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Leke AZ, Malherbe H, Kalk E, Mehta U, Kisa P, Botto LD, Ayede I, Fairlie L, Maboh NM, Orioli I, Zash R, Kusolo R, Mumpe-Mwanja D, Serujogi R, Bongomin B, Osoro C, Dah C, Sentumbwe–Mugisha O, Shabani HK, Musoke P, Dolk H, Barlow-Mosha L. The burden, prevention and care of infants and children with congenital anomalies in sub-Saharan Africa: A scoping review. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001850. [PMID: 37379291 PMCID: PMC10306220 DOI: 10.1371/journal.pgph.0001850] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 03/17/2023] [Indexed: 06/30/2023]
Abstract
The aim of this scoping review was to determine the scope, objectives and methodology of contemporary published research on congenital anomalies (CAs) in sub-Saharan Africa (SSA), to inform activities of the newly established sub-Saharan African Congenital Anomaly Network (sSCAN). MEDLINE was searched for CA-related articles published between January 2016 and June 2021. Articles were classified into four main areas (public health burden, surveillance, prevention, care) and their objectives and methodologies summarized. Of the 532 articles identified, 255 were included. The articles originated from 22 of the 49 SSA countries, with four countries contributing 60% of the articles: Nigeria (22.0%), Ethiopia (14.1%), Uganda (11.7%) and South Africa (11.7%). Only 5.5% of studies involved multiple countries within the region. Most articles included CA as their primary focus (85%), investigated a single CA (88%), focused on CA burden (56.9%) and care (54.1%), with less coverage of surveillance (3.5%) and prevention (13.3%). The most common study designs were case studies/case series (26.6%), followed by cross-sectional surveys (17.6%), retrospective record reviews (17.3%), and cohort studies (17.2%). Studies were mainly derived from single hospitals (60.4%), with only 9% being population-based studies. Most data were obtained from retrospective review of clinical records (56.1%) or via caregiver interviews (34.9%). Few papers included stillbirths (7.5%), prenatally diagnosed CAs (3.5%) or terminations of pregnancy for CA (2.4%).This first-of-a-kind-scoping review on CA in SSA demonstrated an increasing level of awareness and recognition among researchers in SSA of the contribution of CAs to under-5 mortality and morbidity in the region. The review also highlighted the need to address diagnosis, prevention, surveillance and care to meet Sustainable Development Goals 3.2 and 3.8. The SSA sub-region faces unique challenges, including fragmentation of efforts that we hope to surmount through sSCAN via a multidisciplinary and multi-stakeholder approach.
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Affiliation(s)
- Aminkeng Zawuo Leke
- Institute for Nursing and Health Research, Centre for Maternal, Fetal and Infant Research, Ulster University, Newtownabbey, United Kingdom
- Centre for Infant and Maternal Health Research, Health Research Foundation, Buea, Cameroon
| | - Helen Malherbe
- Research & Epidemiology, Rare Diseases South Africa NPC, Bryanston, Sandton, South Africa
| | - Emma Kalk
- Centre for Infectious Disease Epidemiology & Research, School of Public Health, University of Cape Town, Cape Town, South Africa
| | - Ushma Mehta
- Centre for Infectious Disease Epidemiology & Research, School of Public Health, University of Cape Town, Cape Town, South Africa
| | - Phylis Kisa
- Makerere University College of Health Sciences, Kampala, Uganda
| | - Lorenzo D. Botto
- Division of Medical Genetics, University of Utah, Salt Lake City, Utah, United States of America
- International Center on Birth Defects, University of Utah, Salt Lake City, Utah, United States of America
| | - Idowu Ayede
- Department of Paediatrics, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria
| | - Lee Fairlie
- Faculty of Health Sciences, Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa
| | - Nkwati Michel Maboh
- Centre for Infant and Maternal Health Research, Health Research Foundation, Buea, Cameroon
| | - Ieda Orioli
- Genetics Department, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- ReLAMC: Latin American Network for Congenital Malformation Surveillance, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rebecca Zash
- The Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana and Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States of America
| | - Ronald Kusolo
- Makerere University-Johns Hopkins University Research Collaboration, Kampala, Uganda
| | - Daniel Mumpe-Mwanja
- Makerere University-Johns Hopkins University Research Collaboration, Kampala, Uganda
| | - Robert Serujogi
- Makerere University-Johns Hopkins University Research Collaboration, Kampala, Uganda
| | - Bodo Bongomin
- Gulu University Faculty of Medicine: Gulu, Gulu, UG/ World Health Organization, Kampala, Uganda
| | - Caroline Osoro
- Kenya Medical Research Institute, Centre for Global Health Research, Nairobi, Kenya
| | - Clarisse Dah
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | | | | | - Philippa Musoke
- Makerere University-Johns Hopkins University Research Collaboration, Kampala, Uganda
| | - Helen Dolk
- Institute for Nursing and Health Research, Centre for Maternal, Fetal and Infant Research, Ulster University, Newtownabbey, United Kingdom
| | - Linda Barlow-Mosha
- Makerere University-Johns Hopkins University Research Collaboration, Kampala, Uganda
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Sharma AR, Siddiqui MS, Magar S, Kale A, Nelanuthala M, Singh SP. The Etiological Profile of Global Developmental Delay at a Tertiary Care Hospital in India: An Observational Study. Cureus 2023; 15:e41066. [PMID: 37519562 PMCID: PMC10375252 DOI: 10.7759/cureus.41066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2023] [Indexed: 08/01/2023] Open
Abstract
Background Global developmental delay (GDD) is common and has a significant impact on affected children, families, and society. Understanding its etiology is crucial for management and prevention strategies. However, data on the etiological profile of GDD in developing countries are limited. This study aimed to identify the etiological profile of GDD at a tertiary care hospital in India. Methodology This observational study included children aged three months to five years with a developmental quotient below 70%. Data on demographics, clinical features, relevant investigations, and diagnoses were collected. Etiologies were categorized into prenatal, perinatal, postnatal, and unknown causes. Informed consent was obtained from the parents. Results A total of 52 children, with a median age of 15.5 months, were included in the study, with 69.2% being males. Prenatal causes accounted for half of the cases, with genetic abnormalities (32.7%) and chromosomal abnormalities (7.7%) being prominent. Perinatal causes were the next most common (34.6%), including hypoxic-ischemic encephalopathy (26.7%). Postnatal causes were rare (3.8%). The overall etiological yield was 88.4%, with some cases remaining unidentified. Conclusions Prenatal causes, including genetic and chromosomal abnormalities, are common in GDD. The utilization of genetic testing enhances etiological yield. Hypoxic-ischemic encephalopathy remains a significant factor and highlights the importance of perinatal care in preventing developmental delays. Large multicentric studies are needed for a comprehensive database of etiological profiles.
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Affiliation(s)
- Amulya R Sharma
- Department of Paediatrics, Mahatma Gandhi Mission's (MGM) Medical College and Hospital, A Constituent Unit of MGM Institute of Health Sciences, Aurangabad, IND
| | - Mohd Saeed Siddiqui
- Department of Paediatrics, Mahatma Gandhi Mission's (MGM) Medical College and Hospital, A Constituent Unit of MGM Institute of Health Sciences, Aurangabad, IND
| | - Suvarna Magar
- Department of Paediatrics, Mahatma Gandhi Mission's (MGM) Medical College and Hospital, A Constituent Unit of MGM Institute of Health Sciences, Aurangabad, IND
| | - Ajay Kale
- Department of Paediatrics, Mahatma Gandhi Mission's (MGM) Medical College and Hospital, A Constituent Unit of MGM Institute of Health Sciences, Aurangabad, IND
| | - Madhurasree Nelanuthala
- Department of Paediatrics, Mahatma Gandhi Mission's (MGM) Medical College and Hospital, A Constituent Unit of MGM Institute of Health Sciences, Aurangabad, IND
| | - Surya Pratap Singh
- Department of Paediatrics, Mahatma Gandhi Mission's (MGM) Medical College and Hospital, A Constituent Unit of MGM Institute of Health Sciences, Aurangabad, IND
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Demirhan O, Hergüner Ö, Tunç E. A Cytogenetic Study of Turkish Children with Global Developmental Delay. J Pediatr Genet 2022. [DOI: 10.1055/s-0042-1758872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
AbstractGlobal developmental delay (GDD)/intellectual disability (ID) is common in children and its etiology is unknown in many cases. Chromosomal abnormalities are predominant genetic causes of GDD/ID. The aim of this study is to determine the genetic risk factors that may be involved in the etiology of GDD/ID. In this study, 810 children with moderate to severe, clinically unexplained GDD/ID for whom cytogenetic analysis were performed were retrospectively rescreened. The results showed that GDD/ID affected more females than males (2 girls:1 boy). A total of 54 children (6.7%) with GDD showed chromosomal aberrations (CAs): 59.3% of these CAs were structural aberrations, and the rest were numerical aberrations (40.7%). Specifically, inversions, deletions, and reciprocal and robertsonian translocations, which were detected in 1, 0.7, 0.8, and 0.4% of the children, respectively, constituted important categories of structural CAs. Among numerical CAs, classic Turner and mosaics were detected in 1.2% of all children. Trisomy 21 and mosaic trisomy 21 were detected in 1% of the children. Marker chromosomes and 47,XXY karyotypes were found in two children each. Our results suggest that female sex is more affected by CAs among GDD/ID cases, and cytogenetic analysis is useful in the etiological diagnosis of GDD/ID.
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Affiliation(s)
- Osman Demirhan
- Department of Medical Biology and Genetics, Faculty of Medicine, Çukurova University, Balcali-Adana, Turkey
| | - Özlem Hergüner
- Department of Child Neurology, Faculty of Medicine, Çukurova University, Balcali-Adana, Turkey
| | - Erdal Tunç
- Department of Medical Biology and Genetics, Faculty of Medicine, Çukurova University, Balcali-Adana, Turkey
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Lumaka A, Race V, Peeters H, Corveleyn A, Coban-Akdemir Z, Jhangiani SN, Song X, Mubungu G, Posey J, Lupski JR, Vermeesch JR, Lukusa P, Devriendt K. A comprehensive clinical and genetic study in 127 patients with ID in Kinshasa, DR Congo. Am J Med Genet A 2018; 176:1897-1909. [PMID: 30088852 DOI: 10.1002/ajmg.a.40382] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Accepted: 06/06/2018] [Indexed: 12/21/2022]
Abstract
Pathogenic variants account for 4 to 41% of patients with intellectual disability (ID) or developmental delay (DD). In Sub-Saharan Africa, the prevalence of ID is thought to be higher, but data in Central Africa are limited to some case reports. In addition, clinical descriptions of some syndromes are not available for this population. This study aimed at providing an estimate for the fraction of ID/DD for which an underlying etiological genetic cause may be elucidated and provide insights into their clinical presentation in special institutions in a Central African country. A total of 127 patients (33 females and 94 males, mean age 10.03 ± 4.68 years), were recruited from six institutions across Kinshasa. A clinical diagnosis was achieved in 44 but molecular confirmation was achieved in 21 of the 22 patients with expected genetic defect (95% clinical sensitivity). Identified diseases included Down syndrome (15%), submicroscopic copy number variants (9%), aminoacylase deficiency (0.8%), Partington syndrome in one patient (0.8%) and his similarly affected brother, X-linked syndromic Mental Retardation type 33 (0.8%), and two conditions without clear underlying molecular genetic etiologies (Oculo-Auriculo-Vertebral and Amniotic Bands Sequence). We have shown that genetic etiologies, similar to those reported in Caucasian subjects, are a common etiologic cause of ID in African patients from Africa. We have confirmed the diagnostic utility of clinical characterization prior to genetic testing. Finally, our clinical descriptions provide insights into the presentation of these genetic diseases in African patients.
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Affiliation(s)
- Aimé Lumaka
- Centre for Human Genetics, Faculty of Medicine, University of Kinshasa, Kinshasa, DR, Congo.,Département des Sciences Biomédicales et Précliniques, GIGA-R, Laboratoire de Génétique Humaine, University of Liège, Liège, Belgium.,Institut National de Recherche Biomédicale, Kinshasa, DR, Congo.,Department of Pediatrics, Faculty of Medicine, University of Kinshasa, Kinshasa, DR, Congo
| | - Valerie Race
- Centre for Human Genetics, University Hospital, University of Leuven, Leuven, Belgium
| | - Hilde Peeters
- Centre for Human Genetics, University Hospital, University of Leuven, Leuven, Belgium
| | - Anniek Corveleyn
- Centre for Human Genetics, University Hospital, University of Leuven, Leuven, Belgium
| | - Zeynep Coban-Akdemir
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | - Shalini N Jhangiani
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | - Xiaofei Song
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | - Gerrye Mubungu
- Centre for Human Genetics, Faculty of Medicine, University of Kinshasa, Kinshasa, DR, Congo.,Institut National de Recherche Biomédicale, Kinshasa, DR, Congo.,Department of Pediatrics, Faculty of Medicine, University of Kinshasa, Kinshasa, DR, Congo.,Centre for Human Genetics, University Hospital, University of Leuven, Leuven, Belgium
| | - Jennifer Posey
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, Texas
| | - James R Lupski
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas.,Human Genome Sequencing Center, Baylor College of Medicine, Houston, Texas.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas.,Genetics Clinic service, Texas Children's Hospital, Houston, Texas
| | - Joris R Vermeesch
- Centre for Human Genetics, University Hospital, University of Leuven, Leuven, Belgium
| | - Prosper Lukusa
- Centre for Human Genetics, Faculty of Medicine, University of Kinshasa, Kinshasa, DR, Congo.,Département des Sciences Biomédicales et Précliniques, GIGA-R, Laboratoire de Génétique Humaine, University of Liège, Liège, Belgium.,Institut National de Recherche Biomédicale, Kinshasa, DR, Congo.,Centre for Human Genetics, University Hospital, University of Leuven, Leuven, Belgium
| | - Koenraad Devriendt
- Centre for Human Genetics, University Hospital, University of Leuven, Leuven, Belgium
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