Clinical features and aetiology of cerebral palsy in children from Cross River State, Nigeria

Arch Dis Child. 2020 Jul;105(7):625-630. doi: 10.1136/archdischild-2019-317932. Epub 2020 Jan 20.

Abstract

Objective: There are few studies on cerebral palsy (CP) in African children and our study aimed to describe the aetiology, characteristics and severity of CP in children from Nigeria.

Design: A population-based study using key informant methodology (KIM) was conducted as part of a clinical research trial. Children aged 4-15 years were clinically assessed for CP.

Results: The estimated prevalence of CP using KIM was 2.3/1000 children (95% CI 2.0 to 2.5/1000). 388 children were diagnosed with CP, with Gross Motor Function Classification System level 1 in 70 (18.1%), II in 156 (40.2%), III in 54 (13.9%), IV in 54 (13.9%), V in 54 (13.9%). 300/388 (77.3%) had Manual Ability Classification Scale of level 1-3 and 88 (22.7%) of level 4-5. CP types were spastic in 271 (70%), with 60% of these bilateral and 40% unilateral, ataxic 38 (9.8%), dystonic 18 (4.6%), choreoathetoid 29 (7.5%) and unclassifiable 32 (8.3%). Postneonatal risk factors for CP were seen in 140 (36.1%) children including malaria with seizures 101/140 (72.1%), malaria with coma 21/140 (15.0%), meningitis 12/140 (8.6%), tuberculosis 2/140 (1.4%), sickle cell disease 3/140 (2.2%), HIV 1/221 (0.7%). Prenatal/perinatal risk factors were seen in 248 (63.9%%), birth asphyxia 118 (47.6%) and clinical congenital rubella syndrome 8 (3.3%) and hyperbilirubinaemia 59 (23.8%) were identified as preventable risk factors for CP.

Conclusion: The profile of CP in this population is similar to that found in other low-income and middle-income countries (LMIC). Some risk factors identified were preventable. Prevention and management strategies for CP designed for LMIC are needed.

Keywords: aetiology; cerebral palsy; children; profile.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anemia, Sickle Cell / complications
  • Anemia, Sickle Cell / epidemiology
  • Birth Injuries / complications
  • Birth Injuries / epidemiology
  • Cerebral Palsy / classification
  • Cerebral Palsy / epidemiology*
  • Cerebral Palsy / etiology*
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Developing Countries / statistics & numerical data*
  • Female
  • HIV Infections / complications
  • HIV Infections / epidemiology
  • Humans
  • Hyperbilirubinemia / complications
  • Hyperbilirubinemia / epidemiology
  • Malaria / complications
  • Malaria / epidemiology
  • Male
  • Meningitis / complications
  • Meningitis / epidemiology
  • Nigeria / epidemiology
  • Odds Ratio
  • Prevalence
  • Rubella Syndrome, Congenital / complications
  • Rubella Syndrome, Congenital / epidemiology
  • Severity of Illness Index
  • Tuberculosis / complications
  • Tuberculosis / epidemiology