Assessment of Neurodisability and Malnutrition in Children in Africa

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Abstract

Neurodevelopmental delay, neurodisability, and malnutrition interact to contribute a significant burden of disease in global settings. Assessments which are well integrated with plans of management or advice are most likely to improve outcomes. Assessment tools used in clinical research and programming to evaluate outcomes include developmental and cognitive tools that vary in complexity, sensitivity, and validity as well as the target age of assessment. Few tools have been used to measure socioemotional outcomes and fewer to assess the disabled child with malnutrition. There is a paucity of tools used clinically which actually provide families and professionals with advice to improve outcomes. Brain imaging, electroencephalography, audiology, and visual assessment can also be used to assess the effect of malnutrition on brain structure and function. The interaction of neurodisability and malnutrition is powerful, and both need to be considered when assessing children. Without an integrated approach to assessment and management, we will not support children and families to reach their best potential outcomes.

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M.K. is a clinical lecturer funded by NIHR. He gratefully acknowledges support from an Academy of Medical Sciences “Clinical Lecturer Starter Grant” supported by the Wellcome Trust, British Heart Foundation and Arthritis Research UK. M.G. was a clinical lecturer funded by NIHR at the time of writing. She gratefully acknowledges support from an Academy of Medical Sciences “Clinical Lecturer Starter Grant” supported by the Wellcome Trust, British Heart Foundation and Arthritis Research UK as well as a Wellcome Trust Biosciences fellowship.