Estimated prevalence of disability and developmental delay among preschool children in rural Malawi: Findings from "Tikule Limodzi," a cross-sectional survey.

The study reports a baseline survey, not the trial intervention outcome, so it cannot show whether caregiver training changed disability or delay. It is cross-sectional, so age differences reflect different children at one time, not change within the same child. It sampled only children attending community childcare centres who were registered for at least 6 months and attended regularly, so children who were absent, not enrolled, or less regularly attending are not represented. Only centres meeting specific criteria were eligible, including a feeding programme, more than 20 children, at least 2 caregivers, and minimum infrastructure. 960 children were sampled, but 935 were assessed for disability and 933 for developmental delay. Findings were not adjusted for anthropometric measures or confounders such as household socio-economic status, food availability, religion, or parental education. The study was done in one rural district in Malawi, so prevalence may not apply elsewhere.

Do not read the seven times higher disability in older children as proof that disability develops with age. This was a cross-sectional baseline survey of different children, not the same children followed over time.