Epidemiology of Cerebral Palsy in the Kingdom of Saudi Arabia

Abstract

Background: Cerebral palsy (CP) is the primary cause of childhood physical disability and lacks comprehensive epidemiological data in Saudi Arabia and similar regions. This PhD thesis explores the epidemiological profile, clinical manifestations, and challenges of CP in Saudi Arabia, aiming for a better understanding and potential intervention strategies.

Methods: This thesis utilised multiple research methods:

- Narrative literature review to define the burden of CP in Arabic-speaking and Middle Eastern countries.

- Systematic reviews, meta-analyses, and a hospital-based surveillance of children with CP in Saudi Arabia from 2020 to 2022 to assess epidemiology and nutritional status.

- An online survey to examine the impact of COVID-19 on primary caregivers of children with CP in Saudi Arabia.

- Designing and establishing a CP register in Saudi Arabia through multi-organisational collaboration.

Results: Literature reviews indicate scant data on CP epidemiology in the Middle East, including a CP prevalence of 1.8/1000 live births in the region. Spastic CP is predominant (59.8%), with significant consanguinity-related risk (37.7%). In Saudi Arabia and similar regions, 71.5% of children with CP suffer from malnutrition. Surveillance of 442 children indicated a majority are over four years old, with birth asphyxia being a major cause (32.4%). Many children lacked rehabilitation services and were not current on immunizations. COVID-19's impact was notable but mostly non-hospitalised; however, telehealth was deemed inadequate by most families.

Conclusions: CP epidemiology in Saudi Arabia is poorly defined despite being a high-income country. Significant gaps in population-based surveillance and research persist, underscoring the need for comprehensive studies to understand CP's aetiologies and improve prevention, diagnosis, and treatment. Establishing a Saudi CP register is crucial for advancing research and healthcare strategies.