title: Validity and reliability of the 'Ten Questions' questionnaire for detecting moderate to severe neurological impairment in children aged 6-9 years in rural Kenya.
abstract: BACKGROUND
  The 'Ten Questions' Questionnaire (TQQ) is used to detect severe neurological impairment in children living in resource-poor countries. Its usefulness has been established in Asia and the Caribbean, but there are a few published studies from Africa. We evaluated the TQQ as part of a larger study of neurological impairment in a rural community, on the coast of Kenya.
  
  
  METHODS
  The study was conducted in two phases from June 2001 to May 2002; in phase one, a community household screening of 10,218 children aged 6-9 years using the TQQ was performed. Phase two involved a comprehensive clinical and psychological assessment of all children testing positive on the TQQ (n = 810) and an equivalent number of those testing negative (n = 766). Data were interpreted using the impairment-specific approach.
  
  
  RESULTS
  Overall, the sensitivity rates for screening the different impairments were: cognitive (70.0%), motor (71.4%), epilepsy (100%), hearing (87.4%) and visual (77.8%). All the specificity rates were greater than 96%. However, the positive predictive values were low, and ranged from 11 to 33%.
  
  
  CONCLUSIONS
  These results are similar to those from other continents and provide evidence that the TQQ can be used to compare the epidemiology of moderate/severe impairment in different parts of the world. Furthermore, the TQQ can be used to screen for moderately/severely impaired children in resource-poor countries; however, the low positive predictive values mean that other assessments are required for confirmation.
authors.affiliation: Center for Geographic Medicine-Coast, Kenya Medical Research Institute, Kilifi, Kenya. vodera@kilifi.mimcom.net
authors.forename: V
authors.initials: V
authors.lastname: Mung'ala-Odera
authors.forename: R
authors.initials: R
authors.lastname: Meehan
authors.forename: P
authors.initials: P
authors.lastname: Njuguna
authors.forename: N
authors.initials: N
authors.lastname: Mturi
authors.forename: K
authors.initials: K
authors.lastname: Alcock
authors.forename: J A
authors.initials: JA
authors.lastname: Carter
authors.forename: C R J C
authors.initials: CR
authors.lastname: Newton
mesh_terms: D002648:Child; D005260:Female; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D008297:Male; D008403:Mass Screening; D009422:Nervous System Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012424:Rural Population; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires