Prevalence of undernutrition among children with cerebral palsy aged 6-59 months in rehabilitation centers in Kampala, Uganda

Abstract

Abstract Background: In Uganda, a critical health concern emerges with Cerebral Palsy (CP), affecting approximately 2.7 per 1000 children. Notably, anecdotal evidence from rehabilitation centers suggests a strong correlation between CP and the heightened risk of undernutrition and its subsequent complications in children below five years. However, the extent of undernutrition prevalence and the factors contributing to this condition among CP-afflicted children in Uganda’s rehabilitation centers remain largely unexplored. This study aimed to ascertain the prevalence of undernutrition and identify its associated factors in a cohort of Ugandan children aged 6-59 months diagnosed with CP and residing in selected rehabilitation centers (RCs). Methods: In accordance with the WHO Growth Chart (2006) as a benchmark, the study delineated undernutrition as a dependent variable using indicators such as height-for-age, weight-for-height, and weight-for-age with a standard deviation score of ≤ 2.0. This was accomplished through meticulous physical examinations and anthropometric measurements of 168 children. A modified Poisson regression model was utilized to pinpoint the determinants of undernutrition (independent variables), yielding prevalence ratios as a measure of association within 95% confidence intervals, complemented by multivariable logistic regression. Data analysis was conducted using STATA v.12, duly considering the survey design effects, including sampling weight. Results: The results revealed that a majority (53.6%) of the children were aged between 12 and 35 months, with a predominance of male participants (64.3%). Caregivers, primarily female (91%), frequently exhibited financial constraints (56% had no income) and limited educational background (36% lacked formal education or had only primary school education). Alarmingly, the prevalence of undernutrition among children with CP stood at 61.2%, with stunting and underweight being the most common manifestations at 39.9% and 40.2%, respectively. Critical factors associated with undernutrition included the age bracket of 1 to 5 years—precisely, 12-35 months (adj.PR=1.49; 1.01-2.19) and above 35 months (adj.PR=1.55;1.03-2.32)—and a diet comprising less than three food groups daily, significantly increasing the risk of undernutrition. Conclusion: In conclusion, this study highlights a disturbingly high prevalence of undernutrition (61.2%) among children aged 6-59 months with CP in Ugandan rehabilitation centers, with stunting and underweight being the most prevalent forms.