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Data on cerebral palsy in Vietnam will inform clinical practice and policy in low and middle-income countries
Tasneem Karim1,2,3,4, Rachael Dossetor1, Nguyen Thi Huong Giang5
1Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
Insights
This study documented a high burden of severe cerebral palsy (CP) in Vietnamese children, highlighting potentially preventable risk factors. Enhanced surveillance and access to assistive devices are crucial for improving care in low-resource settings.
Area of Science:
- Pediatrics
- Neurology
- Rehabilitation Medicine
Background:
- Cerebral palsy (CP) presents a significant global health challenge, particularly in low and middle-income countries (LMICs).
- Understanding the epidemiology, risk factors, and rehabilitation needs of children with CP is essential for developing targeted interventions.
Purpose of the Study:
- To document risk factors, clinical severity, associated impairments, and rehabilitation status of children with CP presenting to the National Children's Hospital (NCH) in Hanoi, Vietnam.
- To establish hospital-based surveillance for CP in Vietnam.
Main Methods:
- Active prospective surveillance of CP cases presenting to NCH between June and November 2017.
- Data collection modeled on the Paediatric Active Enhanced Disease Surveillance system.
Main Results:
- 765 children with CP were identified; 95.2% had spastic CP, and 69.6% were quadriplegic.
- 60.3% were classified at Gross Motor Functional Classification System levels III-V, indicating severe impairment.
- 76.2% had associated impairments, with presumed perinatal asphyxia (36.3%) and preterm birth (26.5%) as common risk factors.
- Physiotherapy was the most common intervention (94.3%), but only 2.6% of children needing wheelchairs had them.
Conclusions:
- Hospital-based surveillance confirmed a high burden and severity of CP in Hanoi, with potentially preventable risk factors.
- There is an urgent need for improved clinician training, evidence-based interventions, and access to assistive devices.
- The findings will inform health policy and capacity building for CP care in Vietnam and other LMICs.
Purpose:
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.
Materials And Methods:
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.
Results:
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%, n = 729), most were quadriplegic (69.6%, n = 532) and 60.3% (n = 454) were Gross Motor Functional Classification System level III-V. Of the children 76.2% (n = 583) had one/more associated impairments. 36.3% (n = 276) had presumed perinatal asphyxia, 26.5% (n = 202) were preterm. Physiotherapy (94.3%, n = 663) was the most common form of intervention used. Only 2.6% (n = 12) of the children who would have benefitted from assistive devices had wheelchairs.
Conclusion:
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.
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