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Progress in paediatric neurosciences is proceeding rapidly, and we are entering an era in which technologies will allow for a greater knowledge and understanding of normal and abnormal brain development. Because of our improved diagnostic abilities, it is now possible to identify even subtle brain abnormalities early on, thus allowing for early intervention. However, in certain areas of the world, many children do not benefit from this progress because of the shortage of child neurologists and adequately equipped medical centers.
In recent years, this progress in diagnostic and therapeutic capabilities and the growing necessity for advanced technology to diagnose CNS disorders have greatly increased the divide between developed and developing countries. In addition, child neurologists from developing countries are hampered by the lack of professional networks that could provide continuous education and updates on new developments in the specialty.
About 70% of children with disablities live in resource-poor countries, and most of them have neurological diseases. Protein-energy malnutrition, dietary micronutrient deficiencies, environmental toxins and a lack of early sensory stimulation may contribute to the high prevalence of neurodevelopmental disabilities in these countries. Access to up-to-date imaging and genetic and biochemical testing is limited in some regions, which is particularly problematic because delaying diagnosis and treatennt can have deleterious effects on a child's development.
There is an urgent need to identify regional centers and reference labd to improve diagnosis of neurological disease in children in developing countries. In Central Asia, the number of qualified child neurologists has increased in recent years, but they are not equally distributed between urban and rural areas, with about 95% of them concentrated in the countries' capital cities. The situation is worse in Africa, where many countries have no child neurologists at all.
Education is one of the primary goals and purposes of the International Child Neurology Association (ICNA). The ICNA Education Committee has organized numerous programs for improving participants' knowledge of paediatric neurological disorders at the primary care level and for promoting clinical research interest in child neurology and have been organized in several countries, including Egypt, Estonia, Guatemala, India, Kazakhstan, Kenya, Peru, Ukraine, and Uruguay. The main goals of these events were to improve the use of relevant diagnostic measures and management in paediatric neurological care, and enrich the teaching and academic skills of local trainers.
Under the ICNA educational programmes, a number of different strategies have been adopted to promote education in emerging countries. Among these was for the ICNA executive board to hold it's annual meeting in conjunction with local or regional child neurology organizations, and for the association to provide speakers and scientific support to local conferences. In doing these things, ICNA has had a significant impact on the development of regional child neurology associations in Asia, Africa, Eastern Europe, the Middle East, and South America.
In 2002, my administration established research as the top prerogative of our society. Not surprisingly, ICNA's primary research priority is to document and define the causes of neurological handicaps in children in various geographic regions so that approaches to prevention and treatment can be tailored to a region's specific needs.
We urgently need to build this research capacity in emerging countries through international cooperation so that we are united against the devastating neurological disorders that affect millions of children worldwide. ICNA has a unique role in improving international cooperation and promoting clinical and scientific research byneproviding a medium through which physician can exchange opinions at an international level for the advancement of paediatric neurosciences.
The Internet is the key to coordinating global education in paediatric neurology. ICNA supports a Web site, www.icnapedia.org, that provides access to pertinent papers, clinical guidelines, consensus statements,and management protocols. The association is deeply committed to providing innovative, educational and training programs for all professional involved in the care of children with neurological disorders. Its International Education committee plans to develop a distance learning course in paediatric neurology for those who are not able to travel to attend courses and conferences in person.
ICNA is uniquely qualified and well positioned to remedy this deficit by reducing the gap and increasing the level of child neurology care all around the world. To accomplish this ambitions goal, ICNA should work with the World Federation of Neurology and World Health Organization. This international cooperation is more important than ever to promote brain health globally.
Part of this article is adapted from a paper by Prof Curatolo which appeared in the Journal of Child Neurology (2010;25:1444-9)
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