Paralytic poliomyelitis in Addis Ababa: follow-up survey of registered children

A survey was carried out of children resident in Addis Ababa with paralytic poliomyelitis who had been registered at a weekly-held multidisciplinary "polio clinic" at the Ethio-Swedish Children's Hospital. The children were physically examined and traced to their homes, where a questionnaire was completed yielding demographic data, initial disease presentation and subsequent treatment. A total of 557 (90%) children were traced, of whom 80% were between the ages of 5 and 16 years. The pattern of disease with predominantly lower limb involvement was similar to that in previous reports. Contractures were frequent, 50% having contractures both at initial presentation and on follow-up. Standard treatment protocols were offered. Initially, 70% of the patients required a walking aid. Follow-up showed poor compliance, with only half the children using the walking aid. Forty-seven per cent of the patients had not attended the clinic for over 2 years, those with moderate disability being more likely to attend. The survey suggested that poor compliance may be related to a poor understanding of the disease and benefits of rehabilitation, lack of transport and financial constraints. During the past 4 years a further 305 children from the city presented to the clinic with poliomyelitis. Rehabilitation of handicapped children is a problem in all developing countries and the lessons learned from this study may be useful to others planning rehabilitation programmes.