Murthy Gudlavalleti V S, Mactaggart Islay, Mohammad Muhit, Islam Johurul, Noe Christiane, Khan Aynul Islam, Foster Allen
Faculty of Infectious & Tropical Diseases, Department of Clinical Research, International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK.
Child Sight Foundation, Dhaka, Bangladesh.
Arch Dis Child. 2014 Dec;99(12):1103-8. doi: 10.1136/archdischild-2014-305937. Epub 2014 Jul 8.
The study was conducted to determine whether trained key informants (KI) could identify children with impairments.
Trained KI identified children with defined impairments/epilepsy who were then examined by a medical team at a nearby assessment centre (Key Informant Methodology: KIM). A population-based household randomised sample survey was also conducted for comparing the prevalence estimates.
Three districts in North Bangladesh.
Study population of approximately 258 000 children aged 0-<18 years, within which 3910 children were identified by KI, 94.8% of whom attended assessment camps. In the household survey, 8120 children were examined, of whom 119 were identified with an impairment/epilepsy.
Prevalence estimates of severe visual impairment (SVI), moderate/severe hearing impairment (HI), substantial physical impairment (PI) and epilepsy.
Overall prevalence estimates of impairments, including presumed HI, showed significant differences comparing KIM (9.0/1000 (95% CI 8.7 to 9.4)) with the household survey (14.7/1000 (95% CI 12.0 to 17.3)). Good agreement was observed for SVI (KIM 0.7/1000 children: survey 0.5/1000), PI (KIM 6.2/1000 children: survey 8.0/1000) and epilepsy (KIM 1.5/1000 children: survey 2.2/1000). Prevalence estimates for HI were much lower using KIM (2/1000) compared to the survey (6.4/1000). Excluding HI, overall prevalence estimates were similar (KIM: 7.5/1000 children (95% CI 7.2 to 7.8) survey: 8.4/1000 (95% CI 6.4 to 10.4)).
KIM offers a low cost and relatively rapid way to identify children with SVI, PI and epilepsy in Bangladesh. HI is underestimated using KIM, requiring further research.
开展本研究以确定经过培训的关键信息提供者（KI）能否识别出有损伤的儿童。
经过培训的KI识别出患有特定损伤/癫痫的儿童，随后由附近评估中心的医疗团队对这些儿童进行检查（关键信息提供者方法：KIM）。还进行了一项基于人群的家庭随机抽样调查以比较患病率估计值。
孟加拉国北部的三个地区。
研究人群为约25.8万名0至未满18岁的儿童，其中KI识别出3910名儿童，这些儿童中有94.8%参加了评估营地。在家庭调查中，检查了8120名儿童，其中119名被识别为有损伤/癫痫。
重度视力损伤（SVI）、中度/重度听力损伤（HI）、严重身体损伤（PI）和癫痫的患病率估计值。
包括推定HI在内的损伤总体患病率估计值显示，KIM（9.0/1000（95%CI 8.7至9.4））与家庭调查（14.7/1000（95%CI 12.0至17.3））相比存在显著差异。对于SVI（KIM为0.7/1000名儿童：调查为0.5/1000）、PI（KIM为6.2/1000名儿童：调查为8.0/1000）和癫痫（KIM为1.5/1000名儿童：调查为2.2/1000），观察到了良好的一致性。与调查（6.4/1000）相比，使用KIM得出的HI患病率估计值要低得多（2/1000）。排除HI后，总体患病率估计值相似（KIM：7.5/1000名儿童（95%CI 7.2至7.8），调查：8.4/1000（95%CI 6.4至10.4））。
在孟加拉国，KIM提供了一种低成本且相对快速的方法来识别患有SVI、PI和癫痫的儿童。使用KIM会低估HI，需要进一步研究。
