Abstract
BackgroundHip dysplasia is common among children with cerebral palsy (CP), particularly in spastic CP. It can result in pain, reduced function and quality of life. However, the burden of hip dysplasia among children with CP in llow-and middle-income countries (LMICs) like Bangladesh is unknown. We aimed to define the burden of hip dysplasia among children with spastic CP in Bangladesh.MethodsThis study includes a subset of the Bangladesh CP Register (BCPR) study cohort who were registered between January and March 2015. The BCPR is a population-based surveillance of children with CP (aged < 18 years) operating in a northern sub-district (Shahjadpur; child population ~ 226,114) of Bangladesh. Community-based key informant’s method (KIM) survey conducted to identify children with CP in the surveillance area. A diagnosis of CP was made based on clinical history and examination by the study physicians and physiotherapist. Study participants had an antero-posterior (AP) X-ray of their pelvis. The degree of subluxation was assessed by calculating the migration percentage (MP).ResultsDuring the study period, 196 children with CP were registered, 144 had spastic CP. 40 children with spastic CP (80 hips) had pelvic X-Rays (mean age 9.4 years, range 4.0–18.0 years) and 32.5% were female. Gross Motor Function Classification System (GMFCS) showed 37.5% (n = 15) with GMFCS level I-II and 62.5% (n = 25) with GMFCS level III-V. Twenty percent (n = 8) of the children had hip subluxation (MP: 33–80%). Osteopenic changes were found in 42.5% (n = 17) children.ConclusionsTo the best of our knowledge this is one of the first studies exploring hip dysplasia among children with spastic CP in Bangladesh. Our findings reflect that hip dysplasia is common among children with spastic CP. Introduction of hip surveillance programmes is imperative for prevention of secondary complications, reduced function and poor quality of life among these children.
Highlights
Hip dysplasia is common among children with cerebral palsy (CP), in spastic CP
Most of the studies on hip dysplasia among children with CP are reported from high-income countries, and mostly from areas with an existing hip surveillance programme
We aimed to describe the burden of hip dysplasia among a population-based cohort of children with CP in rural Bangladesh using the Bangladesh CP Register (BCPR) to inform clinicians and public health professionals [16]
Summary
Hip dysplasia is common among children with cerebral palsy (CP), in spastic CP It can result in pain, reduced function and quality of life. Cerebral palsy (CP) is a heterogenous group of conditions that affects the developing brain, resulting in a permanent non-progressive dysfunction of the central nervous system manifested by disorders of motor function, movement, and posture [1]. It is the leading cause of childhood physical disability globally affecting two to three children per thousand live births [2, 3]. There is limited data on hip dysplasia from LMICs such as Bangladesh where the burden of CP is substantially high [4]
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