A Population-based Study on the Prevalence of Impairment and Disability Among Young Cambodian Children

Peter Evans, Shaheen Shah, Adam Huebner, Selvaraj Sivasubramaniam, Chhoeurn Vuthy, Kao Sambath, Lucy Haurisa, Yim Borun

Abstract


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.

Keywords


Two-phase procedure; risk factors; treatment needs; education and health services

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DOI: http://dx.doi.org/10.5463/dcid.v25i2.188

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