IJE Advance Access published online on February 21, 2006
International Journal of Epidemiology, doi:10.1093/ije/dyl023
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1 Center for Geographic Medicine-Coast, Kenya Medical Research Institute, PO 428, Kilifi, Kenya
* To whom correspondence should be addressed. Background There is little data on the burden of neurological impairment (NI) in developing countries, particularly in children of Africa. Methods We conducted a survey of NI in children aged 6-9 years in a rural district of Kenya. First, we screened for neurological disability by administering the Ten Questions Questionnaire (TQQ) to parents/guardians of children in a defined population. In phase two, we performed a comprehensive clinical and psychological assessment on children who tested positive on TQQ and on a similar number of children who tested negative. Results A total of 10 218 children were screened, of whom 955 (9.3%) were positive on TQQ. Of these, 810 (84.8%) were assessed, and of those who tested negative 766 (8.3%) were assessed. The prevalence for moderate/severe NI was 61/1000 [95% confidence interval (95% CI) 48-74]. The most common domains affected were epilepsy (41/1000), cognition (31/1000), and hearing (14/1000). Motor (5/1000) and vision (2/1000) impairments were less common. Of the neurologically impaired children (n = 251), 56 (22%) had more than one impairment. Neonatal insults were found to have a significant association with moderate/severe NI in both the univariate [odds ratio (OR) = 1.70; 95% CI 1.12-2.47] and multivariate analyses (OR = 1.30; 95% CI 1.09-1.65). Conclusions There is a considerable burden of moderate/severe NI in this area of rural Kenya, with epilepsy, cognition, and hearing being the most common domains affected. Neonatal insults were identified as an important risk factor.
Accepted January 30, 2006
Original paper
Prevalence and risk factors of neurological disability and impairment in children living in rural Kenya
V. Mung'ala-Odera 1 *,
R. Meehan 1,
P. Njuguna 1,
N. Mturi 1,
K. J. Alcock 2,
and
C. R. J. C. Newton 3
2 Department of Psychology, University of Lancaster, Lancaster, UK
3 Center for Geographic Medicine-Coast, Kenya Medical Research Institute, PO 428, Kilifi, Kenya; Neurosciences Unit, Institute of Child Health, University College, London, UK
V. Mung'ala-Odera, E-mail: vodera{at}kilifi.mimcom.net
Abstract
A Commentary has been commissioned to accompany this article and will appear with this paper in the printed issue.
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