Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
CSF Global, Dhaka, Bangladesh.
Disabil Rehabil. 2022 Jun;44(13):3081-3088. doi: 10.1080/09638288.2020.1854872. Epub 2021 Jan 4.
To document known risk factors, clinical severity, associated impairments and rehabilitation status of children presenting with cerebral palsy (CP) to the National Children's Hospital (NCH) in Hanoi, Vietnam.
Active prospective ascertainment of cases of CP presenting between June and November 2017 to the NCH using surveillance modelled on the Paediatric Active Enhanced Disease Surveillance system in Australia.
Data were collected on 765 children with CP (mean age: 2 years 7 months (SD 2 y 6 mo). Mean age at diagnosis was 1 year 8 months (SD 1 y 9 mo). Children predominantly had spastic CP (95.2%, = 729), most were quadriplegic (69.6%, = 532) and 60.3% ( = 454) were Gross Motor Functional Classification System level III-V. Of the children 76.2% ( = 583) had one/more associated impairments. 36.3% ( = 276) had presumed perinatal asphyxia, 26.5% ( = 202) were preterm. Physiotherapy (94.3%, = 663) was the most common form of intervention used. Only 2.6% ( = 12) of the children who would have benefitted from assistive devices had wheelchairs.
We established hospital-based surveillance of CP in Hanoi and confirmed a high burden and severity of CP with potentially preventable risk factors. These data will inform clinician training and health policy and identify need for evidence-based care and assistive devices.IMPLICATIONS FOR REHABILITATIONWe identified a high number of children with severe forms of cerebral palsy (CP) in Hanoi, Vietnam through hospital-based surveillance.There is an urgent need for clinician training and access to and use of evidence-based interventions including assistive technology.This study will inform local capacity building and health policy for improved diagnosis and care of children with CP in Vietnam and other low and middle-income countries.
记录到越南河内国家儿童医院（NCH）就诊的脑瘫患儿的已知危险因素、临床严重程度、相关损伤和康复状况。
采用澳大利亚儿科主动强化疾病监测系统模型，对 2017 年 6 月至 11 月期间在 NCH 就诊的脑瘫患儿进行主动前瞻性病例发现。
共收集了 765 例脑瘫患儿的数据（平均年龄：2 岁 7 个月（SD 2y 6mo）。平均诊断年龄为 1 岁 8 个月（SD 1y 9mo）。患儿主要患有痉挛型脑瘫（95.2%，729 例），大多数为四肢瘫（69.6%，532 例），60.3%（454 例）为粗大运动功能分级系统 III-V 级。76.2%（583 例）的患儿存在 1 种或多种相关损伤。36.3%（276 例）有围产期窒息的假定病因，26.5%（202 例）为早产儿。最常用的干预形式是物理疗法（94.3%，663 例）。仅有 2.6%（12 例）本应受益于辅助器具的患儿有轮椅。
我们在河内建立了脑瘫医院监测，并证实了脑瘫的高负担和严重程度，且存在潜在可预防的危险因素。这些数据将为临床医生培训和卫生政策提供信息，并确定对循证护理和辅助器具的需求。
我们通过医院为基础的监测在越南河内发现了大量患有严重脑瘫的儿童。急需进行临床医生培训，并获得和使用循证干预措施，包括辅助技术。本研究将为越南和其他中低收入国家改善脑瘫患儿的诊断和护理提供当地能力建设和卫生政策方面的信息。
