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198 Implementing the hammersmith infant neurologic examination (HINE) for early detection of cerebral palsy in Ethiopia: a feasibility and knowledge translation study

bmjpo · 2026-07-14 · canonical JSON source

2 visible annotations · policy: published · automated confidence ≥ 75.00%

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The average age for detection of cerebral palsy (CP) in Ethiopia is 5.6 (SD 3.6) years. We aimed to shift the age of detection of CP to less than 12 months in Tikur Anbessa Specialized Hospital (TASH) in Ethiopia by incorporating the Hammersmith Infant Neurologic Examination (HINE) into clinical practice. The HINE tool has been identified as vital for early CP identification as per an international clinical practice guideline, particularly in low to middle-income settings. Implementation strategies were identified using the ‘Knowledge to Action’ framework. Paediatric staff and 54 residents received HINE training and administered it in selected clinics which included the Pediatric Neurology, Developmental and High-risk infantile clinics. Based on HINE global score, infants were classified into 1) above the 10th percentile score, 2) between the 10th% and high probability of CP cut-off score, and 3) below the high probability of CP cut-off score. Among 117 children assessed, ninety-eight infants with CP risk factors were classified on clinical reasoning and the HINE global score: 48 (49%) scored above the HINE 10th% score, 15 (15%) scored between and 35 (36%) scored below the high probability of CP cut-off score. Children meeting criteria for high probability of CP were referred to community rehabilitation centers (mean age at referral 10.6 months (SD 6.6, range 3–23 months). Implementing the HINE in Ethiopia enabled earlier detection of CP/high probability of CP and timely referral to rehabilitation services. This practice supports future knowledge translation and improve clinical practices for infants with CP in Ethiopia.