Prevalence and aetiology of cerebral palsy among Nigerian children: a systematic review and meta-analysis

BACKGROUND: Nigeria is among the leading countries contributing to the burden of cerebral palsy. Cerebral palsy (CP) is the commonest physical disability in childhood, accounting for 16.2% of child neurology referrals. Many cases of CP are preventable with simple interventions such as neonatal resuscitation and effective phototherapy. Lack of reliable data on the burden of disease limits comprehensive national policy directed to the prevention, holistic care and rehabilitation of patients with cerebral palsy in Nigeria. Therefore, to effectively address this problem, this study aimed to describe the pooled prevalence of CP in Nigeria, its potential causes and types. METHODS: This was a systematic review and meta-analysis of published articles on Nigerian children less than 18 years with CP. A combination of controlled vocabulary and keyword searching was used to reflect the core concepts of CP in Nigeria. Searches were conducted in nine databases and articles were screened using Rayyan. Data extraction forms were developed and refined by the team. Risk of Bias Tool was derived from the Mixed Methods Appraisal Tool (MMAT) 2018. RESULTS: >80%). Univariable meta-regression showed that the prevalence of CP was higher in studies that included younger children while study quality accounted for 20% of heterogeneity. However, this significance was lost with multivariable meta-regression analysis. CONCLUSION: This review highlights the high prevalence of CP in Nigeria. Tackling the leading preventable causes of CP calls for urgent public health interventions such as improved obstetric and neonatal care, in addition to improved rehabilitation services for children with CP.