Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
Department of Pediatrics and Child Health, Makerere University, Kampala, Uganda.
Dev Med Child Neurol. 2020 Apr;62(4):454-462. doi: 10.1111/dmcn.14401. Epub 2019 Nov 25.
To describe the functional limitations and associated impairments of children with cerebral palsy (CP) in rural Uganda, and care-seeking behaviour and access to assistive devices and education.
Ninety-seven children with CP (42 females, 55 males; age range 2-17y) were identified in a three-stage population-based screening with subsequent medical examinations and functional assessments. Information on school and access to care was collected using questionnaires. The data were compared with Swedish and Australian cohorts of children with CP. We used the χ test and linear regression models to analyse differences between groups.
Younger children were more severely impaired than older children. Two-fifths of the children had severe impairments in communication, about half had intellectual disability, and one third had seizures. Of 37 non-walking children, three had wheelchairs and none had walkers. No children had assistive devices for hearing, seeing, or communication. Care-seeking was low relating to lack of knowledge, insufficient finances, and 'lost hope'. One-third of the children attended school. Ugandan children exhibited lower developmental trajectories of mobility and self-care than a Swedish cohort.
The needs for children with CP in rural Uganda are not met, illustrated by low care-seeking, low access to assistive devices, and low school attendance. A lack of rehabilitation and stimulation probably contribute to the poor development of mobility and self-care skills. There is a need to develop and enhance locally available and affordable interventions for children with CP in Uganda.
Development of mobility and self-care skills is lower in Ugandan than Swedish children with cerebral palsy (CP). Older children in Uganda with CP are less impaired than younger children. Untreated seizures and impairments of communication and intellect are common. Access to health services, assistive devices, and education is low. Caregivers lack knowledge and finances to seek care and often lose hope of their child improving.
描述乌干达农村地区脑瘫儿童（CP）的功能障碍及其相关障碍、寻求护理的行为以及获得辅助器具和教育的情况。
通过三阶段的人群基础筛查，对 97 名 CP 儿童（42 名女性，55 名男性；年龄 2-17 岁）进行了鉴定，随后进行了医学检查和功能评估。使用问卷调查收集了有关学校和护理获得情况的信息。使用 χ 检验和线性回归模型分析了组间差异。
年龄较小的儿童比年龄较大的儿童更严重受损。五分之二的儿童在沟通方面存在严重障碍，大约一半的儿童存在智力残疾，三分之一的儿童存在癫痫发作。在 37 名无法行走的儿童中，有 3 人使用轮椅，没有使用助行器的儿童。没有儿童配备用于听力、视力或沟通的辅助器具。由于缺乏知识、资金不足和“失去希望”，寻求护理的比例较低。三分之一的儿童上学。乌干达儿童的移动和自理能力发展轨迹低于瑞典队列。
乌干达农村地区 CP 儿童的需求未得到满足，表现在寻求护理、获得辅助器具和上学的机会低。缺乏康复和刺激可能导致移动和自理技能发展不良。需要为乌干达的 CP 儿童制定和加强当地可用且负担得起的干预措施。
乌干达 CP 儿童的移动和自理技能发展水平低于瑞典儿童。乌干达年龄较大的 CP 儿童比年龄较小的儿童受损程度较低。未经治疗的癫痫发作以及沟通和智力障碍很常见。获得卫生服务、辅助器具和教育的机会很低。照顾者缺乏知识和资金来寻求护理，并且经常对孩子的改善失去希望。
