Risk Factors for Cerebral Palsy in Children in Botswana

Publication date: Available online 3 August 2017
Source:Pediatric Neurology
Author(s): Baphaleng Monokwane, Allison Johnson, Claudia Gambrah-Sampaney, Esha Khurana, James Baier, Esther Baranov, Kate D. Westmoreland, Loeto Mazhani, Andrew P. Steenhoff, David R. Bearden
BackgroundWhile cerebral palsy is reported to have a higher prevalence in low-resource settings, there are few studies describing risk factors for cerebral palsy in these settings. A better understanding of the unique risk factors affecting children with cerebral palsy in low-resource settings could optimize both resource allocation and preventative strategies.MethodsA case-control study comparing children with cerebral palsy ages 2-18 years with age-matched healthy controls was conducted between 2013-2014 at a referral center in Gaborone, Botswana. Study participants were enrolled from inpatient and outpatient settings, and data were collected through caregiver interviews, review of medical records and physical examination of subjects. Risk factors were evaluated using conditional logistic regression models.ResultsWe studied 56 cases and 56 age-matched controls. Significant risk factors for cerebral palsy included a history of serious neonatal infection (odds ratio 15.0, p= 0.009), complications during delivery (odds ratio 13.5, p<0.001), and maternal Human Immunodeficiency Virus (HIV) infection (odds ratio 3.5, p=0.03). Maternal HIV infection remained a significant risk factor after adjusting for potential confounders and covariates (adjusted odds ratio 13.2, p-value=0.05).ConclusionsMajor risk factors for cerebral palsy in Botswana differ from those described in high-resource settings. Modifiable risk factors such as maternal HIV infection should be targeted as a potential strategy to reduce the incidence of cerebral palsy in Botswana. Further studies are necessary to determine optimal preventative and treatment strategies in this population.



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