title: Prevalence of early childhood disability in a rural district of Sind, Pakistan.
abstract: OBJECTIVE
  Children born in low- and mid-income countries are at a high risk of developing disabilities, yet estimates of population-based prevalence are sparse. Our aim was to determine the prevalence of early childhood (0-5 year) disability in Sind, a rural area of Pakistan.
  
  
  METHODS
  We conducted a cross-sectional household survey in a population of 25,196 households. The Ten Questions screen and the Signs of Disability in Newborn and Infants screen were used.
  
  
  RESULTS
  The disability prevalence in a population of 176,364 individuals was 5.5 out of 1000 in children under 2 years and 5.4 out of 1000 in children aged 2-5 years. Fifty-six per cent were males, and 56% had the disability recognized from birth or soon after. The mortality rate of children aged 0-5 years in the area was estimated as 30 out of 1000 live births. Cerebral palsy was the most common disability identified. The Ten Questions screen had better interrater agreement than the Signs of Disability in Newborn and Infants screen.
  
  
  CONCLUSIONS
  This is the largest reported household screening survey for early childhood disability at a population level from rural Pakistan. The comparatively low prevalence may be due to the younger age studied and high early childhood mortality. Our data highlight the importance of prospective surveillance at a population level and the need for preventive and support services.
authors.affiliation: Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan. shahnaz.ibrahim@aku.edu
authors.forename: Shahnaz H
authors.initials: SH
authors.lastname: Ibrahim
authors.forename: Zulfiqar A
authors.initials: ZA
authors.lastname: Bhutta
mesh_terms: D002547:Cerebral Palsy / Q000453:epidemiology; D002675:Child, Preschool; D003072:Cognition Disorders / Q000453:epidemiology; D003241:Consanguinity; D003430:Cross-Sectional Studies; D003625:Data Collection; D003906:Developing Countries / Q000706:statistics & numerical data; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D004827:Epilepsy / Q000453:epidemiology; D005191:Family Characteristics; D005260:Female; D006311:Hearing Disorders / Q000453:epidemiology; D006801:Humans; D007182:Income; D007805:Language Development Disorders / Q000453:epidemiology; D008297:Male; D009069:Movement Disorders / Q000453:epidemiology / Q000209:etiology; D009136:Muscular Dystrophies / Q000453:epidemiology; D010154:Pakistan / Q000453:epidemiology; D015995:Prevalence; D012424:Rural Population / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014786:Vision Disorders / Q000453:epidemiology