Prevalence of developmental delay and associated risk factors among At Risk Surveillance System (ARSS) children at United Bulawayo Hospitals, Zimbabwe

Globally, 8.4% of children under five years of age have developmental disorders, with sub-Saharan Africa having the highest prevalence. In Zimbabwe, the At Risk Surveillance System (ARSS) follows up on babies with known developmental risk factors for early detection of developmental delay. This study aimed to determine the prevalence and severity of developmental delay in children under the ARSS at United Bulawayo Hospitals (UBH). A descriptive cross-sectional study systematically sampled 160 babies enrolled in the ARSS between 2019 and 2020. The Bayley Scales of Infant and Toddler Development Third Edition (BSID-III) tool was used to assess cognitive, motor, and language domains. Developmental delay risk factors were also noted from caregivers and patient files. A prevalence of 83.7% developmental delay was established in our sample, the majority of whom had mild developmental delay. The most important risk factors for developmental delay in all three domains were neonatal convulsions (Adjusted Odds Ratio, aOR, 5.6, p=0.03), Apgar scores of <5 (aOR 2.6, p=0.02), and being a boy (aOR 7.1, p<0.001). Developmental delay of 83.7% is higher than in previous findings because children included in this study had known risk factors for developmental delay. The risk factors were similar to those identified by other studies. Children with the most important risk factors need close monitoring as they have a high chance of developmental delay. Children with known risk factors should be closely monitored using the BSID-III, while the rest can be screened using cheaper and faster tools such as the Ages and Stages Questionnaire (ASQ).