Includes abstract. / Includes bibliographical resources. / Feeding and/or swallowing difficulties (FSD) have been associated with some of the leading causes of infant and child mortality in South Africa. Preventable conditions such as lower respiratory tract infections (LRTI) and under-nutrition may be caused by FSD. FSD are frequently reported in paediatric populations and may occur with various medical co-morbidities. The nature of FSD is however under described and information specific to developing countries is scarce. Furthermore, limited information regarding the service delivery requirements of the paediatric population with FSD is available. To describe in a paediatric population: the nature and frequency of FSD, the nature of FSD in different medical conditions or participant characteristics, and the nature of the services and interventions received by infants and children with FSD. A descriptive, retrospective survey design was used to examine the medical records of 446 infantsand children aged less than 13 years who accessed services for FSD at a paediatric tertiary hospital from January 2007 to December 2009. Seventy percent of participants were under the age of 2 years at the time of first assessment. The nature of participants’ FSD, the medical conditions present, and services/interventions received were recorded. The data were described and associations were analysed statistically. Infants and children with FSD often presented with various medical co-morbidities affecting multiple organ systems with neurologic and gastro-intestinal tract conditions occurring most frequently. A third (34%) of the participants had confirmed aspiration on instrumental assessment. Participants with confirmed aspiration presented with statistically significantly more aspiration pneumonia (x2 = 26.4314, p <; .001) and unspecified LRTI (x2 = 21.2757, p <; .001) than those without aspiration. Participants required a range of services for FSD from Speech-Language Therapists (SLT) as well as medical intervention, and surgical procedures. Most participants (91%) received intervention for FSD for an average of 6 months with a mean of 6 SLT consultations. Forty-three percent of participants completed intervention while 20% continued to receive intervention. The present study profiled paediatric FSD in the Western Cape, South Africa. Infants and children with FSD presented with varied and multiple underlying medical conditions. The safety of swallowing was often (34%) compromised in this population which may have affected respiratory health negatively. Infants and children with FSD frequently presented with LRTI and growth faltering/under-nutrition, two of the leading causes of death in children under the age of 5 years. There is a need for dysphagia services at primary and district levels of health care in the Western Cape to detect and prevent paediatric FSD. While the management of FSD requires the collaboration of many health care professionals, the inclusion of SLTs and dieticians into primary and district level teams may assist with the identification of FSD for early intervention and may prevent FSD-related LRTI and undernutrition in infants and children with FSD
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:uct/oai:localhost:11427/2931 |
| Date | January 2012 |
| Creators | Oosthuizen, Nicolene |
| Contributors | Norman, Vivienne, Singh, Shajila |
| Publisher | University of Cape Town, Faculty of Health Sciences, Division of Communication Sciences and Disorders |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Master Thesis, Masters, MSc |
| Format | application/pdf |
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