Outpatient Management of Clinical Comorbidities in Children With Cerebral Palsy in Low- and Middle-Income Countries

IF 1.8 4区医学 Q2 PEDIATRICS

Child Care Health and Development Pub Date : 2025-02-22 DOI:10.1111/cch.70052

Bruno Leonardo Scofano Dias, Lenamaris Mendes Rocha Duarte, Daniela Fava, Fernanda Marinho de Lima

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引用次数: 0

Abstract

Background

Cerebral palsy (CP) is the most common physical disability of childhood. Its prevalence in low-and middle-income countries (LMICs) is over 3/1000 live births, about double the 1.6/1000 in high income countries (HICs). Multimorbidity is highly prevalent in CP. In LMICs, there are higher rates of prevalence, severity, comorbidities and mortality in children with CP. The evidence base for the recommendations in CP emanates overwhelmingly from studies conducted in HICs. Research conducted in LMICs settings, involving local clinicians, considering local context and investigating local solutions are urgently needed.

Methods

This scoping review aimed to identify and synthesise current evidence on management of clinical comorbidities in children with CP in LMICs. The Joanna Briggs Institute guidelines were followed for the data extraction and analysis phases. The following questions guided the scoping review: What are the main clinical comorbidities in children with CP? What are the gold standards for diagnosis and treatment of these comorbidities? What options do we have to diagnose and treat these comorbidities in LMICs when gold standards are not available?

Results

A total of 22 188 citations were identified by our search strategy, with 21 380 remaining after the removal of 808 duplicates. After screening titles and abstracts, 1918 citations progressed to full text review. A total of 194 articles met the eligibility criteria and were included in the review. The guiding questions of the review were answered for the following morbidities: respiratory impairments, dysphagia and aspiration, gastroesophageal reflux disease, drooling, obstructive sleep apnea syndrome, malnutrition, constipation, epilepsy, sleep disorders, spasticity, dystonia, pain, hip disorders, scoliosis and osteoporosis.

Conclusion

This article highlights the need for interventions adapted to the realities of LMICs. Empowering paediatricians and healthcare professionals in LMICs is crucial for early diagnosis and proactive interventions. Specific guidelines for LMICs can better guide professionals in managing these complex conditions.

查看原文本刊更多论文

中低收入国家脑瘫儿童临床合并症的门诊管理

背景脑瘫（CP）是儿童最常见的肢体残疾。它在低收入和中等收入国家的流行率超过3/1000活产，约为高收入国家1.6/1000的两倍。多发病在CP中非常普遍。在中低收入国家，CP儿童的患病率、严重程度、合并症和死亡率更高。CP建议的证据基础绝大多数来自高收入国家的研究。迫切需要在低收入和中等收入国家环境中开展研究，包括当地临床医生，考虑当地情况并调查当地解决方案。方法本综述旨在识别和综合目前关于低收入国家CP患儿临床合并症管理的证据。数据提取和分析阶段遵循了乔安娜布里格斯研究所的指导方针。以下问题指导了范围审查：CP患儿的主要临床合并症是什么？诊断和治疗这些合并症的金标准是什么？在没有金标准的情况下，我们有哪些选择来诊断和治疗中低收入国家的这些合并症？结果我们的检索策略共检索到22 188篇文献，去除808个重复文献后，还剩下21 380篇。在筛选标题和摘要之后，1918年的引文进展到全文审查。共有194篇文章符合资格标准，并被纳入审查。综述的指导性问题回答了以下发病率：呼吸障碍、吞咽困难和误吸、胃食管反流病、流口水、阻塞性睡眠呼吸暂停综合征、营养不良、便秘、癫痫、睡眠障碍、痉挛、肌张力障碍、疼痛、髋关节疾病、脊柱侧凸和骨质疏松症。本文强调了采取适应中低收入国家现实的干预措施的必要性。增强中低收入国家儿科医生和卫生保健专业人员的权能对于早期诊断和主动干预至关重要。针对低收入和中等收入国家的具体指南可以更好地指导专业人员管理这些复杂的情况。

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

Child Care Health and Development 医学-小儿科

CiteScore

3.40

自引率

5.30%

发文量

136

审稿时长

4-8 weeks

期刊介绍： Child: care, health and development is an international, peer-reviewed journal which publishes papers dealing with all aspects of the health and development of children and young people. We aim to attract quantitative and qualitative research papers relevant to people from all disciplines working in child health. We welcome studies which examine the effects of social and environmental factors on health and development as well as those dealing with clinical issues, the organization of services and health policy. We particularly encourage the submission of studies related to those who are disadvantaged by physical, developmental, emotional and social problems. The journal also aims to collate important research findings and to provide a forum for discussion of global child health issues.