A Population-based Study on the Prevalence of Impairment and Disability Among Young Cambodian Children

Peter Evans; Shaheen Shah; Adam Huebner; Selvaraj Sivasubramaniam; Chhoeurn Vuthy; Kao Sambath; Lucy Haurisa; Yim Borun

doi:10.5463/dcid.v25i2.188

Peter Evans ⁽¹⁾, Shaheen Shah ⁽²⁾, Adam Huebner ⁽³⁾, Selvaraj Sivasubramaniam ⁽⁴⁾, Chhoeurn Vuthy ⁽⁵⁾, Kao Sambath ⁽⁶⁾, Lucy Haurisa ⁽⁷⁾, Yim Borun ⁽⁸⁾

(1) Special Education, United Kingdom,

(2) Brisbane, Australia,

(3) Handicap International, Cambodia,

(4) University of Aberdeen, United Kingdom,

(5) National Paediatric Hospital, Cambodia,

(6) Centre for Child and Adolescent Mental Health, Cambodia,

(7) WHO Western Pacific Region, Philippines,

(8) Kampot Hospital, Cambodia

https://doi.org/10.5463/dcid.v25i2.188

Issue
Vol. 25 No. 2 (2014): Summer 2014

Submitted
September 14, 2020

Published
August 17, 2014

Keywords:

Two-phase procedure, risk factors, treatment needs, education and health services

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Abstract

Purpose: This population-based study aimed to estimate the prevalence of impairment and disability and associated risk factors among children between 2 – 9 years of age in Cambodia.

Method: A two-phase method was employed. In phase 1, children were screened using the Ten Question Screening Instrument (TQSI) developed for the World Health Organisation (WHO). Those identified positive, were then referred to phase 2 for a detailed multi-professional assessment. A further 10% of children pre-selected at random were also referred to phase 2. Treatment needs for children with disability and risk factors for their disability were also determined.

Results: Prevalence of impairment was estimated at 15.59% (95% CI: 15.05, 16.14), disability at 10.06% (95% CI: 9.16, 10.1) and moderate/severe/profound at 3.22% (95% CI: 2.96, 3.49). Cognition (5.48%. 95% CI: 5.15, 5.83), speech (motor) (2.05%. 95% CI: 1.85, 2.27), speech (language) (1.80%. 95% CI: 1.61, 2.01) and hearing (2.51%. 95% CI: 2.29, 2.76) were the most common disabilities. History of difficult delivery, child’s age, major injury, gender and large family size were significant predictors of disability. Analysis of ‘false negatives’ in the validation group suggested that many parents and caretakers were unaware of their child’s disability.

Treatment needs were found to be very high, approaching 100% for children with moderate or worse disabilities.

Conclusions: Prevalence estimates based on this study are more than 10 times higher than those reported in Cambodia's 2008 National Census. The identified risk factors imply the need for substantial expansion of obstetric services. Education and awareness of disabilities in the population and strategies to prevent injuries require more government attention.

Limitations: The main limitation was the relatively low response rate in phase 2, following referral from phase 1, despite efforts made to encourage attendance. This issue would need to be addressed in future work.

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Authors

Peter Evans

Special Education

plcevans@hotmail.com (Primary Contact)

Shaheen Shah

Brisbane

Adam Huebner

Handicap International

Selvaraj Sivasubramaniam

University of Aberdeen

Chhoeurn Vuthy

National Paediatric Hospital

Kao Sambath

Centre for Child and Adolescent Mental Health

Lucy Haurisa

WHO Western Pacific Region

Yim Borun

Kampot Hospital

Author Biographies

Peter Evans, Special Education

Professor Peter Evans, B.Sc., Ph.D., F.B.Ps.S., is a consultant in special education. Formerly, he was a senior analyst at the Organisation for Economic Co-operation and Development's Centre for Educational Research and Innovation where he managed the work on special education and statistics and indicators.

Shaheen Shah, Brisbane

Dr. Shah is a specialist paediatric ophthalmologist practicing in Brisbane, Australia. He qualified as a statistician and epidemiologist after completing two post graduate degrees at the London School of Hygiene and Tropical Medicine and the Institute of Child Health (University College London). Being extensively involved in research, he has published over 30 peer reviewed papers in the field of epidemiology and paediatric ophthalmology.

Adam Huebner, Handicap International

Adam Huebner received his undergraduate degree in cultural anthropology from the University of Wisconsin in the USA and a masters degree in public health systems development from Chulalongkorn University in Thailand, both times receiving academic honors. Mr. Huebner has worked for the US government and International NGOs in infectious disease control, disability and mother and child health for more than 15 years in the US, Africa and Asia. He speaks English, French, Khmer and Thai. He currently works as a health coordinator for an NGO in Sierra Leone and Liberia.

Selvaraj Sivasubramaniam, University of Aberdeen

Selvaraj Sivasubramaniam is a Lecturer in Medical Statistics at the University of Aberdeen, United Kingdom. He has his Postgraduate degree in Biostatistics and a Postgraduate diploma in Computer Programming. He has collaborated extensively with international researchers and contributed his statistical expertise in major research programmes over two decades and has published 50 peer reviewed papers in the fields of ophthalmology and epidemiology.

Chhoeurn Vuthy, National Paediatric Hospital

Professor Vuthy CHHOEURN, M.D, Paediatric Orthopaedic Surgeon, is currently Head of the Department of Surgery, National Pediatric Hospital, Phnom Penh. He also serves as the President of the Cambodian Society of Orthopaedics and Traumatology (2012-Present), Medical Director of the Cure Clubfoot Cambodia (2007-Present), Members of Board of Trustees of Exceed/Cambodia Trust (2013-Present). Prof. Vuthy CHHOEURN teaches at the University of Health Sciences, and the International University, Phnom Penh.

Kao Sambath, Centre for Child and Adolescent Mental Health

Dr. Kao Sambath, MSc in Medicine (Pediatrics), is a chief of service, Center for Child and Adolescent Mental Health (Caritas-CCAMH) responsible for overall clinical services for children (0-18 years) with Neuro-Psychiatic and Neuro-developmental disorder, facilitating the capacity building program at the center, coordinating the school and community mental health programs and the out reach services at Battambong and Kompong Thom province, Cambodia.

Lucy Haurisa, WHO Western Pacific Region

Lucy Haurisa, MD, ENT Specialist, MScPH, is a consultant in Ear, Nose and Throat Medicine with clinical and public health working experience in Germany, UK, Singapore, Hongkong and Cambodia. Her special interest lies in the prevention and management of ear and hearing disease in developing countries.

Yim Borun, Kampot Hospital

Head of Eye Department

1.

Evans P, Shah S, Huebner A, Sivasubramaniam S, Vuthy C, Sambath K, Haurisa L, Borun Y. A Population-based Study on the Prevalence of Impairment and Disability Among Young Cambodian Children. DCIDJ [Internet]. 2014 Aug. 17 [cited 2025 Apr. 19];25(2):5-20. Available from: https://dcidj.uog.edu.et/index.php/up-j-dcbrid/article/view/148

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