Paediatric cerebral palsy in South Africa: Prevention and care gaps at hospital level.

IF 1.3 Q4 HEALTH CARE SCIENCES & SERVICES
African Journal of Disability Pub Date : 2024-10-30 eCollection Date: 2024-01-01 DOI:10.4102/ajod.v13i0.1449
Thembi J Katangwe, Mariana Kruger, Ronald van Toorn, Jeanetta van Zyl, Sandile Ndlovu, Regan Solomons, Kirsten A Donald
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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.

南非的小儿脑瘫:医院一级的预防和护理差距。
背景:基于人口的数据显示,在撒哈拉以南非洲等资源匮乏地区,严重脑瘫(CP)病例的比例很高,而这些地区的大多数儿童都存在潜在的可预防风险因素(可能会增加发生脑瘫的可能性,但可以通过医疗干预措施加以缓解的因素):本研究旨在描述 10 年内(2010-2020 年)在泰格贝格医院接受治疗的 CP 患儿的人口和临床概况,确定潜在的护理缺口(一个国家中需要但未接受次优或不适当护理的人数比例),并与 20 年前在同一中心进行的类似研究进行比较:这项为期 10 年的回顾性研究调查了在南非西开普省一家中心医院就诊的 CP 患儿的病因和发病情况:结果:共发现了 613 名患有脊髓灰质炎的儿童。围产期病因占主导地位,尤其是57.7%(n = 354)的患者:围产期窒息(41.1%)和早产(16.6%)。产后原因占 15.2%(93 人),包括结核性脑膜炎(3.6%)和细菌性脑膜炎(3.6%)。最常见的并发症是智力障碍(61.8%;n = 379)、癫痫(30.8%;n = 189)和视力障碍(54.7%;n = 234)。三分之一的患者患有严重的CP,被归类为粗大运动功能分类系统IV级和V级(38%):结论:之前记录的大多数导致 CP 的主要因素仍然存在,医疗保健预防策略的实施仍然不足:本研究提供的纵向证据证实,在南非环境中,CP 与潜在可预防原因的高负担有关。
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来源期刊
African Journal of Disability
African Journal of Disability HEALTH CARE SCIENCES & SERVICES-
CiteScore
2.10
自引率
5.90%
发文量
50
审稿时长
20 weeks
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.
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