Performance of the UNICEF/UN Washington Group tool for identifying functional difficulty in rural Zimbabwean children.
Performance of the UNICEF/UN Washington Group tool for identifying functional difficulty in rural Zimbabwean children.
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DOI：
10.1371/journal.pone.0274664
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发表时间：
2022
期刊：
影响因子：
3.7
通讯作者：
Gladstone, Melissa J.
中科院分区：
文献类型：
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作者：
Dunne, Thomas Frederick;Chandna, Jaya;Majo, Florence;Tavengwa, Naume;Mutasa, Batsirai;Chasekwa, Bernard;Ntozini, Robert;Prendergast, Andrew J.;Humphrey, Jean H.;Gladstone, Melissa J.
全世界有超过10亿残疾人，其中80%生活在发展中国家。可靠的儿童残疾数据是有限的，特别是作为识别幼儿残疾功能不良的工具。一组儿童参加了婴儿营养功效试验（SHINE）（在津巴布韦两个农村地区进行的一项以社区为基础的聚类随机、2x2因子试验），在2岁时接受了神经发育评估。我们使用华盛顿组儿童功能模块（WGCFM）评估hiv暴露儿童和未暴露儿童的功能困难患病率，使用卡方检验或Fisher精确检验比较绝对差异。马拉维发展评估工具（MDAT）的并发效度评估采用MDAT队列评分四分位数的逻辑回归、原始评分单位增加的线性回归和广义估计方程方法（调整聚类）来比较有和无功能困难的MDAT评分。然后采用三步聚类调整多变量回归模型来检查功能困难的危险因素。未接触艾滋病毒儿童（n = 1606）的功能困难患病率为4.2% (95%CI: 3.2%, 5.2%)，而接触艾滋病毒儿童（n = 314）的功能困难患病率为6.1% (95%CI: 3.5%, 8.9%)（绝对差异为1.9%,95%CI: -0.93%, 4.69%; p = 0.14）。功能困难评分与MDAT呈负相关：WGCFM评分每增加一个单位，儿童完成的MDAT项目减少2.6个（95%CI: 2.2, 3.1） （p = 0.001）。来自粮食不安全和住房条件较差家庭的儿童更有可能出现功能障碍。在津巴布韦农村地区，大约每20名儿童中就有1名存在功能障碍，这与以前的研究结果相当。WGCFM与MDAT同时显示效度，支持其在儿童早期使用。
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. 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. 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. 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.
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DOI：
10.1016/s2214-109x(18)30309-7
发表时间：
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期刊：
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影响因子：
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作者：
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通讯作者：
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影响因子：
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