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Cerebral palsy in African paediatric populations: A scoping review
Serini Murugasen1,2, Priscilla Springer1, Bolajoko O Olusanya3
1Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa.
Insights
Cerebral palsy (CP) in African children presents unique challenges, including higher mortality and severe impairments. More research is needed to understand risk factors and improve care access for these children.
Area of Science:
- Pediatrics
- Neurology
- Public Health
Background:
- Cerebral palsy (CP) affects children globally, with varying epidemiology and outcomes.
- Understanding the specific context of CP in African children is crucial for targeted interventions.
Purpose of the Study:
- To review the epidemiology and outcomes of African children with cerebral palsy (CP) over a 21-year period.
Main Methods:
- A comprehensive literature search was conducted across PubMed, Scopus, and Web of Science databases.
- Original research on African children (aged ≤18 years) with CP published between 2000 and 2021 was included.
Main Results:
- Prevalence of CP in Africa ranged from 0.8 to 10 per 1000 children.
- African children with CP faced significantly higher premature mortality (approx. 25x general population), often due to infections.
- Comorbidities like epilepsy and intellectual disability were common, alongside inadequate access to care and education.
Conclusions:
- The prevalence of CP in Africa requires further investigation.
- African children with CP exhibit distinct risk profiles, higher mortality, and more severe impairments compared to those in the Global North.
- Barriers to optimal care persist, highlighting the need for larger African studies on effective interventions.
Aim:
To review the epidemiology and outcomes of African children with cerebral palsy (CP) over a 21-year period.
Method:
The PubMed, Scopus, and Web of Science online databases were searched for original research on African children with CP aged 18 years and younger published from 2000 to 2021.
Results:
A total of 1811 articles underwent review against explicit criteria; 93 articles were selected for inclusion in the scoping review. The reported prevalence of CP ranged from 0.8 to 10 per 1000 children. Almost half had perinatal risk factors, but up to 26% had no identifiable risk factor. At least one-third of children with CP had one or more comorbidities, most commonly epilepsy, intellectual disability, and malnutrition. African children with CP demonstrated excess premature mortality approximately 25 times that of the general population, predominantly from infections. Hospital-based and younger populations had larger proportions of children with severe impairments. African children with CP had inadequate access to care and education, yet showed functional improvements compared to controls for all evaluated interventions.
Interpretation:
The prevalence of CP in Africa remains uncertain. African children with CP have different risk profiles, greater premature mortality, and more severe functional impairments and comorbidities compared to the Global North. Several barriers prevent access to optimal care. Larger African studies on validated and effective interventions are needed.
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