Katangwe Thembi J, Kruger Mariana, van Toorn Ronald, van Zyl Jeanetta, Ndlovu Sandile, Solomons Regan, Donald Kirsten A
Department of Pediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa.
School of Psychology, University of KwaZulu-Natal, Pietermaritzburg, South Africa.
Afr J Disabil. 2024 Oct 30;13:1449. doi: 10.4102/ajod.v13i0.1449. eCollection 2024.
Population-based data show high proportions of severe cases of cerebral palsy (CP) in resource-poor regions such as sub-Saharan Africa, where most children have potentially preventable risk factors (factors that may increase the likelihood of CP occurrence but can be mitigated through medical interventions).
This study aimed to describe the demographic and clinical profile of children living with CP accessing services at Tygerberg Hospital over a period of 10 years (2010-2020), identify the potential gaps in care (proportion of individuals in a country requiring but not receiving suboptimal or inadequate care), and comparison with a similar study at the same centre two decades ago.
This 10-year retrospective study investigated causes and morbidities in children with CP, attending a central hospital in the Western Cape, South Africa.
A total of 613 children with CP were identified. Perinatal causes were predominant, especially in 57.7% ( = 354) of the cohort: perinatal asphyxia (41.1%) and preterm birth (16.6%). Postnatal causes constituted 15.2% ( = 93), which included tuberculous meningitis (3.6%) and bacterial meningitis (3.6%). The most common complications were intellectual impairment (61.8%; = 379); epilepsy (30.8%; = 189) and visual impairment (54.7%; = 234). A third of the cohort had severe CP, classified as Gross Motor Function Classification System IV and V (38%).
Most of the previously documented main drivers of CP are still present and the implementation of healthcare prevention strategies remains inadequate.
This study provides longitudinal evidence to confirm that CP in a South African setting is associated with a high burden of potentially preventable causes.
基于人群的数据显示，在撒哈拉以南非洲等资源匮乏地区，脑瘫（CP）重症病例的比例很高，那里的大多数儿童都有潜在的可预防风险因素（这些因素可能增加脑瘫发生的可能性，但可通过医疗干预减轻）。
本研究旨在描述在泰格伯格医院接受服务的脑瘫患儿在10年期间（2010 - 2020年）的人口统计学和临床特征，确定护理方面的潜在差距（一个国家中需要但未得到次优或不足护理的个体比例），并与20年前同一中心的类似研究进行比较。
这项为期10年的回顾性研究调查了南非西开普省一家中心医院脑瘫患儿的病因和发病率。
共确定了613例脑瘫患儿。围产期病因占主导，特别是在队列中的57.7%（n = 354）：围产期窒息（41.1%）和早产（16.6%）。产后病因占15.2%（n = 93），其中包括结核性脑膜炎（3.6%）和细菌性脑膜炎（3.6%）。最常见的并发症是智力障碍（61.8%；n = 379）；癫痫（30.8%；n = 189）和视力障碍（54.7%；n = 234）。三分之一的队列患有重度脑瘫，分类为粗大运动功能分类系统IV级和V级（38%）。
大多数先前记录的脑瘫主要驱动因素仍然存在，医疗预防策略的实施仍然不足。
本研究提供了纵向证据，证实南非环境下的脑瘫与潜在可预防病因的高负担相关。
