Epidemiology of cerebral palsy on Tanna Island, Vanuatu: A population-based register study.

AIM: To describe the epidemiology of cerebral palsy (CP) and access to related services on Tanna Island, Vanuatu, a low-income country in the Pacific region with limited data on childhood disability, including CP.

METHOD: A population-based register of children (aged 0-18 years) with CP was established on Tanna Island. Children with suspected CP were identified using the key informant method and assessed by a multidisciplinary team for clinical diagnosis. Data were collected on demographics, aetiology, clinical characteristics, rehabilitation, and education using a culturally adapted case record form from the Global Low- and Middle-Income Country CP Register.

RESULTS

Of the 98 children assessed, 52 had CP and two acquired brain injury. The observed prevalence of CP was 3.4 per 1000 in the paediatric population; mean age at diagnosis was 8 years 1 month (SD = 5 years 1 month). Sixty-three per cent (n = 34) of children had primary motor-type spasticity, 43% (n = 23) were classified in Gross Motor Function Classification System levels III to V, 43% (n = 21) were severely underweight, 83% (n = 45) had never received any rehabilitation, and 79% of school-age children (n = 30 of 38) did not attend school.

INTERPRETATION: The prevalence and motor severity of CP is alarmingly high on Tanna Island, Vanuatu. Delayed diagnosis and lack of access to rehabilitation and education highlights the urgent need for early diagnosis, intervention, and rehabilitation services for children with CP in Vanuatu.