Abstract

BackgroundCerebral palsy (CP) is a common chronic childhood disorder worldwide. There is limited information about the CP panorama in sub-Saharan Africa. Our aim was to describe the clinical subtypes, gross and fine motor functions and presence of co-morbidities in a group of children with CP attending a tertiary hospital in Uganda.MethodsChildren with CP in the age range of 2-12 years visiting the paediatric CP clinic at Mulago Hospital, Kampala, were enrolled. Screening and inclusion were based on a three-stage procedure: i) Two screening questions from the Ten Question Screen; ii) Clinical assessments adapted from the Surveillance for Cerebral Palsy in Europe (SCPE); iii) Clinical examinations and diagnoses of subtype, severity level and co-morbidities. Caregivers were interviewed using questionnaires to provide information on child’s medical history and co-morbidities. Co-morbidity scores were calculated for each child.ResultsOne hundred and thirty five children with CP were enrolled (72 males, 63 females, median age 3 years 5 months, IQR-2 years 4 months-5 years 6 months). Bilateral spastic type was commonest (45%); moderate impairment in gross motor function was present in 43%, with comparable numbers (37%) in the mild and severely impaired fine motor function groups. The severe gross and fine motor function levels were seen in the bilateral spastic and dyskinetic CP subtypes.Signs of learning disability (75%) and epilepsy (45%) were the commonest co-morbidities. Higher co-morbidity scores were obtained in children with dyskinetic CP and severe levels of gross and fine motor function. There was a significant difference in distribution of the co-morbidity scores between the CP subtypes, gross motor and fine motor function levels (p <0.001). Signs of speech and language impairments were associated with bilateral spastic CP and severe gross and fine motor dysfunction (p < 0.05).ConclusionsBilateral spastic CP was the main clinical subtype, with signs of learning disability and epilepsy as major causes of co-morbidity. The severity of gross and fine motor function levels was related to severity of clinical CP subtypes. Our findings imply a higher occurrence of birth asphyxia or post natally acquired infections. Improvement in emergency obstetric and postnatal care may reduce this burden.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-015-1125-9) contains supplementary material, which is available to authorized users.

Highlights

  • Cerebral palsy (CP) is a common chronic childhood disorder worldwide

  • In order to get information about the situation in a subSaharan region we studied children with CP in Mulago Hospital, Kampala

  • The frequency distribution of CP type and severity is similar to other studies in previous literature in Low and Middle Income countries (LMIC) and High Income Countries (HIC) the frequency of the co-morbidities differs with speech and language impairments frequently coexistent

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Summary

Introduction

Cerebral palsy (CP) is a common chronic childhood disorder worldwide. There is limited information about the CP panorama in sub-Saharan Africa. Despite lack of reliable information on the prevalence of CP in Uganda, there is reason to believe that this condition is significant in view that for every 1,000 live births in Uganda approximately five children (5.4) do not live to their first birthday and four women (4.38) die during pregnancy and its related complications [5]. This is magnified by the frequent exposures to virus and other infections during pregnancy, greater birth trauma, malnutrition, HIV/AIDS and complications of cerebral infections especially cerebral malaria and meningoencephalitis

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