Adaptation of the "ten questions" to screen for autism and other neurodevelopmental disorders in Uganda.
OBJECTIVE To determine the prevalence of disability in children under 10 years of age in the Manguzi subdistrict, in order to inform the development of an appropriate rehabilitation service. SETTING Twelve areas within the rural Manguzi subdistrict of the Jozini-Uthungulu district in the far north-east of KwaZulu-Natal. DESIGN A descriptive study in two stages. The first stage identified children under the age of 10 years reported with a disability. For this stage, 12 community health workers (CHWs) were trained to use a validated '10-question' screening tool with probes, adapted to include the under-2-year age group. The second stage involved confirmation of actual disability by the Manguzi rehabilitation team. RESULTS A total of 2,036 children were screened. Of these children, 168 were reported with a disability giving an overall rate of 83/1,000 (95% confidence interval (CI): 71-95). The overall confirmed prevalence rate for children with disabilities under 10 years was 60/1,000 (95% CI: 50-71). The most prevalent disabilities were mild perceptual or learning disability (17/1,000), followed by cerebral palsy (10/1,000), hearing loss (10/1,000), moderate to severe perceptual disability (6/1,000) and seizure disorders (4/1,000). CONCLUSION The prevalence of disabilities among children aged under 10 years is high. This has major implications for health, rehabilitation, welfare and educational services in rural areas. These implications must be addressed in order to develop appropriate rehabilitation services for children in rural areas.