Factors associated with cognitive developmental delay among infants attending Reproductive and Child Health clinics in Dar es salaam, Tanzania

Background; Early child cognitive development is important throughout one’s life span. It is estimated that more than 200 million children under five years of age fail to achieve full cognitive development in the world and 80% of them are in south Asia and sub-Sahara-Africa. Genetic and environmental factors play a role in early child development (ECD). Most of the ECD occurs in the first 2years of life, but largely during infancy. Malnutrition, poverty and poor health care to children have been found to have association with poor cognitive development and create a vicious cycle of poverty. This study gives the proportion and factors that are associated with infants’ cognitive developmental delay in our setting. Knowing these factors enhance early intervention to break the viscious cycle.This study aimed to determine the proportion and factors associated with cognitive developmental delay among infants attending RCH clinics in Dar es Salaam.

Patients/ Material and Methods; This was a health facility based descriptive cross-sectional study conducted by using a structured data collecting tool done in three health centers in Dar es Salaam from July to December 2012. A two- stage sampling technique and Lottery were used to get the health centers. The data were analyzed using SPSS software by Pearson’s chi-square, Fisher exact test and logistic regressions.

Results; A total of 350 infants were assessed for cognitive development in a period of six months. Male infants were the majority by 50.6%. Our study Participants aged 1to 12 months with a mean (SD) of 7.26 (3.43) months with their birth weight ranging from 1.3 to 4.6kg with mean (SD) of 3.11(0.50) kg. The Proportion of infants with cognitive developmental delay was 12.3%. Age of the child, caretakers and wasting were significantly associated with cognitive developmental delays even after adjusting for confounders. Infants aged less than 6months were 14 times more likely to have cognitive developmental delay compared to those aged six months and above (adjusted oddis ratio{aOR=14; 95%CI 5.3-38.3, P<0.001}). Infants cared by assistant caretakers especially during day-time, were 12 times more likely to have cognitive developmental delay compared to infants who stayed with their mothers (aOR=12.1; 95%CI 3.0-53, P=0.001). Wasted infants were 4 times more likely to have cognitive developmental delay (aOR=3.9; 95%CI 1.1-13.3, P=0.032) compared to infants with good nutritional status.

Conclusion; The proportion of cognitive developmental delay among infants attending Reproductive and Child Health( RCH) clinics in Dar es Salaam was 12.3%. Young age of the child, use of other caretakers in absence of the mother, and wasting were associated with cognitive developmental delays. Infants need Mothers to spend time with them and prevention of malnutrition plays a role in cognitive development.