121 Assessing nutritional and educational inclusion status of nepali children screening positive for disability and variation of prevalence at different thresholds of disability screening definition. (December 2018)

• Record Type: Journal Article
• Authors: Cupp, M; Haworth, Ed; Costello, A; Manikam, L; Manandhar, D; Kuper, H; Heys, M
• Is Part Of: Archives of disease in childhood. Volume 103:Supplement 2(2018)
• Page Start: A48
• Page End: A49
• Publication Date: 2018-12
• Subjects: Infants -- Diseases -- Periodicals; Newborn infants -- Diseases -- Periodicals; Fetus -- Diseases -- Periodicals; 618.920105
• DOI: 10.1136/goshabs.121
• Languages: English
• ISSNs: 1359-2998

Abstract

Abstract : Background: Assessment of prevalence and associated outcomes for childhood disability is vital for quantification of global impact and addressing the sustainable development goals. This study assesses the prevalence of disability in children aged 9 to 13 years in rural Nepal's Makwanpur District, including sensitivity analysis of disability prevalence at different thresholds through the Module on Child Functioning and Disability (MCFD). We also assess the nutritional and education inclusion characteristics of those screening positive for disability. Methods: The 4098 participants in this study represent the individuals available for a household interview between 2014 and 2015, from an original cohort of 6, 436 Nepali infants recruited into a Randomised Control Trial between 2001 and 2003 (ISRCTN31137309 ). Characteristics of children with and without a disability are compared through an assessment of significance of Odds Ratios. Results: At a mean age of 11.4 years, the prevalence of disability is estimated at 7.4% when the least stringent criteria are applied, indicating that participants reported at least some difficulty in one or more of the core domains of the MCFD (table 1). The prevalence of disability using more stringent cut offs provided lower prevalence estimates, with 1.0% of participants reporting a lot of difficulty in at least one domain and 0.3% reporting cannot do at all in at least one domain. Children with disability were more likely to be severely underweight (Weight/Age Z-scores≤3: 8% versus 15%, p-value<0.001) and stunted (Height/Age Z-score ≤3: 8% versus 15%, p-value≤0.001) themselves. Furthermore, children with disability were significantly less likely to be attending school (96% vs 92%, p-value<0.001). Conclusion: Results indicate that prevalence figures for disability should be interpreted with caution according to the criteria utilised. Furthermore, Nepali children with disability appear to be at a greater risk of both underweight, stunting and exclusion from education compared to children without disability.