Share This Article:

Causes of developmental delay in children of 5 to 72 months old at the child neurology unit of Yaounde Gynaeco-Obstetric and Paediatric Hospital (Cameroon)

Abstract Full-Text HTML Download Download as PDF (Size:327KB) PP. 279-285
DOI: 10.4236/ojped.2013.33050    5,019 Downloads   7,381 Views   Citations

ABSTRACT

Background: According to the World Health Organization, about 5% of children world-wide of 14-year-old and under have a moderate to severe developmental disability, and up to 15% of children under 5-year-old are developmentally delayed. Purpose: To determine the prevalence, socio-demographic profile, aetiologies, and the clinical presentation of developmental delay in children less than 6-year-old at the child neurology unit in a university-affiliated hospital in Yaounde. Materials and methods: It was a crosssectional descriptive study carried out in Yaounde Gynaeco-Obstetric and Paediatric Hospital (Cameroon) from August to December 2012. Children aged between 5 - 72 months with a developmental quotient less than 70 were enrolled. Developmental delay (DD) was diagnosed and classified using the Denver developmental screening test (DDST). Data concerning the child (age, gender, severity of DD), the mother (age, age at conception, educational level, marital status), history of pregnancy and delivery, perinatal and postnatal events, results of para-clinical explorations (EEG, CT-scan, genetic tests), the severity of DD and the probable or demonstrate cause of DD were recorded on a standardized questionnaire. The chisquare test was used to compare variables. Results: During the study period, 2171 children aged 5 - 72 months consulted the paediatric department of the hospital, 296 were examined at the child neurology unit of which 153 had a developmental quotient less than 70, giving a hospital prevalence of 7.0% and a prevalence of 51.7% at the child neurology unit. The mean age was 26.6 ± 18.0 months and there were 56% males. The main reason for consulting was tonus disorder (43.8%) and the developmental area of parental concern was the motor domain (90.2%). Regarding the clinical presentation, 75.2% of our population were children with cerebral palsy. DD was severe, mild, moderate and profound respectively in 14.2%, 13.5%, 12.2%, and 11.1%. Gross DD represented 90.2% of all DD children. The causes of DD were hypoxic-ischemic encephalopathy (41.8%), epilepsy (13.7%), sequelae of meningitis (6.5%), sequelae of kernicterus (6.5%), and infectious embryofoetopathies (5.2%). Conclusion: Developmental delay is frequent in paediatric neurology, with perinatal disorders being the leading aetiologies in Cameroon. Prevention of perinatal hypoxic-ischemic encephalopathy risk factors needs to be reinforced.


Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Nguefack, S. , Kamga, K. , Moifo, B. , Chiabi, A. , Mah, E. and Mbonda, E. (2013) Causes of developmental delay in children of 5 to 72 months old at the child neurology unit of Yaounde Gynaeco-Obstetric and Paediatric Hospital (Cameroon). Open Journal of Pediatrics, 3, 279-285. doi: 10.4236/ojped.2013.33050.

References

[1] Ellis, M., Manandher, N., Shrestha, P.S., Shrestha, L.M.D. and Costello, A.M. (1999) Outcome at 1 year of neonatal encephalopathy in Kathmandu, Nepal. Developmental Medicine & Child Neurology, 41,687-695. doi:10.1017/S0012162299001413
[2] Anderson, L.M., Shinn, C., Fullilove, M.T., et al. (2003) The effectiveness of early childhood development program: A systemic review. American Journal of Preventive Medicine, 24, 32-46. doi:10.1016/S0749-3797(02)00655-4
[3] Engle, P.L., Black, M.M. and Behrman, J.R. (2007) Strategies to avoid the loss of developmental potential in more than 200 million children in the developing world. Lancet, 369, 229-242. doi:10.1016/S0140-6736(07)60112-3
[4] Peter, M.C., Keibe, D.A. and Palmer, F.B. (1998) Classification of developmental delays. Seminars in Pediatric Neurology, 5, 2-14. doi:10.1016/S1071-9091(98)80012-0
[5] Burton, K.J. and Allen, S. (2003) A review of neurological disorders presenting at a paediatric neurology clinic and response to anticonvulsant therapy in Gambian children. Annals of Tropical Paediatrics, 23, 139-143. doi:10.1179/027249303235002215
[6] World Health Organization (2008) The global burden of disease. World Health Organization Press, Geneva.
[7] Narayaman, H.S., Rao, B.S., Rao, P.M. and Subbnkrishna, D.K. (1987) Observation of mental retarded cases with special reference to consanguinity. NIMHANS Journal, 5, 121-123.
[8] Singh, H., Nizamie, A., Jahan, M., Jagadheesan, K. and Nizamie, S.H. (2002) Profiles of individuals with mental retardation in Ranchi: A community study. Indian Journal of Clinical Psychology, 29, 178-185.
[9] Persha, A.J. and Rao, V.R. (2003) Early intervention a service model; early intervention to IUGR children at risk for developmental delays Secumderabad: National institude for the mentally handicapped 2003. Manovikasnaga, India.
[10] Majnemer, A. (1998) Benefits of early intervention for children with developmental disabilities. Seminars in Pediatric Neurology, 5, 62-69. doi:10.1016/S1071-9091(98)80020-X
[11] Meliegy, E.E. and Sabbagh, H.E. (2004) Etiologies of developmental delay in Egyptian children. International Journal of Child Neuropsychiatry, 1, 29-40.
[12] Campell, F.A., Ramey, C.T., Pungello, E., Sparling, J. and Miller-Johnson, S. (2002) Early childhood education: Young adult outcomes from the abecedarian project. Applied Developmental Science, 6, 42-57. doi:10.1207/S1532480XADS0601_05
[13] Rydz, D., Srour, M., Oskoui, M., et al. (2006) Screening for developmental delay in the setting of a community pediatric clinic: A prospective assessement of parent-report auestionnaires. Pediatrics, 118, 1178-1186. doi:10.1542/peds.2006-0466
[14] Accurso, F.J., Ambruso, D.R., Anderson, M.S., et al. (2009) Child development and behaviour. In: The Mc-Graw-Hill Companies, Ed., Current Diagnosis and Treatment: Paediatric, The McGraw-Hill Companies, New York.
[15] Kirsty, D. (2011) Developmental assessement of the prescholer. Department of Developmental Paediatrics, Red Cross Children’s Hospital, Johanesburg.
[16] Adebamia, O.J., Onigbindea, O.M., Joel-Medewasea, V., Oyedejia, A.G. and Afolabib, A.A. (2011) Neurological disorders among children in Osogbo, southwestern Nigeria. Journal of Pediatric Neurology, 9, 341-345.
[17] Bang, K. (2008) Analysis of risk factors in children with suspected developmental delay. World Academy of Science, Engineering and Technology, 36, 3070-3074.
[18] Johnson, M. and Hagberg, H. (2007) Sex and the pathogenesis of cerebral palsy. Developmental Medicine and Child Neurology, 49, 74-78. doi:10.1017/S0012162207000199.x
[19] Ellis, M., Manandhar, N. and Manandhar, D. (2000) Risk factors for neonatal encephalopathy in Kathmandu, Nepal, a developing country: Unmatched case-control study. BMJ, 320, 1229-1236. doi:10.1136/bmj.320.7244.1229
[20] Badawi, N., Kurinczuk, J.J., Keogh, J.M., et al. (1998) Intrapartum risk factors for newborn encephalopathy: The Western Australian case-control study. BMJ, 317, 1554-1558. doi:10.1136/ bmj.317.7172.1554
[21] Badawi, N., Kurinczuk, J.J., Keogh, J.M., et al. (1998) Antepartum risk factors for newborn encephalopathy: The Western Australian case-control study. BMJ, 317, 1549-1553. doi:10.1136/ bmj.317.7172.1549
[22] Institut National de la Statistique (INS) et ICF International (2012) Enquête demographique et de sante et a indicateurs multiples du cameroun 2011. INS et ICF International, Calverton, 72-86.
[23] Itoo, B.A., Al-Hawsawi, Z.M. and Khan, A.H. (2003) Hypoxic ischemic encephalopathy incidence and risk factors in North Western Saudi Arabia. Saudi Medical Journal, 24, 147-153.
[24] Chen, I.C., Lee, H.C., Yeh, G.C., Lai, C.H. and Chen, S.C. (2004) The relationship between parental concerns and professional assessment in developmental delay in infants and children: A hospital-based study. Journal of the Chinese Medical Association, 67, 239-244.
[25] Bediang, G.W. (2008) Aspects cliniques, etiologiques et scanographiques des infirmites motrices cérebrales de l’enfant a Yaoundé. University of Yaounde I, Yaoundé.
[26] Mbonda, E., Nguefack, S., Chiabi, A., et al. (2011) Epilepsie chez les enfants atteints d’infirmite motrice cerebrale: A propos de 412 observations à Yaoundé, Cameroun. Clinics in Mother and Child Health, 8, 1-5. doi:10.4303/cmch/C110801
[27] Ikeoluwa, A.L. and Oluyemisi, J.F. (2009) The child with cerebral palsy in a developing country—Diagnosis and beyond. Journal of Pediatric Neurology, 7, 375-379.
[28] Santos, R.S., Araujo, A.P. and Porto, M.A. (2008) Early diagnosis of abnormal development of preterm newborns: Assessment instrument. Journal of Pediatrics, 84, 289-299. doi:10.2223/JPED.1815
[29] Behrman, R., Kliegman, R. and Jenson H. (2000) Nelson textbook of pediatrics. 16th Edition, WB Sauders Company, Philadelphia, 493-494.
[30] Tebeu, P.M., Mboudou, E., Halle, G., Kongnyuy, E., Nkwabong, E. and Fomulu, J.N. (2011) Risk factors of delivery by caesarean section in Cameroon (2003-2004): A regional hospital report. ISRN Obstetrics and Gynecology, 6, 1-6.
[31] Paxton, A., Bailey, P. and Lobis, S. (2006) The united nations process indicators for emergency obstetric care: Reflections based on a decade of experience. International Journal of Gynecology and Obstetrics, 95, 192-208. doi:10.1016/j.ijgo.2006.08.009
[32] Bouhadiba, Z., Dacher, J., Monroc, M., Vanhulle, C., Ménard, J.F. and Kalifa, G. (2000) MRI of the brain in the evaluation of children with developmental delay. Journal of Radiology, 81, 870-873.
[33] Filippi, C.G., Lin, D.D., Tsiouris, A.J., et al. (2003) Diffusion-tensor MR imaging in children with developmental delay: Preliminary findings. Radiology, 229, 44-50. doi:10.1148/radiol.2291020049

  
comments powered by Disqus

Copyright © 2018 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.