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Mortality in children with cerebral palsy in rural Bangladesh: a population‐based surveillance study
Author(s) -
Jahan Israt,
Karim Tasneem,
Das Manik Chandra,
Muhit Mohammad,
Mcintyre Sarah,
SmithersSheedy Hayley,
Badawi Nadia,
Khandaker Gulam
Publication year - 2019
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/dmcn.14256
Subject(s) - medicine , verbal autopsy , cerebral palsy , pediatrics , underweight , hazard ratio , population , mortality rate , cause of death , child mortality , life expectancy , malnutrition , infant mortality , confidence interval , surgery , physical therapy , environmental health , disease , body mass index , overweight
Aim To determine the mortality rate, immediate cause of death (CoD), and predictors of death in children with cerebral palsy ( CP ) in rural Bangladesh. Method We carried out a prospective population‐based surveillance study of children with CP aged 0 to 18 years registered with the Bangladesh Cerebral Palsy Register ( BCPR ) between January 2015 and December 2016, with subsequent follow‐up until December 2017. Verbal autopsy was applied to assign immediate CoD. Crude mortality rates, hazard ratios of death, and survival probabilities were estimated. Results Twenty‐nine of the 678 children in the BCPR died during the study period, resulting in a crude mortality rate of 19.5 per 1000 person‐years of observation (total follow‐up duration 1486.8 person‐years; mean 2y [standard deviation 6mo]). The leading immediate CoD was meningitis ( n =9) and pneumonia ( n =8). Survival probability and hazard ratio of death was significantly associated with age, Gross Motor Functional Classification System level, and associated impairments. Severe underweight and/or severe stunting was significantly overrepresented among deceased children than others in the cohort ( p <0.05) when compared with the World Health Organization reference population. Interpretation The majority of deaths were due to potentially preventable causes. The life expectancy of these children could have been extended by ensuring primary healthcare and nutritional supplementation. What this paper adds Mortality rate in children with cerebral palsy (CP) in rural Bangladesh is 19.5 per 1000 person‐years. The majority of children with CP died from potentially preventable and treatable conditions. Motor severity, associated impairments, and malnutrition make children with CP vulnerable to premature death in rural Bangladesh.