Background: Cerebral palsy (CP) is a common chronic childhood disorder worldwide. There is limited information
about the CP panorama in sub-Saharan Africa. Our aim was to describe the clinical subtypes, gross and fine motor
functions and presence of co-morbidities in a group of children with CP attending a tertiary hospital in Uganda.
Methods: Children with CP in the age range of 2-12 years visiting the paediatric CP clinic at Mulago Hospital,
Kampala, were enrolled. Screening and inclusion were based on a three-stage procedure: i) Two screening
questions from the Ten Question Screen; ii) Clinical assessments adapted from the Surveillance for Cerebral
Palsy in Europe (SCPE); iii) Clinical examinations and diagnoses of subtype, severity level and co-morbidities.
Caregivers were interviewed using questionnaires to provide information on child’s medical history and co-morbidities.
Co-morbidity scores were calculated for each child.
Results: One hundred and thirty five children with CP were enrolled (72 males, 63 females, median age 3 years
5 months, IQR-2 years 4 months-5 years 6 months). Bilateral spastic type was commonest (45%); moderate impairment
in gross motor function was present in 43%, with comparable numbers (37%) in the mild and severely impaired fine
motor function groups. The severe gross and fine motor function levels were seen in the bilateral spastic and dyskinetic
CP subtypes.
Signs of learning disability (75%) and epilepsy (45%) were the commonest co-morbidities. Higher co-morbidity scores
were obtained in children with dyskinetic CP and severe levels of gross and fine motor function. There was a significant
difference in distribution of the co-morbidity scores between the CP subtypes, gross motor and fine motor function
levels (p <0.001). Signs of speech and language impairments were associated with bilateral spastic CP and severe gross
and fine motor dysfunction (p < 0.05).
Conclusions: Bilateral spastic CP was the main clinical subtype, with signs of learning disability and epilepsy as major
causes of co-morbidity. The severity of gross and fine motor function levels was related to severity of clinical CP subtypes.
Our findings imply a higher occurrence of birth asphyxia or post natally acquired infections. Improvement in emergency
obstetric and postnatal care may reduce this burden.