Rehabilitation status of children with cerebral palsy in Bangladesh: Findings from the Bangladesh Cerebral Palsy Register

Mahmudul Hassan Al Imam; Israt Jahan; Manik Chandra Das; Mohammad Muhit; Hayley Smithers-Sheedy; Sarah McIntyre; Nadia Badawi; Gulam Khandaker

doi:10.1371/journal.pone.0250640

Rehabilitation status of children with cerebral palsy in Bangladesh: Findings from the Bangladesh Cerebral Palsy Register

PLoS One. 2021 May 3;16(5):e0250640. doi: 10.1371/journal.pone.0250640. eCollection 2021.

Authors

Mahmudul Hassan Al Imam^{1

2

3}, Israt Jahan^{1

2

3}, Manik Chandra Das^{1

2}, Mohammad Muhit^{1

2}, Hayley Smithers-Sheedy⁴, Sarah McIntyre⁴, Nadia Badawi^{4

5}, Gulam Khandaker^{1

2

6

7}

Affiliations

¹ CSF Global, Dhaka, Bangladesh.
² Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh.
³ School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia.
⁴ Cerebral Palsy Alliance, Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia.
⁵ Grace Centre for Newborn Intensive Care, Sydney Children's Hospital Network, Westmead, New South Wales, Australia.
⁶ Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
⁷ Central Queensland Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, Queensland, Australia.

Abstract

Objective: The objective of this study was to assess the rehabilitation status and factors associated with rehabilitation service utilisation among children with cerebral palsy (CP) in Bangladesh.

Materials and methods: This is a population-based surveillance study conducted among children with CP registered in the Bangladesh CP Register (BCPR), the first population-based register of children with CP aged <18 years (y) in Bangladesh. Children with CP were identified from the community using the key informant method and underwent a detailed neurodevelopmental assessment. Socio-demographic, clinical and rehabilitation status were documented. Unadjusted and adjusted analyses with a 95% confidence interval (CI) were used to identify potential predictors of rehabilitation service uptake.

Results: Between January 2015 and December 2019, 2852 children with CP were registered in the BCPR (mean (standard deviation, SD) age: 7 y 8 months (mo) (4 y 7 mo), 38.5% female). Of these, 50.2% had received rehabilitation services; physiotherapy was the most common type of service (90.0%). The mean (SD) age at commencement of rehabilitation services was 3 y 10 mo (3 y 1 mo). The odds of not receiving rehabilitation was significantly higher among female children (adjusted odds ratio (aOR) 1.3 [95% CI: 1.0-1.7], children whose mothers were illiterate and primary level completed (aOR 2.1 [95% CI: 1.4-3.1] and aOR 1.5 [95% CI: 1.1-2.1], respectively), fathers were illiterate (aOR 1.9 [95% CI: 1.3-2.8]), had a monthly family income ~US$ 59-118 (aOR: 1.8 [95% CI: 1.2-2.6]), had hearing impairment (aOR: 2.3 [95% CI: 1.5-3.5]) and motor severity (i.e. Gross Motor Function Classification System level III (aOR: 0.6 [95% CI: 0.3-0.9]) and level V (aOR: 0.4 [95% CI: 0.2-0.7])).

Conclusions: Rehabilitation status was poor among the majority of the children with CP in the BCPR cohort, limiting their opportunities for functional improvement. A community-based rehabilitation model focusing on socio-demographic and clinical characteristics should be a public health priority in Bangladesh.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Bangladesh
Cerebral Palsy / rehabilitation*
Child
Child, Preschool
Female
Humans
Infant
Male
Registries*

Grants and funding

This study has been conducted as a part of the BCPR research project. The BCPR is funded by the Research Foundation of Cerebral Palsy Alliance (PG4314 – Bangladesh CP Register) and internal funding from CSF Global, Bangladesh. GK is supported by the Cerebral Palsy Alliance Research Foundation Career Development Fellowship (CDF 0116).