Determinants of Hearing Loss in Children with Cerebral Palsy in Kano, Nigeria

Abstract

Background: Cerebral palsy (CP) is a commonly occurring disorder of movement and posture that starts in early childhood. It is accompanied by other disturbances including hearing loss which has been shown to worsen the quality of life of the patients due to problems associated with speech and language acquisition. Several factors are responsible for developing hearing loss in CP. Aims: To determine the factors that can help in early diagnosis and treatment of hearing loss in children with cerebral palsy. Methodology: This was a hospital based cross-sectional study conducted among 165 randomly selected children with CP. An interviewer-administered questionnaire was used to obtain relevant sociodemographic and clinical information. The data collected was analyzed using Statistical Product and Services Solution (SPSS) version 21. Results: The age range of the participants was 1–12 years, with a mean age and standard deviation (SD) of 4.49 ± 2.85. The male to female ratio was 2:1. The commonest type of CP encountered was of spastic variety seen in 47.3%, while the least encountered variety was of the ataxic type, seen in only 4.2%;46.7% of the children were reported to have hearing impairment by their guardian. Other comorbidities reported included epilepsy (33.9%), speech impairment (27.3%), mental retardation (17.0%) and visual impairment (8.5%). A statistically significant association was found between the presence of comorbidities (P = 0.05) and hearing loss among children with CP. Conclusion: Hearing impairment is common among children with CP. Several factors are associated with the development of hearing loss among children with CP. However, only presence of comorbidities was found to be a significant determinant of hearing loss among children with CP.

Frequency of hearing loss in children with cerebral palsy and parents’ perception regarding their child’s hearing.

“…18 Timely identification and intervention for hearing loss among children with CP should be performed to decrease the overall burden of impairment among these children. 19 As this was a single center study conducted on a relatively small sample size during the Covid-19 pandemic, our findings cannot be generalized and should further be verified in large scale multicentric studies. Furthermore, due to a lack of education and awareness among parents of CP children, consent was not given by some of the parents for the questionnaire to be filled.…”

Evaluation of Hearing Status in Various Type of Cerebral Palsy Children in a Tertiary Hospital

“…CP patients are usually associated with disability like, hearing loss, visual impairments, epilepsy, speech and language disorders, and cognitive impairments. 6,15,16 In this study out of fifty children, majority (32/50) were male and maximum (18/50) children were from 1-3 year age group (Mean age was 5.57 years).…”

Cerebral palsy in African paediatric populations: A scoping review

“…The range of comorbidities reported in 33 studies was largely consistent across countries and included epilepsy, sensory impairment, communication disorders, feeding difficulties, intellectual disability, orthopaedic complications, malnutrition, and high risk of infections. 11,23,31,33,34,37,38,40,41,46,47,53,[60][61][62][63]70,[72][73][74][75][76][77][78][79][80][81][82][83][84][85][86][87][88] At least a third of children had more than one comorbidity: in a cross-sectional population-based study in Uganda, 31% had two or more associated comorbidities; 74 in a hospital-based study in Ethiopia, 100% of children with CP had two or more comorbidities. 46 Comorbidities differed according to clinical subtype (χ 2 = 21.51, df = 4, p < 0.001), GMFCS (χ 2 = 14.98, df = 2, p = 0.001), and fine motor function level (χ 2 = 25.60, df = 2, p < 0.001) in a cross-sectional study in Uganda, 19 and according to topography (p = 0.024) in a cross-sectional study in Nigeria.…”

“…46 Comorbidities differed according to clinical subtype (χ 2 = 21.51, df = 4, p < 0.001), GMFCS (χ 2 = 14.98, df = 2, p = 0.001), and fine motor function level (χ 2 = 25.60, df = 2, p < 0.001) in a cross-sectional study in Uganda, 19 and according to topography (p = 0.024) in a cross-sectional study in Nigeria. 40 Epilepsy was the most commonly reported comorbidity, 11,19,33,34,37,38,40,41,46,47,43,60,62,63,74,79,81,82,89,90 with the proportion of children with CP affected ranging from 11% 60 to 76%. 11 Although 85% of children with CP and comorbid epilepsy were treated with antiseizure medication in an Ethiopian hospital cohort, 46 irregular use of antiseizure medications was found in 5.4% of Nigerian children 81 and treatment gaps as high as 61% were reported in Uganda 74 in community-based studies.…”

“…Intellectual disability was also common among children living with CP, 11,19,23,31,34,38,40,41,60,62,63,78,82,91 with the proportion of children with intellectual disability as high as 86% (95% CI = 73%-91%) in hospital cohorts in Botswana 11 and Ethiopia. 46 While not consistent across all studies, a positive association was found between the presence of intellectual disability and GMFCS level in Botswana, 11 Uganda, 74 South Africa, 38 and Egypt, 34 and an inverse association between intellectual disability and age in Uganda.…”