Nutrition Interventions for Children with Cerebral Palsy in Low- and Middle-Income Countries: A Scoping Review

Israt Jahan; Risad Sultana; Mohammad Muhit; Delwar Akbar; Tasneem Karim; Mahmudul Hassan Al Imam; Manik Chandra Das; Hayley Smithers-Sheedy; Sarah McIntyre; Nadia Badawi; Gulam Khandaker

doi:10.3390/nu14061211

Nutrition Interventions for Children with Cerebral Palsy in Low- and Middle-Income Countries: A Scoping Review

Nutrients. 2022 Mar 12;14(6):1211. doi: 10.3390/nu14061211.

Authors

Israt Jahan^{1

2

3}, Risad Sultana^{1

2}, Mohammad Muhit^{1

2}, Delwar Akbar⁴, Tasneem Karim^{1

2

5

6}, Mahmudul Hassan Al Imam^{1

2

3

7}, Manik Chandra Das^{1

2}, Hayley Smithers-Sheedy⁶, Sarah McIntyre⁶, Nadia Badawi^{6

8}, Gulam Khandaker^{3

5

7}

Affiliations

¹ CSF Global, Dhaka 1213, Bangladesh.
² Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka 1212, Bangladesh.
³ School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD 4701, Australia.
⁴ School of Business and Law, Central Queensland University, Rockhampton, QLD 4701, Australia.
⁵ Specialty of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, NSW 2145, Australia.
⁶ Cerebral Palsy Alliance, Sydney Medical School, The University of Sydney, Camperdown, NSW 2006, Australia.
⁷ Central Queensland Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, QLD 4700, Australia.
⁸ Grace Centre for Newborn Intensive Care, The Children's Hospital at Westmead, Sydney Children's Hospital Network, Westmead, NSW 2145, Australia.

Abstract

Background: Malnutrition is substantially higher among children with cerebral palsy (CP) in low- and middle-income countries (LMICs) when compared with the general population. Access to appropriate interventions is crucial for better management of malnutrition and nutritional outcomes of those children. We aimed to review the existing evidence on nutrition interventions for children with CP in LMICs.

Methods: Online databases, i.e., PubMed and Scopus, and Google Scholar were searched up to 10 January 2022, to identify peer-reviewed publications/evidence on LMIC focused nutritional management guidelines/interventions. Following title screening and abstract review, full articles that met the inclusion/exclusion criteria were retained for data charting. Information about the study characteristics, nutrition interventions, and their effectiveness were extracted. Descriptive data were reported.

Results: Eight articles published between 2008 and 2019 were included with data from a total of n = 252 children with CP (age range: 1 y 0 m-18 y 7 m, 42% female). Five studies followed experimental design; n = 6 were conducted in hospital/clinic/center-based settings. Four studies focused on parental/caregiver training; n = 2 studies had surgical interventions (i.e., gastrostomy) and n = 1 provided neurodevelopmental therapy feeding intervention. Dietary modification as an intervention (or component) was reported in n = 5 studies and had better effect on the nutritional outcomes of children with CP compared to interventions focused on feeding skills or other behavioral modifications. Surgical interventions improved nutritional outcomes in both studies; however, none documented any adverse consequences of the surgical interventions.

Conclusion: There is a substantial knowledge gap on nutrition interventions for children with CP in LMICs. This hinders the development of best practice guidelines for the nutritional management of children with CP in those settings. Findings suggest interventions directly related to growth/feeding of children had a better outcome than behavioral interventions. This should be considered in planning of nutrition-focused intervention or comprehensive services for children with CP in LMICs.

Keywords: LMICs; cerebral palsy; children; disability; intervention; nutrition.

Publication types

Review

MeSH terms

Cerebral Palsy* / complications
Cerebral Palsy* / epidemiology
Cerebral Palsy* / therapy
Child
Developing Countries
Female
Humans
Income
Infant
Male
Malnutrition* / etiology
Malnutrition* / prevention & control
Poverty