International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
Department of Ophthalmology, Calabar Children's Eye Centre, University of Calabar Teaching Hospital, Calabar, Cross River State, Nigeria.
Arch Dis Child. 2020 Jul;105(7):625-630. doi: 10.1136/archdischild-2019-317932. Epub 2020 Jan 20.
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.
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.
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.
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.
关于非洲儿童脑瘫的研究较少，本研究旨在描述尼日利亚儿童脑瘫的病因、特征和严重程度。
采用关键信息提供者方法（KIM）进行了一项基于人群的研究，作为一项临床研究试验的一部分。对 4-15 岁的儿童进行了脑瘫临床评估。
使用 KIM 估计的脑瘫患病率为 2.3/1000 名儿童（95%CI 2.0 至 2.5/1000）。388 名儿童被诊断为脑瘫，其中粗大运动功能分级系统（GMFCS）水平 1 为 70 名（18.1%），水平 2 为 156 名（40.2%），水平 3 为 54 名（13.9%），水平 4 为 54 名（13.9%），水平 5 为 54 名（13.9%）。300/388（77.3%）名患儿的手动能力分级系统（MACS）为 1-3 级，88 名（22.7%）为 4-5 级。脑瘫类型为痉挛型 271 名（70%），其中 60%为双侧，40%为单侧，共济失调型 38 名（9.8%），肌张力障碍型 18 名（4.6%），舞蹈手足徐动型 29 名（7.5%），无法分类型 32 名（8.3%）。140 名（36.1%）儿童存在围生期后脑瘫的危险因素，包括疟疾伴惊厥 101/140（72.1%）、疟疾伴昏迷 21/140（15.0%）、脑膜炎 12/140（8.6%）、结核病 2/140（1.4%）、镰状细胞病 3/140（2.2%）、艾滋病毒 1/221（0.7%）。248 名（63.9%）儿童存在围生期脑瘫的危险因素，其中出生窒息 118 名（47.6%），临床先天性风疹综合征 8 名（3.3%），高胆红素血症 59 名（23.8%）。
该人群的脑瘫特征与其他低收入和中等收入国家（LMIC）相似。一些确定的危险因素是可以预防的。需要为 LMIC 制定脑瘫预防和管理策略。
