A Population-based Study on the Prevalence of Impairment and Disability Among Young Cambodian Children
Purpose: This population-based study aimed to estimate the prevalence of impairment and disability and associated risk factors among children between 2 – 9 years of age in Cambodia.
Method: A two-phase method was employed. In phase 1, children were screened using the Ten Question Screening Instrument (TQSI) developed for the World Health Organisation (WHO). Those identified positive, were then referred to phase 2 for a detailed multi-professional assessment. A further 10% of children pre-selected at random were also referred to phase 2. Treatment needs for children with disability and risk factors for their disability were also determined.
Results: Prevalence of impairment was estimated at 15.59% (95% CI: 15.05, 16.14), disability at 10.06% (95% CI: 9.16, 10.1) and moderate/severe/profound at 3.22% (95% CI: 2.96, 3.49). Cognition (5.48%. 95% CI: 5.15, 5.83), speech (motor) (2.05%. 95% CI: 1.85, 2.27), speech (language) (1.80%. 95% CI: 1.61, 2.01) and hearing (2.51%. 95% CI: 2.29, 2.76) were the most common disabilities. History of difficult delivery, child’s age, major injury, gender and large family size were significant predictors of disability. Analysis of ‘false negatives’ in the validation group suggested that many parents and caretakers were unaware of their child’s disability.
Treatment needs were found to be very high, approaching 100% for children with moderate or worse disabilities.
Conclusions: Prevalence estimates based on this study are more than 10 times higher than those reported in Cambodia's 2008 National Census. The identified risk factors imply the need for substantial expansion of obstetric services. Education and awareness of disabilities in the population and strategies to prevent injuries require more government attention.Limitations: The main limitation was the relatively low response rate in phase 2, following referral from phase 1, despite efforts made to encourage attendance. This issue would need to be addressed in future work.
Belmont L (1984). Final report of the international pilot study of severe childhood disability. New York: Gertrude Sergievsky Center, Columbia University.
Durkin MS, Hasan MZ, Hasan Z (1995). The ten questions screen for childhood disabilities: Its uses and limitations in Pakistan. Journal of Epidemiology and Community Health; 49: 431-436. http://dx.doi.org/10.1136/jech.49.4.431 PMid:7650469 PMCid:PMC1060134
Durkin MS, Khan NZ, Davidson LL, Huq S, Munir S, Rasul E, Zaman SS (2000). Risk factors for mental retardation among children in Bangladesh. American Journal of Epidemiology; 152 (11): 1024-1033. http://dx.doi.org/10.1093/aje/152.11.1024. PMid:11117611
Education for Children with Disabilities (2008). Kingdom of Cambodia, Ministry of Education Youth and Sport, Phnom Penh.
Evans P (2012). Manual for carrying out quantitative surveys on out of school children and those with disabilities - Cambodia.
Kingdom of Cambodia (2008). Implementation manual on the procedures for identification of poor households. Ministry of Planning, Phnom Penh, Cambodia.
Kingdom of Cambodia (2008). National Census 2008. Phnom Penh: Ministry of Planning.
Muhit MA, Shah SP, Gilbert CE, Hartley SD, Foster A (2007). The key informant method: a novel means of ascertaining blind children in Bangladesh. British Journal of Ophthalmology; 91: 995–999. http://dx.doi.org/10.1136/bjo.2006.108027. PMid:17431019 PMCid:PMC1954788
Mung'ala-Odera V, Meehan R, Njuguna P, Mturi N, Alcock K, Newton CRJC (2006). Prevalence and risk factors of neurological disability and impairment in children living in rural Kenya. International Journal of Epidemiology; 35: 683-688. http://dx.doi.org/10.1093/ije/dyl023. PMid:16492712
Organisation for Economic Cooperation and Development - OECD (2007). Students with disabilities, learning difficulties and disadvantages – policies, statistics and indicators. Paris: OECD.
Shrout PE, Newman SC (1989). Design of two-phase prevalence surveys of rare disorders. Biometrics; 45(2): 549-55. http://dx.doi.org/10.2307/2531496. PMid:2765638
Thorburn M, Desai P, Paul TJ, Malcolm L, Durkin M, Davidson L (1992). Identification of childhood disability in Jamaica: the 'ten questions' screen. International Journal of Rehabilitation Research; 15: 115-127. http://dx.doi.org/10.1097/00004356-199206000-00003. http://dx.doi.org/10.1097/00004356-199209000-00013. PMid:1388141
United Nations Convention on the Rights of Persons with Disabilities (2008). New York: UN.
United Nations International Children's Emergency Fund (2007). The Cambodia accident and injury survey. New York: UNICEF.
United Nations International Children's Emergency Fund (2012). A framework for rights-based, child-friendly schools. Available from: http://www.unicef.org/lifeskills/index_7260.html#A Framework for Rights-Based, Child-Friendly [Accessed on 1 June 2014].
World Health Organisation (1980). International classification of impairments, disabilities and handicaps, Geneva, WHO.
World Health Organisation (2007). The international classification of functioning, disability and health - Children and Youth (ICF-CY). Geneva: WHO.
Zaman SS, Khan N, Islam S, Banu S, Dixit S, Shrout P, Durkin M (1990). Validity of the 'ten questions' for screening serious childhood disability: Results from Urban Bangladesh. International Journal of Epidemiology; 19(3): 613-620. http://dx.doi.org/10.1093/ije/19.3.613. PMid:2148168
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