Dunne, Thomas Frederick, Chandna, Jaya, Majo, Florence, Tavengwa, Naume, Mutasa, Batsirai, Chasekwa, Bernard, Ntozini, Robert, Prendergast, Andrew J, Humphrey, Jean H and Gladstone, Melissa J 
ORCID: 0000-0002-2579-9301
(2022)
Performance of the UNICEF/UN Washington Group tool for identifying functional difficulty in rural Zimbabwean children.
PLOS ONE, 17 (9).
e0274664-.
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Performance of the UNICEFUN Washington Group tool for identifying functional difficulty in rural Zimbabwean children.pdf - Published version Download (1MB) | Preview |
Abstract
<h4>Introduction</h4>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.<h4>Methods</h4>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.<h4>Findings</h4>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.<h4>Interpretation</h4>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.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Humans, HIV Infections, Child, Child, Preschool, Infant, Rural Population, United Nations, Zimbabwe, Washington |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 07 Oct 2022 10:21 |
| Last Modified: | 06 May 2023 00:36 |
| DOI: | 10.1371/journal.pone.0274664 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3165097 |
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