Estimate the burden of malnutrition among children with cerebral palsy in Sub-Saharan Africa: a systematic review with meta-analysis.

Malnutrition is more prevalent among children with cerebral palsy and a major factor for child morbidity and mortality in children with different co-morbidity, especially in Sub-Saharan Africa: The main aim of this systematic review and meta-analysis was to estimate the burden of malnutrition among children with cerebral palsy in Sub-Saharan Africa. We searched PubMed, Web of Science, Google Scholar, Research Gate, and institutional repositories for papers that reported the proportion of malnutrition among children with cerebral palsy that were published between December 2010 and September 2023. Data were retrieved using the standardized JBI data extraction checklist through Microsoft Excel, and then exported to STATA 17 for further analysis. DerSimonian and Laird's estimator was used to calculate the pooled effect size in the random-effects model. Statistics such as the Cochran Q test and I2 test were employed to measure heterogeneity. Egger's test and the funnel plot were used to look for publication bias. This systematic review and meta-analysis used 16 studies from Sub-Saharan Africa to estimate the proportion of malnutrition among 2,120 children with cerebral palsy. The pooled proportion of malnutrition among children with cerebral palsy in Sub-Saharan Africa by using random-effects model analysis was found to be 59.7% (95% CI; 49.8-69.6). The proportion of malnutrition was also estimated by sample sizes categorized as ≤ 120 and > 120, and the proportion of malnutrition was found to be 54.0 (95% CI: 44.7-63.3) and 64.5 (95% CI: 50.5-78.5). Moreover, the proportion of malnutrition was estimated by accounting for the difference in the year of publication. In this regard, the study classified before ≤ 2017 and > 2017, and the proportion of malnutrition was found to be 53.7 (95% CI: 38.0-69.3) and 62.5 (95% CI: 49.7-75.3) in Sub-Saharan Africa respectively. Malnutrition among children with cerebral in Sub-Saharan Africa was found to be very high. Hence, enhancing and developing strategic guidelines for malnutrition screening, prevention, and nutritional support are crucial among children with cerebral palsy. Furthermore, systematic review, randomized control trials, and qualitative studies are recommended to understand the burden more among children with cerebral palsy in the continent.

Incidence and predictors of early posttraumatic seizures among patients with moderate or severe traumatic brain injury in Northwest Ethiopia: an institution-based prospective study.

BACKGROUND: Early posttraumatic seizure (PTS) is a well-known complication of traumatic brain injury (TBI) that can induce the development of secondary brain injuries, including increased intracranial pressure, brain death, and metabolic crisis which may result in worse outcomes. It is also a well-recognized risk factor for the development of late post-traumatic seizure and epilepsy. This study was aimed to assess the incidence and predictors of PTS among patients with moderate or severe TBI admitted to Debre Tabor Comprehensive Specialized Hospital, Northwest Ethiopia. METHODS AND SETTING: An institutional-based prospective follow-up study was conducted on 402 patients with TBI admitted to the neurologic unit from June 1, 2022 to January 30, 2023. A systematic sampling technique was employed. The incidence rate of occurrence of early PTS was calculated. Both bivariable and multivariable Cox proportional hazard regression was performed. The strength of the association was measured using adjusted hazard ratios with a 95% confidence interval and p-values < 0.05. RESULTS: The incidence rate of early PTS was 2.7 per 100 person-days observation. Early PTS was observed in 17.7% of TBI patients. Age 75 and above (AHR = 2.85, 95%CI: 1.58-5.39), severe TBI (AHR = 2.06, 95%CI: 1.03-3.71), epidural hematoma (AHR = 2.4, 95% CI: 1.28-4.57), brain contusion (AHR = 2.6, 95%CI: 1.07-4.09), surgical intervention (AHR = 1.7, 95%CI: 1.03-3.82), posttraumatic amnesia (AHR = 1.99, 95%CI: 1.08-3.48), history of comorbidities (AHR = 1.56, 95%CI: 1.08-3.86), and history of alcohol abuse (AHR = 3.1, 95%CI: 1.89-5.23) were potential predictors of early PTS. CONCLUSION: The incidence of early PTS was high. Since, early PTS can worsen secondary brain damage, knowing the predictors helps to provide an effective management plan for patients likely to develop early PTS and improve their outcome.