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. 2018 Oct 19;18(1):332.
doi: 10.1186/s12887-018-1305-6.

Cerebral palsy in Moldova: subtypes, severity and associated impairments

Ecaterina Gincota Bufteac  1   2 , Guro L Andersen  3   4 , Vik Torstein  4 , Reidun Jahnsen  5
Affiliations

Cerebral palsy in Moldova: subtypes, severity and associated impairments

Ecaterina Gincota Bufteac et al. BMC Pediatr. .

Abstract

Background: Moldova is ranked as one of the countries in Europe with the lowest income per capita and with a relatively high infant and maternal mortality rate. Information on neurodisabilities in general is limited, and regarding cerebral palsy (CP) in particular, it is completely lacking. The aim of this study was therefore to make a crude estimate of the prevalence of CP and to describe subtypes and the severity of motor impairments and associated problems in this country.

Methods: Children with CP born 2009-2010, attending the National Hospital Institute of Mother and Child, the reference hospital for ~ 75% of children in Moldova with neurological disabilities, were identified from medical records.

Results: Among 207 children with CP (estimated prevalence 3.4 per 1000 live births), 185 (mean age 7.3 years; 36% girls) had detailed information. Thirty seven (20%) children had spastic unilateral, 113 (61%) spastic bilateral, 22 (12%) dyskinetic and 9 (5%) children had ataxic CP. The subtype was unclassified in four children. Among all children, 93 (51%) had epilepsy, 109 (59%) intellectual disability, 42 (23%) severe vision and 10 (5%) hearing impairments while 84 (45%) children had severe speech impairments. Fifty-two (28%) children were born prematurely, and 46 (25%) had Apgar scores below 7 at five minutes.

Conclusion: Compared to other European studies, the distribution of CP subtypes was different in Moldova. Moreover, the estimated prevalence, the proportions with severe motor and associated impairments and of children born at term were higher in Moldova while the proportion with low Apgar did not differ. The findings may suggest different etiological pathways causing CP in Moldova than in other European countries. A national register is warranted for quality assurance and improvement.

Keywords: Cerebral palsy; Epidemiology; Moldova; Severity; Subtype.

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Conflict of interest statement

Authors’ information

Ecaterina Gincota Bufteac is a medical doctor at Voinicel Early Intervention Centre in Chisinau, Moldova and PhD candidate at Oslo Metropolitan University, Norway,

Guro L. Andersen is a pediatrician PhD, leader of the Cerebral Palsy Registry of Norway (CPRN) at Vestfold Hospital trust and associate professor at Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology in Trondheim, Norway.

Vik Torstein is professor of pediatrics at Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology in Trondheim, Norway.

Reidun Jahnsen is a physical therapist PhD and senior researcher at Oslo University Hospital. She is leader of the national CP surveillance program (CPOP) in Norway.

Ethics approval and consent to participate

The study was approved by the National Committee for Ethical Expertise in Clinical Trials (Nr. 266) and by the Centre of Early Intervention ‘Voinicel’ Ethical Committee (nr. 01/17). A statement of Agreement of Collaboration between the State Medical and Pharmacy University and the Institute of Mother and Child was signed, and finally, permission to conduct the study was obtained from the Ministry of Health (12th of July, nr. 08/88), from the Municipality Council of Social Protection, (13.07.2016, nr. 070117/957) and from the Ministry of Labour, Social Protection and Family of the Republic of Moldova. Permission to access the children’s data was obtained from the Republican Ethics Committee, The State Medical and Pharmacy Ethics Committee, Ministry of Health and Ministry of Labour and Social Protection and the Directors of the Main Hospital for Children in RM- Institute of Mother and Child.

Consent for publication

not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

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

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