Usefulness of Child Development Assessments for Low-Resource Settings in Francophone Africa
Usefulness of Child Development Assessments for Low-Resource Settings in Francophone Africa
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DOI：
10.1097/dbp.0b013e31829d211c
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发表时间：
2013-09-01
影响因子：
2.4
通讯作者：
Bodeau-Livinec, Florence
中科院分区：
文献类型：
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作者：
Koura, Kobto G.;Boivin, Michael J.;Bodeau-Livinec, Florence
目的：几乎没有工具可用于筛查或评估婴儿的认知发展，特别是在讲法语的非洲。本研究评估了法语国家贝宁1岁儿童对马伦早期学习量表(MSEL)和十个问题问卷(TQ)的法语翻译的使用情况。方法：在贝宁的一个半自然地区的3个卫生中心进行了横断面研究。2011年，357名12个月大的儿童及其母亲参加了注册。在当地卫生中心评估婴儿发育情况，然后进行家访，收集有关社会经济状况、母亲乌鸦评分、母亲抑郁症状和母婴互动(家庭观察环境测量[HOME]问卷)的信息，并管理TQ。结果：在多因素分析中，婴儿的性别(女性)、家庭和母亲教育与较高的早期学习综合得分相关(p=0.02，p=0.004，p=0.007)。家庭财富和家庭财富也与粗大汽车等级相关(分别为p=0.03和p=0.03)。当孩子在MSEL上表现出较低的分数时，母亲更有可能报告TQ上的困难。当以粗大运动量表作为定义中度延迟的金标准时，TQ上的两个与运动相关的组合问题显示出良好的敏感性和特异性(76.5和75.7)。结论：在非洲一个资源匮乏的农村地区，TQ有效地确定了四分之三的1岁婴儿发育迟缓。在这次筛查后，MSEL可能对进一步的评估有用，因为它显示了良好的可行性和对儿童发育不良的已知风险因素的敏感性。
Objective: Few tools are available to screen or assess infant's cognitive development, especially in French-speaking Africa. This study evaluated the use of the French translation of the Mullen Scales of Early Learning (MSEL), and the "Ten Questions" questionnaire (TQ) in 1-year-old children in Benin, a francophone country. Methods: A cross-sectional study was conducted in 3 health centers serving a semirural area in Benin. Three hundred fifty-seven children aged 12 months and their mothers were enrolled in 2011. Infant development was assessed at local health centers followed by a home visit to collect information on socioeconomic status, maternal Raven score, maternal depressive symptoms, and mother-child interactions (Home Observation for the Measurement of the Environment [HOME] Inventory), and to administer the TQ. Results: The infant's gender (female), the HOME, and maternal education were associated with a higher Early Learning Composite score in multivariate analyses (p = .02, p = .004, p = .007, respectively). The HOME and family wealth were also associated with the Gross Motor Scale (p = .03 and p = .03, respectively). Mothers were more likely to report difficulties on the TQ when the child presented lower score on the MSEL. When considering the Gross Motor Scale as the gold standard to define moderate delays, the 2 combined motor-related questions on the TQ showed good sensitivity and specificity (76.5 and 75.7). Conclusion: In a low-resource rural setting in Africa, the TQ effectively identified 3 quarters of 1-year-old infants with delayed development. After this screening, the MSEL may be useful for further assessment as it showed good feasibility and sensitivity to known risk factors for poor child development.