Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
Dev Med Child Neurol. 2013 Apr;55(4):357-63. doi: 10.1111/dmcn.12103.
Children born in low- and mid-income countries are at a high risk of developing disabilities, yet estimates of population-based prevalence are sparse. Our aim was to determine the prevalence of early childhood (0-5 year) disability in Sind, a rural area of Pakistan.
We conducted a cross-sectional household survey in a population of 25,196 households. The Ten Questions screen and the Signs of Disability in Newborn and Infants screen were used.
The disability prevalence in a population of 176,364 individuals was 5.5 out of 1000 in children under 2 years and 5.4 out of 1000 in children aged 2-5 years. Fifty-six per cent were males, and 56% had the disability recognized from birth or soon after. The mortality rate of children aged 0-5 years in the area was estimated as 30 out of 1000 live births. Cerebral palsy was the most common disability identified. The Ten Questions screen had better interrater agreement than the Signs of Disability in Newborn and Infants screen.
This is the largest reported household screening survey for early childhood disability at a population level from rural Pakistan. The comparatively low prevalence may be due to the younger age studied and high early childhood mortality. Our data highlight the importance of prospective surveillance at a population level and the need for preventive and support services.
在中低收入国家出生的儿童有很高的残疾风险，但基于人群的患病率估计数据很少。我们的目的是确定巴基斯坦信德省（Sind）农村地区幼儿（0-5 岁）残疾的患病率。
我们在 25196 户家庭中进行了横断面家庭调查。使用了 10 个问题筛查和新生儿及婴儿残疾迹象筛查。
在 176364 名个体中，2 岁以下儿童的残疾患病率为每 1000 人中有 5.5 人，2-5 岁儿童的残疾患病率为每 1000 人中有 5.4 人。56%为男性，56%的残疾是从出生或出生后不久就被发现的。该地区 0-5 岁儿童的死亡率估计为每 1000 例活产中有 30 例。脑瘫是最常见的残疾类型。10 个问题筛查的评分者间一致性优于新生儿及婴儿残疾迹象筛查。
这是巴基斯坦农村地区从人群层面报告的最大规模的幼儿残疾家庭筛查调查。相对较低的患病率可能是由于研究的年龄较小和幼儿死亡率较高。我们的数据突出了在人群层面进行前瞻性监测的重要性，以及对预防和支持服务的需求。
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