Clinical Profile and Outcomes of Children with Defects, Diseases, Deficiencies and Disabilities Attending a District Early Intervention Centre: A Cross-Sectional Study

Abstract

Background: District Early Intervention Centres (DEICs) were created under Rashtriya Bal Swasthya Karyakram to identify and manage childhood defects, diseases, deficiencies and developmental delays or disabilities. Programme-level evidence from individual districts is useful because the case-mix, referral routes and response to intervention vary across local health systems.

Objective: To describe the clinical profile and documented outcomes of children with one or more of the 4Ds attending a District Early Intervention Centre.

Materials and Methods: This hospital-based cross-sectional study included 1000 children up to 18 years of age who attended the District Early Intervention Centre, Government Dharmapuri Medical College Hospital, Dharmapuri, from January 2020 to December 2020. Demographic profile, referral source, 4D category, diagnosis, investigations, interventions, follow-up and outcome were recorded. Frequencies and percentages were used for categorical variables. Associations between categorical variables were assessed using the chi-square test, with p<0.05 considered statistically significant.

Results: The median age was 10 years (interquartile range 5-13 years). Males constituted 541 (54.1%) children and females 459 (45.9%). The largest age group was 6-10 years, 322 (32.2%), followed by 11-15 years, 294 (29.4%). Most children were referred through RBSK, 535 (53.5%), followed by primary health centres, 261 (26.1%). Disease was the commonest 4D category, 379 (37.9%), followed by deficiency, 245 (24.5%), disability, 162 (16.2%), defect, 110 (11.0%), and other conditions, 104 (10.4%). Dental caries, malnutrition, anaemia, thalassaemia, skin disorders, learning disorder and refractive error were the most frequent specific diagnoses. Age showed a significant association with referral source and 4D category (both p<0.001). Sex was also significantly associated with referral source (p=0.033) and 4D category (p<0.001). All children were followed up. Commonly documented positive outcomes included improved oral hygiene, improved haemoglobin level, improved weight-for-age, improved vision, corrected refractive error, better speech and seizure control.

Conclusion: The DEIC functioned as an accessible district-level hub for screening, multidisciplinary assessment, intervention and referral. The findings show a broad paediatric burden extending beyond birth defects alone, with diseases and deficiencies forming a substantial proportion of service needs. Strengthening referral continuity, rehabilitation equipment and outcome documentation can improve the measurable impact of DEIC services.