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The Malawi key informant child disability project

TATARYN, Myroslava
et al
August 2014

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“The aim of this study was to use the KIM to estimate the prevalence of moderate/severe physical, sensory and intellectual impairments and epilepsy among children in two districts (Ntcheu and Thyolo) in Malawi. The Key Informant Method (KIM) is a novel method for generating these data. KIM focuses on training community volunteers to identify local children who may have disabilities, who are then screened by medical professionals and referred on for appropriate health and rehabilitation interventions. Consequently, the method offers an alternative to population-based surveys of disability in children, which can be costly and time consuming”

The Malawi key informant child disability project : summary report

TATARYN, Myroslava
et al
August 2014

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This report provides a summary of research project conducted by the International Centre for Evidence in Disability at the London School of Hygiene and Tropical Medicine and the University of Malawi. The study used the Key Informant Method (KIM) to estimate the prevalence of moderate/severe physical, sensory and intellectual impairments and epilepsy among children in two districts (Ntcheu and Thyolo) in Malawi. This report presents summary of the study’s background information, aims and objectives, key findings, conclusions and recommendations

Assessment of neurodisability and malnutrition in children in Africa

GLADSTONE, Melissa
MALLEWA, Mac
ALUSINE JALLOH, Alhaji
VOSJUIKL, Wieger
POSTELS, Douglas
GROCE, Nora
KERAC, Marco
MOLYNEUX, Elizabeth
March 2014

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Neurodevelopmental delay, neurodisability, and malnutrition interact to contribute a significant burden of disease in global settings. Assessments which are well integrated with plans of management or advice are most likely to improve outcomes. Assessment tools used in clinical research and programming to evaluate outcomes include developmental and cognitive tools that vary in complexity, sensitivity, and validity as well as the target age of assessment. Few tools have been used to measure socioemotional outcomes and fewer to assess the disabled child with malnutrition. There is a paucity of tools used clinically which actually provide families and professionals with advice to improve outcomes. Brain imaging, electroencephalography, audiology, and visual assessment can also be used to assess the effect of malnutrition on brain structure and function. The interaction of neurodisability and malnutrition is powerful, and both need to be considered when assessing children.

Seminars in Pediatric Neurology, Child Neurology in Africa, Volume 21, Issue 1, March 2014, Pages 50–57

The Relationship Between Gross Motor Function and Quality of Life Among Children with Cerebral Palsy

PUSPITASARI, M
RUSMIL, K
GURNIDA, D
2014

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Purpose: The aim of this study was to determine the relationship between gross motor function and quality of life among children with Cerebral Palsy (CP).

 

Method: This observational analytical study with cross-sectional design, was conducted at Yayasan Pembinaan Anak Cacat (YPAC) Bandung, Sekolah Luar Biasa (SLB) Cileunyi, and Paediatric Neurology Clinic of Dr. Hasan Sadikin Hospital Bandung, Indonesia, from March 2011 to September 2012. Gross motor function was assessed using Gross Motor Function Scale (GMFCS). Cerebral Palsy-Quality of Life (CP-QOL) questionnaire for parent-proxy version was used to assess quality of life of children with CP. Statistical analysis was done using Spearman rank test to determine the relationship between variables.

 

Results: Participants were 31 children with CP, between 4 -12 years of age. The most common type of CP was spastic quadriplegia (17 of the 31 children). Around 17 children had mild disability (GMFCS level I and II), 3 children had moderate disability (GMFCS level III), and 16 children had severe disability (GMFCS level IV and V). Majority of the parents had senior high school level education. Most of the fathers were self-employed while most of the mothers were housewives. Gross motor function was not significantly correlated to quality of life in general in children with CP (rs=-0.153, p=0.205). Although gross motor function was significantly correlated to pain and the impact of disability (rs=-0.313, p=0.043), other aspects of quality of life (social well-being and acceptance, feeling about functioning, participation and physical health, emotional well-being and self-confidence, access to services, and family health) were not significantly correlated (p>0,05) to it.

 

Conclusions: Gross motor function in children with CP was correlated to pain and the impact of disability domain of quality of life.

Effects of Multisensory Training on Balance and Gait in Persons with Type 2 Diabetes: A Randomised Controlled Trial

KUTTY, N A M
MAJIDA, N A
2013

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Purpose: Progressive deterioration of physical function occurs in persons with Type 2 diabetes and peripheral neuropathy. This study assessed the effects of multisensory training on balance and gait in persons with diabeticneuropathies.

 

Method: Thirty two persons with peripheral neuropathies were enrolled, randomised, and subdivided into 2 groups - an experimental group of 16 participants with diabetes (65 ± 2.12 years) and a control group of 16 participants with diabetes (68 ± 2.17 years). For 6 weeks, both groups were given health education on diabetes for 30 minutes a week. In addition, the experimental group practised a multisensory exercise programme for 30 minutes, 3 times a week over 6 weeks. Outcome measures used were ‘timed up and go’ test for assessing balance and ‘6-minute walk’ test for gait. Standard descriptive statistics were used to report means, standard deviation, and range for baseline characteristics. Paired and unpaired ‘t-tests’ were used wherever necessary, to determine significant differences in data among groups and between pre-test and post-test scores (p<0.05).

 

Results: By the end of the trial period, the intervention group showed a significant improvement in scores of the ‘timed up and go’ test (t= 14.7092), but there was no statistically significant difference in the ‘6-minute walk’ test scores (p=0.7206, t= 0.3644).There was no difference for both measures in the control group.

 

Conclusion: The study showed that multisensory exercises could improve balance in persons with Type 2 diabetes and peripheral neuropathy. The findings suggest that along with physiological sensory factors, cognitive-behavioural factors and strengthening of the lower limb muscles should be considered when treating diabetic persons with gait alterations.

Constraint - Induced Movement Therapy: Determinants and Correlates of Duration of Adherence to Restraint use Among Stroke Survivors with Hemiparesis

OLASUNKANMI, D O
OLASUMBO, S A
2012

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Background: Constraint-Induced Movement Therapy (CIMT) was developed to improve purposeful movement of the stroke-affected extremity by restricting the use of the unaffected extremity. The two main components of CIMT are the training of the more-impaired arm to perform functional tasks, and the restraint of the less-impaired arm. One challenge that the application of CIMT faces is in ensuring adherence to the use of restraint.

 

Purpose: There is a need to determine the factors that may influence adherence, as this would allow CIMT to be delivered more effectively, and prevent situations where unrealistic expectations are placed on stroke–affected individuals.

 

Methods: Thirty stroke survivors with hemiparesis who met the inclusion criteria were consecutively recruited from the physiotherapy out-patient clinics, using a purposive sampling technique. A structured questionnaire was used to obtain information on clinical and socio-demographic parameters. The participants were given a restraint and an adherence time log-book, to make a daily record during the period they wore the restraint. The adherence time log- book was collected at the end of every week of the 3-week study. Motor function and functional use of the upper limb were measured using Motricity Index and Motor Activity Log respectively. Data was analysed using mean and standard deviations, independent t-test and Spearman rho; p was significant at 0.05.

 

Results: Gender (p=0.73) and side affected/handedness (p=0.79) had no significant influence on the percentage duration of adherence to restraint use (DARU). The influence of socio-economic status was seen, with the participants of middle socio-economic status adhering for longer duration (p=0.02). Age had weak and no significant correlation with percentage DARU (p=0.55). There was significantly fair correlation between motor function/functional use at any stage (p=0.55) and the corresponding percentage duration of adherence to restraint use, except the functional use in the first week (p=0.44).

 

Conclusion: Socio-economic status should be considered when applying CIMT.

Mental Health and Quality of Life of Caregivers of Individuals with Cerebral Palsy in a Community Based Rehabilitation Programme in Rural Karnataka

DEEPTHI, N
KRISHANMURTHY, A
2012

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Background: Cerebral palsy is a type of non-progressive central nervous system disorder with multiple impairments. As there are sensory, communicatory and intellectual impairments, providing care at home may be stressful and affect to the physical and mental health of the caregivers. This in turn could interfere with rehabilitation of persons with cerebral palsy.

 

Purpose: This study assesses the mental health status and quality of life of caregivers of persons with disabilities. The study group consisted of caregivers of 23 children with cerebral palsy and intellectual disability.

 

Method: The needs of the children with disabilities were assessed using a pre- tested interview schedule, while caregivers were administered GHQ-28 and WHO-QOL.

 

Results: Thirteen (56.52%) of the primary caregivers tested positive for GHQ. The psychological and environmental domains of QOL were found to be most affected, while the physical and social domains were relatively better.

 

Conclusion: There was a significant (p<0.05) correlation between the GHQ scores and quality of life.

CVD project evaluation : baseline diabetes study, Davao, Philippines 2010

PILLERON, Sophie
June 2011

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This study gathered baseline data for the CVD Project evaluation. "This study also concerned gathering information on the nature of diabetes and common practices in diabetes management and care, to improve project implementation strategy and data on promoting health care services in the community...This study was the first part of a quasi-experimental before-after here-there study conducted in 10 intervention barangays and 5 control barangays of Davao City. The study population consisted of people with diabetes aged 20 years and above who had visited the Barangay Health Centre and had proof of a doctor’s diagnosis for diabetes mellitus or proof of a relative-to-diabetes medicine prescription...Despite its limitations, this study provides a first insight on the people living with diabetes in Davao City. With 72% of diabetics having uncontrolled glycaemia, this study shows the relevance of the CVD project. As a baseline, this study provides comparison elements for the 2013 survey in order to test effectiveness of the CVD project with the percentage of diabetics with HbA1c<6.5% as effectiveness criterion"
DS/RD 01

Rehabilitation Services for Persons Affected by Stroke in Jordan

AL-ORAIBI, S
DAWSON, V L
BALLOCH, S
MOORE, A P
2011

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The purpose of this study was to explore the perceptions stroke survivors have of the rehabilitation services received by them in the Jordanian community. A secondary aim was to explore the impact of culture on providing appropriate services for stroke survivors.

 

Eighteen stroke survivors were recruited from an outpatient stroke rehabilitation programme. All 18 participants had been discharged from hospital for between one and six months. Semi-structured interviews were performed, either in thephysiotherapy outpatient clinic where the affected person was attending a clinic or in their homes. Transcription of interviews carried out in Arabic and thematic analysis was also carried out in that language by transcribers who were fluent in Arabic and English, using a back-translation method. Necessary measures were taken to ensure the accuracy, reliability and validity of the data collection and analysis.

 

Following thematic analysis, themes arising out of the data included physiotherapy and occupational therapy support in the community, out-patient rehabilitation clinic services, community clinic services and support from families, friends and neighbours. Participants expressed satisfaction with their therapists, but there were large areas of unmet rehabilitation need for stroke survivors in the Jordanian community such as a limited availability of occupational therapy services, insufficient amount of therapy services and poor medical support.

 

This study presents a unique contribution to knowledge relating to the experiences of stroke survivors in a developing country, and also shows how care systems are very dependent on cultural contexts, cultural beliefs and practices.

Disability and non communicable disease

HANDICAP INTERNATIONAL (HI)
et al
2011

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"This brief discusses the actions urgently needed to ensure that people with impairments due to NCDs have access to treatment and appropriate, timely, affordable, and high quality rehabilitation interventions for all those who need them. These actions are in line with the Proposed Outcomes Document for the Prevention and Control of NCDs, recommendations of the World Report on Disability and the principles and standards of international human rights law, in particular the Convention on the Rights of Persons with Disabilities"

Nutrition, physical activity and NCD prevention : a briefing document

THE NCD ALLIANCE
2011

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"The NCD Alliance Proposed Outcomes Document calls on governments around the world to commit to actions in a number of key areas to tackle the global burden of Non-Communicable Diseases (NCDs). This briefing document works in synergy with the Proposed Outcomes Document and provides evidence-based actions for nutrition and physical activity related aspects of NCD prevention...(This) briefing document is divided into two sections. Part A provides Key Messages and Guiding Principles together with clear Calls for Action to improve nutrition and increase physical activity. Part B presents an overview of the available evidence of nutrition, physical activity and NCDs, and of effective policies and interventions to reduce the common risk factors"

Packages of care for epilepsy in low- and middle-income countries

MBUBA, Caroline K
NEWTON, Charles R
October 2009

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This article focuses on the management of epilepsy in low- and middle-income countries and recommends a package of care - a combination of interventions aimed at improving the recognition and management of conditions to achieve optimal outcomes - for epilepsy, that is sustainable

Needs assessment to develop diabetes control and prevention projects in limited-resource countries

HANDICAP INTERNATIONAL
June 2009

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This toolkit provides a guide for international NGOs to implement a needs assessment to develop diabetes control and prevention projects in limited-resource countries. This practical toolkit highlights the necessary details for related log books, guides, frameworks, checklists, job descriptions, reports and templates. This guide is useful for organisations interested in needs assessment to develop diabetes control and prevention projects in limited-resource countries

Future sight loss UK (2) : an epidemiological and economic model for sight loss in the decade 2010 to 2020

MINASSIAN, Darwin
REIDY, Angela
2009

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This report provides estimates of the numbers of persons that were likely to have age-related macular disease, cataract, diabetic retinopathy and glaucoma at two points in time 2010 and 2020. Estimates of the baseline and cumulative costs to society of the prevailing health and social care provision and support in that time frame are provided using a cost of illness approach from the societal perspective. Useful figures and tables are provided to present the results

Essential skills for mental health care

CRABB, Jim
RAZI, Emma
September 2007

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This manual has been designed to provide essential information to mental health professionals to help provide good, safe care to people with mental ill health. The initial chapters provide an introduction to mental health and the later chapters and the appendices will be of more use to experienced health professionals who prescribe medicine

Tonga national disability identification survey 2006

TAYLOR, Dimity
March 2006

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This survey identifies the prevalence of disability among the population of Tonga; the main causes of disability; the extent to which people with disabilities are able to participate in the community, education and employment sectors and the needs of people with disabilities. A list of recommendations for creating a more inclusive society focuses on government policy and direction, legislation, various government departments and ministries, women's development, the police, national organisations and NGOs, churches, sport and the media. It was conducted on behalf of DACTION - the Tonga Disability Action Committee, and the Tonga Red Cross Society. Executive summary also available in Tongan

Comprehensive cervical cancer control : a guide to essential practice

WORLD HEALTH ORGANIZATION
2006

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"This publication - produced by WHO and its partners - is designed to provide comprehensive practical advice to health care providers at all levels of the health care system on how to prevent, detect early, treat and palliate cervical cancer. In particular, the Guide seeks to ensure that health care providers at the primary and secondary levels will be empowered to use the best available knowledge in dealing with cervical cancer for the benefit of the whole community."

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