Healthcare utilization by children with neurological impairments and disabilities in rural Kenya: a retrospective cohort study combined with secondary analysis of audit data

LATEST ARTICLES
SEARCH INDEX
SUGGEST ARTICLE
THE OSI COLLECTIONS
AUDIOGRAM SERIES
ABOUT THE OSI
2020 SUMMARY
2021 SUMMARY

OSI STATISTICS

Open access articles:
1592
Annotations added:
3
Countries represented:
117
No. of contributors:
14
Bookmarks made:
26

Healthcare utilization by children with neurological impairments and disabilities in rural Kenya: a retrospective cohort study combined with secondary analysis of audit data


JournalWellcome Open Research
Article typePre-print – Clinical research
Publication date – Nov – 2022
Authors – Jonathan Abuga, Lucy Mwangi, Joyce Ndolo, Symon Kariuki, Charles Newton
Keywordsadmission, Children, healthcare, hospitalization, Kenya, LMICs, neurological impairments and disability, rehabilitation
Open access – Yes
SpecialityNeurosurgery, Trauma and orthopaedic surgery
World region Eastern Africa
Country: Kenya
Language – English
Submitted to the One Surgery Index on December 3, 2022 at 2:08 am
Abstract:

Background: There is a paucity of data on healthcare utilization by children with neurological impairments (NI) in sub-Saharan Africa. We determined the rate, risk factors, causes, and outcomes of hospital admission and utilization patterns for rehabilitative care among children with NI in a defined rural area in Kenya.
Methods: We designed two sub-studies to address the primary objectives. Firstly, we retrospectively observed 251 children aged 6–9 years with NI and 2162 age-matched controls to determine the rate, causes and outcomes of hospitalization in a local referral hospital. The two cohorts were identified from an epidemiological survey conducted in 2015 in a defined geographical area. Secondly, we reviewed hospital records to characterize utilization patterns for rehabilitative care.
Results: Thirty-four in-patient admissions occurred in 8503 person-years of observation (PYO), yielding a crude rate of 400 admissions per 100 000 PYO (95% confidence interval (Cl): 286–560). The risk of admission was similar between cases and controls (rate ratio=0.70, 95%CI: 0.10–2.30, p = 0.31). The presence of electricity in the household was associated with reduced odds of admission (odds ratio=0.32, 95% Cl: 0.10–0.90, p < 0.01). Seizures and malaria were the main causes of admission. We confirmed six (0.3%) deaths during the follow-up period. Over 93% of outpatient paediatric visits for rehabilitative care were related to cerebral palsy and intellectual developmental delay. Health education (87%), rehabilitative exercises (79%) and assistive technology (64%) were the most common interventions.
Conclusions: Surprisingly, the risk of hospitalization was not different between children with NI and those without, possibly because those with severe NI who died before this follow-up were under seclusion and restraint in the community. Evidence-based and tailored rehabilitative interventions are urgently required based on the existing secondary data.

OSI Number – 21834

Public annotations on this article:
No public annotations yet