Significant cognitive delay among 3- to 4-year old children in low- and middle-income countries: Prevalence estimates and potential impact of preventative interventions

Eric Emerson, Amber Savage, Gwynnyth Llewellyn

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)

Abstract

Background: We sought to: (i) estimate the prevalence of significant cognitive delay (a marked delay in the development of general cognitive functioning) among nationally representative samples of young children in middle- and low-income countries; (ii) estimate the total number of children under 5 years of age with significant cognitive delay living in low- and middle-income countries; and (iii) estimate the potential impact of five preventative interventions. Methods: Secondary analysis of data collected in Rounds 4 and 5 of UNICEF’s Multiple Cluster Indicators Surveys in 51 countries involving 163 293 3- to 4-year-old children. Adjusted population-attributable fractions were used to estimate the potential impact of five interventions based on Sustainable Development Goals (SDGs). Results: The prevalence of significant cognitive delay in 3- to 4-year-old children in middle- and low-income countries was 10.1% (95% confidence interval 9.7–10.4%). Prevalence was strongly inversely related to country economic wealth. The estimated total number of children under 5 with significant cognitive delay living in low- and middle-income countries was just under 55 million. This number could be reduced by over 60% if three separate SDGs were achieved; every mother had secondary-level education, every household had access to improved water and sanitation, and every child had an acceptable level of home stimulation. Conclusions: Our results provide additional evidence in support of a range of specific preventative interventions in early childhood to reduce the loss of developmental potential among children in low- and middle-income countries.

Original languageEnglish
Pages (from-to)1465-1474
Number of pages10
JournalInternational journal of epidemiology
Volume47
Issue number5
DOIs
Publication statusPublished - 1 Oct 2018
Externally publishedYes

Keywords

  • Cognitive delay
  • Intellectual disability
  • Low- and middle-income countries
  • Prevention
  • Young children

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