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

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.

Study of perinatal factors in children with developmental delay

“…Few studies, Nguefack et al, and Meliegy et al, had high proportions of birth asphyxias similar to ours as a cause of developmental delay. 9,10 Nguefack et al, had 68 (44.40%) children with history of birth asphyxia similar to the present study as a leading cause of developmental delay. 9 Most of the studies found etiology of birth asphyxia to be around 9 -23% in children with developmental delay in their studies, and birth asphyxia was taken as an important predictor of developmental delay.…”

“…9,10 Nguefack et al, had 68 (44.40%) children with history of birth asphyxia similar to the present study as a leading cause of developmental delay. 9 Most of the studies found etiology of birth asphyxia to be around 9 -23% in children with developmental delay in their studies, and birth asphyxia was taken as an important predictor of developmental delay. Some Indian studies by Jain et al, Tikaria et al, and Sachdeva et al, found birth asphyxia in 9.8%, 20%, and 9% of children enrolled in their studies respectively which are lower than our study.…”

“…7,8 Similarly other studies by Meiliegy EI et al, and Nguefack et al, also found prematurity correlating with global developmental delay. 9,10 The percentage of the preterm children in the present study was double that of the preterm in the general population (22% versus 11%). When compared with the proportion of preterms in general population they were significantly higher in our study as shown in Table 3.1(p value = 0.0001), they were 2 times more frequent than general population.…”

Risk factors for delayed speech in children aged 1-2 years

“…In addition, Nguefack et al in 2013 stated that perinatal asphyxia was the most frequent perinatal factor to cause developmental delay (44%; P=0.05). 12 Perinatal hypoxia-ischemia is responsible for primary and secondary cerebral energy failure, a phenomena in which the blood flow to the brain is decreased, thus reducing oxygen transport. These phenomena are also responsible for decreased highenergy phosphorylated compounds.…”

Prevalence and CT-Scan Presentations of Brain Malformations in Children at a University-Affiliated Mother and Child Hospital (Cameroon)

“…In Cameroon, BMs are often discovered during investigation for epilepsy or psychomotor retardation [13] Open Journal of Medical Imaging [14]. MRI has been recently introduced and the CT scan was previously the reference technique for the diagnosis of BM in our context.…”