社会人口和临床预测因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Developmental Medicine and Child Neurology 医学-临床神经学

CiteScore

7.80

自引率

13.20%

发文量

338

审稿时长

3-6 weeks

期刊介绍： Wiley-Blackwell is pleased to publish Developmental Medicine & Child Neurology (DMCN), a Mac Keith Press publication and official journal of the American Academy for Cerebral Palsy and Developmental Medicine (AACPDM) and the British Paediatric Neurology Association (BPNA). For over 50 years, DMCN has defined the field of paediatric neurology and neurodisability and is one of the world’s leading journals in the whole field of paediatrics. DMCN disseminates a range of information worldwide to improve the lives of disabled children and their families. The high quality of published articles is maintained by expert review, including independent statistical assessment, before acceptance.