Performance of the UNICEF/UN Washington Group tool for identifying functional difficulty in rural Zimbabwean children.
PLoS One
; 17(9): e0274664, 2022.
Article
em En
| MEDLINE
| ID: mdl-36112574
ABSTRACT
INTRODUCTION:
Over one billion people live with disability worldwide, of whom 80% are in developing countries. Robust childhood disability data are limited, particularly as tools for identifying disability function poorly at young ages.METHODS:
A subgroup of children enrolled in the Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial (a cluster-randomised, community-based, 2x2 factorial trial in two rural districts in Zimbabwe) had neurodevelopmental assessments at 2 years of age. We evaluated functional difficulty prevalence in HIV-exposed and HIV-unexposed children using the Washington Group Child Functioning Module (WGCFM), comparing absolute difference using chi-squared or Fisher's exact tests. Concurrent validity with the Malawi Developmental Assessment Tool (MDAT) was assessed using logistic regression with cohort MDAT score quartiles, linear regression for unit-increase in raw scores and a Generalised Estimating Equation approach (to adjust for clusters) to compare MDAT scores of those with and without functional difficulty. A 3-step, cluster-adjusted multivariable regression model was then carried out to examine risk factors for functional difficulty.FINDINGS:
Functional Difficulty prevalence was 4.2% (95%CI 3.2%, 5.2%) in HIV-unexposed children (n = 1606) versus 6.1% (95%CI 3.5%, 8.9%) in HIV-exposed children (n = 314) (absolute difference 1.9%, 95%CI -0.93%, 4.69%; p = 0.14). Functional difficulty score correlated negatively with MDAT for each unit increase in WGCFM score, children completed 2.6 (95%CI 2.2, 3.1) fewer MDAT items (p = 0.001). Children from families with food insecurity and poorer housing were more at risk of functional difficulty.INTERPRETATION:
Functional difficulty was identified in approximately 1-in-20 children in rural Zimbabwe, which is comparable to prevalence in previous studies. WGCFM showed concurrent validity with the MDAT, supporting its use in early childhood.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
População Rural
/
Infecções por HIV
Tipo de estudo:
Clinical_trials
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Child
/
Child, preschool
/
Humans
/
Infant
País como assunto:
Africa
/
America do norte
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article