A systematic review of cerebral palsy in African paediatric populations
Date
2022-09
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Stellenbosch : Stellenbosch University
Abstract
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.
AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar.
AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar.
Description
Thesis (MMed) -- Stellenbosch University, 2022.
Keywords
Cerebral palsy -- Africa, Pediatric neurology -- Africa, Fetus -- Development -- Africa, Infants -- Development -- Africa, Children -- Diseases -- Africa