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. 1991;69(6):779–789.

Prevention of mental handicaps in children in primary health care.

P M Shah 1
PMCID: PMC2393331  PMID: 1786628

Abstract

Some 5-15% of children aged 3 to 15 years in both developing and developed countries suffer from mental handicaps. There may be as many as 10-30 million severely and about 60-80 million mildly or moderately mentally retarded children in the world. The conditions causing mental handicaps are largely preventable through primary health care measures in developing countries. Birth asphyxia and birth trauma are the leading causes of mental handicaps in developing countries where over 1.2 million newborns die each year from moderate or severe asphyxia and an equal number survive with severe morbidity due to brain damage. The other preventable or manageable conditions are: infections such as tuberculous and pyogenic meningitides and encephalopathies associated with measles and whooping cough; severe malnutrition in infancy; hyperbilirubinaemia in the newborn; iodine deficiency; and iron deficiency anaemia in infancy and early childhood. In addition, recent demographic and socioeconomic changes and an increase in the number of working mothers tend to deprive both infants and young children of stimulation for normal development. To improve this situation, the primary health care approach involving families and communities and instilling the spirit of self-care and self-help is indispensable. Mothers and other family members, traditional birth attendants, community health workers, as well as nurse midwives and physicians should be involved in prevention and intervention activities, for which they should be trained and given knowledge and skills about appropriate technologies such as the risk approach, home-based maternal record, partograph, mobilogram (kick count), home-risk card, icterometer, and mouth-to-mask or bag and mask resuscitation of the newborn. Most of these have been field-tested by WHO and can be used in the home, the health centre or day care centres to detect and prevent the above-mentioned conditions which can cause mental handicap.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. De Souza S. W., Richards B. Neurological sequelae in newborn babies after perinatal asphyxia. Arch Dis Child. 1978 Jul;53(7):564–569. doi: 10.1136/adc.53.7.564. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Dweck H. S., Huggins W., Dorman L. P., Saxon S. A., Benton J. W., Jr, Cassady G. Developmental sequelae in infants having suffered severe perinatal asphyxia. Am J Obstet Gynecol. 1974 Jul 15;119(6):811–815. doi: 10.1016/0002-9378(74)90094-5. [DOI] [PubMed] [Google Scholar]
  3. Grantham-McGregor S., Stewart M. E., Schofield W. N. Effect of long-term psychosocial stimulation on mental development of severely malnourished children. Lancet. 1980 Oct 11;2(8198):785–789. doi: 10.1016/s0140-6736(80)90395-5. [DOI] [PubMed] [Google Scholar]
  4. Gustavson K. H., Hagberg B., Hagberg G., Sars K. Severe mental retardation in a Swedish county. I. Epidemiology, gestational age, birth weight and associated CNS handicaps in children born 1959--70. Acta Paediatr Scand. 1977 May;66(3):373–379. doi: 10.1111/j.1651-2227.1977.tb07910.x. [DOI] [PubMed] [Google Scholar]
  5. Gustavson K. H., Hagberg B., Hagberg G., Sars K. Severe mental retardation in a Swedish county. II. Etiologic and pathogenetic aspects of children born 1959--1970. Neuropadiatrie. 1977 Aug;8(3):293–304. doi: 10.1055/s-0028-1091525. [DOI] [PubMed] [Google Scholar]
  6. Hagberg B. Severe mental retardation in Swedish children born 1959-1970: epidemiological panorama and causative factors. Ciba Found Symp. 1978;(59):29–51. doi: 10.1002/9780470720417.ch4. [DOI] [PubMed] [Google Scholar]
  7. Khare R. D., Shah P. M., Junnarkar A. R. Management of kwashiorkor in its milieu--a follow-up for fifteen months. Indian J Med Res. 1976 Aug;64(8):1119–1127. [PubMed] [Google Scholar]
  8. Kramer M. S. Determinants of low birth weight: methodological assessment and meta-analysis. Bull World Health Organ. 1987;65(5):663–737. [PMC free article] [PubMed] [Google Scholar]
  9. Mariga L., McConkey R. Home-based learning programmes for mentally handicapped people in rural areas of Zimbabwe. Int J Rehabil Res. 1987;10(2):175–183. doi: 10.1097/00004356-198706000-00007. [DOI] [PubMed] [Google Scholar]
  10. Molteno C. D., Malan A. F., Heese H. de V. Asphyxia neonatorum--assessment of the infant at birth. S Afr Med J. 1974 Oct 19;48(51):2139–2142. [PubMed] [Google Scholar]
  11. Oski F. A., Honig A. S. The effects of therapy on the developmental scores of iron-deficient infants. J Pediatr. 1978 Jan;92(1):21–25. doi: 10.1016/s0022-3476(78)80063-8. [DOI] [PubMed] [Google Scholar]
  12. Paneth N., Stark R. I. Cerebral palsy and mental retardation in relation to indicators of perinatal asphyxia. An epidemiologic overview. Am J Obstet Gynecol. 1983 Dec 15;147(8):960–966. doi: 10.1016/0002-9378(83)90254-5. [DOI] [PubMed] [Google Scholar]
  13. Pollitt E., Saco-Pollitt C., Leibel R. L., Viteri F. E. Iron deficiency and behavioral development in infants and preschool children. Am J Clin Nutr. 1986 Apr;43(4):555–565. doi: 10.1093/ajcn/43.4.555. [DOI] [PubMed] [Google Scholar]
  14. Rantakallio P., von Wendt L., Koivu M. Prognosis of perinatal brain damage: a prospective study of a one year birth cohort of 12,000 children. Early Hum Dev. 1987 Mar;15(2):75–84. doi: 10.1016/0378-3782(87)90040-5. [DOI] [PubMed] [Google Scholar]
  15. Scott H. Outcome of very severe birth asphyxia. Arch Dis Child. 1976 Sep;51(9):712–716. doi: 10.1136/adc.51.9.712. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Shah K. P., Shah P. M. Factors leading to severe malnutrition. A relationship of maternal nutrition and marasmus in the infants. Indian Pediatr. 1975 Jan;12(1):64–67. [PubMed] [Google Scholar]
  17. Shah P. M. Birth asphyxia: a crucial issue in the prevention of developmental disabilities. Midwifery. 1990 Jun;6(2):99–107. doi: 10.1016/s0266-6138(05)80154-8. [DOI] [PubMed] [Google Scholar]
  18. Shah P. M., Udani P. M. Analysis of the vital statistics from the rural community, Palghar. II. Perinatal, neonatal and infant mortalities. Indian Pediatr. 1969 Oct;6(10):651–668. [PubMed] [Google Scholar]
  19. Shah P. M., Udani P. M., Aphale R. V. Domiciliary management of kwashiorkor in rural set up: a longitudinal study of clinical, economic and social aspects. Indian Pediatr. 1971 Dec;8(12):805–813. [PubMed] [Google Scholar]
  20. Ziegler A. L., Calame A., Marchand C., Passera M., Reymond-Goni I., Prod'hom L. S. Cerebral distress in full-term newborns and its prognostic value. A follow-up study of 90 infants. Helv Paediatr Acta. 1976 Dec;31(4-5):299–317. [PubMed] [Google Scholar]

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