Prevalence and risk factors of neurological impairment among children aged 6–9 years from population based cross sectional study in western Kenya 英文参考文献.docVIP

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Prevalence and risk factors of neurological impairment among children aged 6–9 years from population based cross sectional study in western Kenya 英文参考文献.doc

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Prevalence and risk factors of neurological impairment among children aged 6–9 years from population based cross sectional study in western Kenya 英文参考文献

Kawakatsuetal.BMCPediatrics2012,12:186 /1471-2431/12/186 RESEARCH ARTICLE OpenAccess Prevalenceandriskfactorsofneurological impairmentamongchildrenaged6–9years:from populationbasedcrosssectionalstudyinwestern Kenya YoshitoKawakatsu1,2,6*,SatoshiKaneko3,4,MohamedKarama4,5andSumihisaHonda2 Abstract Background:Theburdenofdisabilityismoresevereamongchildreninlowincomecountries.Moreover,the numberofchildrenwithdisabilities(CWDs)insub-SaharanAfricaispredictedtoincreasewithreductioninchild mortality.AlthoughtheissueonCWDsisimportantinsub-SaharanAfrica,therearefewresearchesonriskfactorsof disabilities.Thepurposeofthisstudywastoevaluatetheriskfactorsofneurologicalimpairment(NI)among childreninwesternKenya. Methods:ThepresentstudywasconductedinMbitadistrict(whichhashighHIVinfectiousprevalence),Kenya fromApril2009toDecember2010.Thestudyconsistedoftwophases.Inphase1,theTenQuestionQuestionnaire (TQQ)wasadministeredtoall6362caregiversofchildrenaged6–9years.Inphasetwo,all413childrenwithTQQ positiveandasimilarnumberofcontrols(n=420)whichwererandomlyselectedfromchildrenwithTQQnegative wereexaminedforphysicalandcognitivestatus.Inaddition,astructuredquestionnairewasalsoconductedtotheir caregivers. Results:Theprevalencewasestimatedtobe29/1000.Amongthetypesofimpairments,cognitiveimpairmentwas themostcommon(24/1000),followedbyphysicalimpairment(5/1000).Inmultivariateanalysis,havingmorethan fivechildren[adjustedoddsratio(AOR):2.85;95%IC:1.25–6.49;p=0.013],maternalageolderthan35yearsold [AOR:2.31;95%IC:1.05–5.07;p=0.036]weresignificantfactorsassociatedwithNI.Inaddition,monthlyincome under3000ksh[AOR:2.79;95%IC:1.28–6.08;p=0.010]andnomaternaltetanusshotduringantenatalcare[AOR: 5.17;95%IC:1.56–17.14;p=0.007]werealsosignificantlyrelatedwithhavingmoderate/severeneurological impairment. Conclusion:Itwasindicatedthatincreasingcoverageofantenatalcareincludingmaternaltetanusshotand educationofhowtotakecareofneonatalchildrentopreventneurologicalimpairmentareimportant. Keywords:Disability,Neuroep