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. 2017 Nov 28;17(1):198.
doi: 10.1186/s12887-017-0948-z.

Childhood disability in Malawi: a population based assessment using the key informant method

Myroslava Tataryn  1 , Sarah Polack  2 , Linda Chokotho  3 , Wakisa Mulwafu  4 , Petros Kayange  5 , Lena Morgon Banks  1 , Christiane Noe  6 , Chris Lavy  7 , Hannah Kuper  1
Affiliations

Childhood disability in Malawi: a population based assessment using the key informant method

Myroslava Tataryn et al. BMC Pediatr. .

Erratum in

Abstract

Background: Epidemiological data on childhood disability are lacking in Low and Middle Income countries (LMICs) such as Malawi, hampering effective service planning and advocacy. The Key Informant Method (KIM) is an innovative, cost-effective method for generating population data on the prevalence and causes of impairment in children. The aim of this study was to use the Key Informant Method to estimate the prevalence of moderate/severe, hearing, vision and physical impairments, intellectual impairments and epilepsy in children in two districts in Malawi and to estimate the associated need for rehabilitation and other services.

Methods: Five hundred key informants (KIs) were trained to identify children in their communities who may have the impairment types included in this study. Identified children were invited to attend a screening camp where they underwent assessment by medical professionals for moderate/severe hearing, vision and physical impairments, intellectual impairments and epilepsy.

Results: Approximately 15,000 children were identified by KIs as potentially having an impairment of whom 7220 (48%) attended a screening camp. The estimated prevalence of impairments/epilepsy was 17.3/1000 children (95% CI: 16.9-17.7). Physical impairment (39%) was the commonest impairment type followed by hearing impairment (27%), intellectual impairment (26%), epilepsy (22%) and vision impairment (4%). Approximately 2100 children per million population could benefit from physiotherapy and occupational therapy and 300 per million are in need of a wheelchair. An estimated 1800 children per million population have hearing impairment caused by conditions that could be prevented or treated through basic primary ear care. Corneal opacity was the leading cause of vision impairment. Only 50% of children with suspected epilepsy were receiving medication. The majority (73%) of children were attending school, but attendance varied by impairment type and was lowest among children with multiple impairments (38%).

Conclusion: Using the KIM this study identified more than 2500 children with impairments in two districts of Malawi. As well as providing data on child disability, rehabilitation and referral service needs which can be used to plan and advocate for appropriate services and interventions, this method study also has an important capacity building and disability awareness raising component.

Keywords: Children; Disability; Epilepsy; Impairment; Intellectual impairments; Key informant method; Malawi; Physical impairments; Sensory impairments; Service needs.

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Conflict of interest statement

Ethics approval and consent to participate

Ethical approval was obtained from the College of Medicine Research Ethics Committee, Malawi and the London School of Hygiene and Tropical Medicine. The study purpose and procedures were explained to the child and the accompanying parent/caregiver and signed/thumb-printed consent was obtained from the parents/caregiver of all participating children. Children and their guardians identified as having an impairment/epilepsy were referred to onward services as appropriate.

Consent for publication

Not applicable (no individual level data was used).

Competing interests

One of the authors (CN) works for CBM (a disability and international development organisation: http://www.cbm.org/) who co-funded the study. CN contributed to the conception of the study, interpretation of findings and reviewing the manuscript but CBM do not stand to gain or lose financially from the publication of this manuscript.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Causes of moderate/severe vision impairment
Fig. 2
Fig. 2
Proportion of children with intellectual impairment reported ‘unable’ to do each screening tool item
See this image and copyright information in PMC

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MeSH terms