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Marshall J, Wylie K, McLeod S, McAllister L, Barrett H, Owusu NA, Hettiarachchi S, Atherton M. Communication disability in low and middle-income countries: a call to action. BMJ Glob Health 2024; 9:e015289. [PMID: 38991579 PMCID: PMC11288154 DOI: 10.1136/bmjgh-2024-015289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 05/31/2024] [Indexed: 07/13/2024] Open
Affiliation(s)
- Julie Marshall
- Health Professions Department, Manchester Metropolitan University, Manchester, UK
| | - Karen Wylie
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
- School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana
| | - Sharynne McLeod
- School of Education, Charles Sturt University, Bathurst, New South Wales, Australia
| | - Lindy McAllister
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Helen Barrett
- CBM Global Inclusion Advisory Group, Amstelveen, The Netherlands
| | - Nana Akua Owusu
- School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana
- AwaaWaa2, Accra, Ghana
| | - Shyamani Hettiarachchi
- Department of Disability Studies, University of Kelaniya, Faculty of Medicine, Colombo, Sri Lanka
| | - Marie Atherton
- Australian Catholic University, Faculty of Health Sciences, Melbourne, Victoria, Australia
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Williams EH, Thompson NM, McCray G, Crespo-Llado MM, Bhavnani S, Gajria D, Mukherjee D, Del Bianco T, Lockwood-Estrin G, Mason L, Ngoma V, Namathanga C, Nkhata R, Bennie A, Ranjan A, Kawelama U, Midha N, Singh A, Mpakiza I, Gautam A, Gulati S, Johnson MH, Lancaster G, Belmonte MK, Jones E, Patel V, Chandran S, Mbale E, Divan G, Gladstone M, Chakrabarti B. Scalable Transdiagnostic Early Assessment of Mental Health (STREAM): a study protocol. BMJ Open 2024; 14:e088263. [PMID: 38871663 DOI: 10.1136/bmjopen-2024-088263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/15/2024] Open
Abstract
INTRODUCTION Early childhood development forms the foundations for functioning later in life. Thus, accurate monitoring of developmental trajectories is critical. However, such monitoring often relies on time-intensive assessments which necessitate administration by skilled professionals. This difficulty is exacerbated in low-resource settings where such professionals are predominantly concentrated in urban and often private clinics, making them inaccessible to many. This geographic and economic inaccessibility contributes to a significant 'detection gap' where many children who might benefit from support remain undetected. The Scalable Transdiagnostic Early Assessment of Mental Health (STREAM) project aims to bridge this gap by developing an open-source, scalable, tablet-based platform administered by non-specialist workers to assess motor, social and cognitive developmental status. The goal is to deploy STREAM through public health initiatives, maximising opportunities for effective early interventions. METHODS AND ANALYSIS The STREAM project will enrol and assess 4000 children aged 0-6 years from Malawi (n=2000) and India (n=2000). It integrates three established developmental assessment tools measuring motor, social and cognitive functioning using gamified tasks, observation checklists, parent-report and audio-video recordings. Domain scores for motor, social and cognitive functioning will be developed and assessed for their validity and reliability. These domain scores will then be used to construct age-adjusted developmental reference curves. ETHICS AND DISSEMINATION Ethical approval has been obtained from local review boards at each site (India: Sangath Institutional Review Board; All India Institute of Medical Science (AIIMS) Ethics Committee; Indian Council of Medical Research-Health Ministry Screening Committee; Malawi: College of Medicine Research and Ethics Committee; Malawi Ministry of Health-Blantyre District Health Office). The study adheres to Good Clinical Practice standards and the ethical guidelines of the 6th (2008) Declaration of Helsinki. Findings from STREAM will be disseminated to participating families, healthcare professionals, policymakers, educators and researchers, at local, national and international levels through meetings, academic journals and conferences.
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Affiliation(s)
- Elin H Williams
- Centre for Autism, School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Nicholas M Thompson
- Centre for Autism, School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
- Faculty of Health, Education and Society, University of Northampton, Northampton, UK
| | | | - Maria M Crespo-Llado
- Department of Women and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | | | | | - Debarati Mukherjee
- Indian Institute of Public Health, Bengaluru, Public Health Foundation of India, Kamataka, India
| | - Teresa Del Bianco
- Centre for Brain & Cognitive Development, Birkbeck University of London, London, UK
- School of Social Sciences and Professions, London Metropolitan University, London, UK
| | | | - Luke Mason
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Vukiwe Ngoma
- Kamuzu University of Health Sciences, Blantyre, Malawi
| | | | | | - Allan Bennie
- Kamuzu University of Health Sciences, Blantyre, Malawi
| | | | | | | | | | | | - Akshat Gautam
- Indian Institute of Technology Bombay, Mumbai, Maharashtra, India
| | - Sheffali Gulati
- Center of Excellence & Advanced Research for Childhood Neurodevelopmental Disorders, Child Neurology Division, Department of Paediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Mark H Johnson
- Department of Psychology, University of Cambridge, Cambridge, UK
| | | | - Matthew K Belmonte
- The Com DEALL Trust, Bengaluru, Karnataka, India
- Department of Psychology, Nottingham Trent University, Nottingham, UK
| | - Emily Jones
- Centre for Brain & Cognitive Development, Birkbeck University of London, London, UK
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Sharat Chandran
- Indian Institute of Technology Bombay, Mumbai, Maharashtra, India
| | - Emmie Mbale
- Department of Paediatrics, Kamuzu University of Health Sciences, Blantyre, Malawi
| | | | - Melissa Gladstone
- Department of Women and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - Bhismadev Chakrabarti
- Centre for Autism, School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
- Department of Psychology, Ashoka University, Sonipat, India
- India Autism Center, Kolkata, India
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3
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Zupo R, Murgia F, Sardone R, Vimercati L, Matera E, Clodoveo ML. Editorial: Influence of diet and maternal environment on neuropsychological development early in life. Front Public Health 2024; 12:1401154. [PMID: 38887244 PMCID: PMC11180899 DOI: 10.3389/fpubh.2024.1401154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 05/27/2024] [Indexed: 06/20/2024] Open
Affiliation(s)
- Roberta Zupo
- Department of Interdisciplinary Medicine (DIM), University of Bari Aldo Moro, Bari, Italy
| | - Ferdinando Murgia
- Department of Obstetrics and Gynecology, “Miulli” General Hospital, Bari, Italy
| | - Rodolfo Sardone
- Unit of Statistics and Epidemiology, Local Health Authority of Taranto, Taranto, Italy
- Department of Eye and Vision Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Luigi Vimercati
- Section of Occupational Medicine, Interdisciplinary Department of Medicine, University of Bari, Bari, Italy
| | - Emilia Matera
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari Aldo Moro, Bari, Italy
| | - Maria Lisa Clodoveo
- Department of Interdisciplinary Medicine (DIM), University of Bari Aldo Moro, Bari, Italy
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Williams ME, Corn EA, Martinez Ransanz S, Berl MM, Andringa-Seed R, Mulkey SB. Neurodevelopmental assessments used to measure preschoolers' cognitive development in Latin America: a systematic review. J Pediatr Psychol 2024; 49:321-339. [PMID: 38244996 PMCID: PMC11098046 DOI: 10.1093/jpepsy/jsad089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 11/13/2023] [Accepted: 11/15/2023] [Indexed: 01/22/2024] Open
Abstract
OBJECTIVE The objective of this study was to systematically review the standardized neurodevelopmental assessments used to study preschool-aged children's cognitive development in Spanish-speaking Latin America. METHODS The authors systematically searched PubMed, PsycINFO, and ERIC databases for peer-reviewed articles from Spanish-speaking Latin American countries. Articles were included if they measured cognitive development among children aged 2-6 years using at least one standardized assessment tool; 97 articles were included and reviewed in accordance with PRISMA guidelines to assess their use of these tools. RESULTS Ninety-seven studies across 13 countries used a total of 41 assessments to measure cognitive development; most widely used were the Wechsler intelligence scales (n = 46/97), particularly the Wechsler Preschool and Primary Scale of Intelligence and Wechsler Intelligence Scale for Children (n = 23 and 29, respectively). Other common assessments included the McCarthy Scales of Children's Abilities (n = 9), Raven's Progressive Matrices (n = 9), Child Neuropsychological Assessment (n = 8), and Peabody Picture Vocabulary Test (n = 7). In regions where normative data for a given assessment were unpublished, authors commonly used norms from the United States, Mexico, or Spain or did not report standard scores in their analyses. CONCLUSIONS The wide range of tools used in these studies presents a challenge for generalizing results when measuring the neurodevelopment of Latin American preschool-aged children. The low availability of normative data for specific regions reveals concerns if some tools are culturally and linguistically appropriate even when Spanish is a common language, particularly in low-resource settings. Future work to forge greater consistency in the use of validated measures, clarity in reporting research methods, and publication of regional normative data would benefit the field.
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Affiliation(s)
- Meagan E Williams
- Prenatal Pediatrics Institute, Children’s National Hospital, Washington, DC, United States
| | - Elizabeth A Corn
- Prenatal Pediatrics Institute, Children’s National Hospital, Washington, DC, United States
| | - Santiago Martinez Ransanz
- Prenatal Pediatrics Institute, Children’s National Hospital, Washington, DC, United States
- Department of Emergency Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC, United States
| | - Madison M Berl
- Prenatal Pediatrics Institute, Children’s National Hospital, Washington, DC, United States
- Department of Psychiatry and Behavioral Sciences, The George Washington University School of Medicine and Health Sciences, Washington, DC, United States
| | - Regan Andringa-Seed
- Prenatal Pediatrics Institute, Children’s National Hospital, Washington, DC, United States
| | - Sarah B Mulkey
- Prenatal Pediatrics Institute, Children’s National Hospital, Washington, DC, United States
- Department of Neurology, The George Washington University School of Medicine and Health Sciences, Washington, DC, United States
- Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, DC, United States
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5
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Elliott SD, Vickers ML, McKeon G, Eriksson L, Malacova E, Scott JG. Iron Supplementation in Management of Neurodevelopmental Disorders: Systematic Review, Meta-Analysis, and Qualitative Synthesis. J Neuropsychiatry Clin Neurosci 2024; 36:178-186. [PMID: 38343311 DOI: 10.1176/appi.neuropsych.20230081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/12/2024]
Abstract
OBJECTIVE The authors sought to explore the role of iron supplementation in the management of neurodevelopmental disorders among children and youths. METHODS A systematic review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was undertaken. A subset of results was suitable for meta-analysis. The quality of the evidence and strength of the clinical recommendations were assessed by using the Grading of Recommendations, Assessment, Development, and Evaluation method, and critical appraisal was conducted with the Joanna Briggs Institute critical appraisal tools. RESULTS Nine articles met inclusion criteria. These articles included studies of attention-deficit hyperactivity disorder (ADHD) (N=7), autism spectrum disorder (N=1), and Tourette's syndrome (N=1). Three randomized controlled trials evaluating iron supplementation for ADHD hyperactivity symptom severity (124 participants: placebo, N=56; supplement, N=68) met inclusion criteria for a meta-analysis. Effect sizes for the placebo and supplement groups were moderate (Cohen's d=0.76) and large (Cohen's d=1.70), respectively, although these differences were not significant. The impact of iron supplementation on inattentive ADHD symptom severity was examined in two trials (75 participants: placebo, N=31; supplement, N=44). Large, nonsignificant effect sizes were demonstrated for the placebo (Cohen's d=1.66) and supplementation (Cohen's d=3.19) groups. The quality of the evidence and strength of the clinical recommendations were considered very low. CONCLUSIONS Further research is needed to examine the role of iron supplementation in the management of ADHD and neurodevelopmental disorders more generally. Additionally, iron supplementation comes with risks, including death in the case of overdose.
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Affiliation(s)
- Stephen D Elliott
- Metro North Mental Health Service, Herston, Australia (Elliott, Vickers); Faculty of Medicine, University of Glasgow, Glasgow, United Kingdom (Elliott); Faculty of Medicine (Vickers), Child Health Research Center (McKeon, Scott), and Herston Health Sciences Library (Eriksson), University of Queensland, Brisbane, Australia; Faculty of Health, Queensland University of Technology, Brisbane, Australia (Vickers); West Moreton Health Psychology, Park Center for Mental Health, Brisbane, Australia (McKeon); Child and Youth Mental Health Group, Queensland Center for Mental Health Research, Brisbane, Australia (McKeon, Scott); Queensland Institute of Medical Research Berghofer Medical Research Institute, Brisbane, Australia (Malacova, Scott); Child and Youth Mental Health Service, Children's Health Queensland Hospital and Health Service, Brisbane, Australia (Scott)
| | - Mark L Vickers
- Metro North Mental Health Service, Herston, Australia (Elliott, Vickers); Faculty of Medicine, University of Glasgow, Glasgow, United Kingdom (Elliott); Faculty of Medicine (Vickers), Child Health Research Center (McKeon, Scott), and Herston Health Sciences Library (Eriksson), University of Queensland, Brisbane, Australia; Faculty of Health, Queensland University of Technology, Brisbane, Australia (Vickers); West Moreton Health Psychology, Park Center for Mental Health, Brisbane, Australia (McKeon); Child and Youth Mental Health Group, Queensland Center for Mental Health Research, Brisbane, Australia (McKeon, Scott); Queensland Institute of Medical Research Berghofer Medical Research Institute, Brisbane, Australia (Malacova, Scott); Child and Youth Mental Health Service, Children's Health Queensland Hospital and Health Service, Brisbane, Australia (Scott)
| | - Gemma McKeon
- Metro North Mental Health Service, Herston, Australia (Elliott, Vickers); Faculty of Medicine, University of Glasgow, Glasgow, United Kingdom (Elliott); Faculty of Medicine (Vickers), Child Health Research Center (McKeon, Scott), and Herston Health Sciences Library (Eriksson), University of Queensland, Brisbane, Australia; Faculty of Health, Queensland University of Technology, Brisbane, Australia (Vickers); West Moreton Health Psychology, Park Center for Mental Health, Brisbane, Australia (McKeon); Child and Youth Mental Health Group, Queensland Center for Mental Health Research, Brisbane, Australia (McKeon, Scott); Queensland Institute of Medical Research Berghofer Medical Research Institute, Brisbane, Australia (Malacova, Scott); Child and Youth Mental Health Service, Children's Health Queensland Hospital and Health Service, Brisbane, Australia (Scott)
| | - Lars Eriksson
- Metro North Mental Health Service, Herston, Australia (Elliott, Vickers); Faculty of Medicine, University of Glasgow, Glasgow, United Kingdom (Elliott); Faculty of Medicine (Vickers), Child Health Research Center (McKeon, Scott), and Herston Health Sciences Library (Eriksson), University of Queensland, Brisbane, Australia; Faculty of Health, Queensland University of Technology, Brisbane, Australia (Vickers); West Moreton Health Psychology, Park Center for Mental Health, Brisbane, Australia (McKeon); Child and Youth Mental Health Group, Queensland Center for Mental Health Research, Brisbane, Australia (McKeon, Scott); Queensland Institute of Medical Research Berghofer Medical Research Institute, Brisbane, Australia (Malacova, Scott); Child and Youth Mental Health Service, Children's Health Queensland Hospital and Health Service, Brisbane, Australia (Scott)
| | - Eva Malacova
- Metro North Mental Health Service, Herston, Australia (Elliott, Vickers); Faculty of Medicine, University of Glasgow, Glasgow, United Kingdom (Elliott); Faculty of Medicine (Vickers), Child Health Research Center (McKeon, Scott), and Herston Health Sciences Library (Eriksson), University of Queensland, Brisbane, Australia; Faculty of Health, Queensland University of Technology, Brisbane, Australia (Vickers); West Moreton Health Psychology, Park Center for Mental Health, Brisbane, Australia (McKeon); Child and Youth Mental Health Group, Queensland Center for Mental Health Research, Brisbane, Australia (McKeon, Scott); Queensland Institute of Medical Research Berghofer Medical Research Institute, Brisbane, Australia (Malacova, Scott); Child and Youth Mental Health Service, Children's Health Queensland Hospital and Health Service, Brisbane, Australia (Scott)
| | - James G Scott
- Metro North Mental Health Service, Herston, Australia (Elliott, Vickers); Faculty of Medicine, University of Glasgow, Glasgow, United Kingdom (Elliott); Faculty of Medicine (Vickers), Child Health Research Center (McKeon, Scott), and Herston Health Sciences Library (Eriksson), University of Queensland, Brisbane, Australia; Faculty of Health, Queensland University of Technology, Brisbane, Australia (Vickers); West Moreton Health Psychology, Park Center for Mental Health, Brisbane, Australia (McKeon); Child and Youth Mental Health Group, Queensland Center for Mental Health Research, Brisbane, Australia (McKeon, Scott); Queensland Institute of Medical Research Berghofer Medical Research Institute, Brisbane, Australia (Malacova, Scott); Child and Youth Mental Health Service, Children's Health Queensland Hospital and Health Service, Brisbane, Australia (Scott)
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Devagiri B, Ariyasena ADK, Siriwardhana DD, Sumanasena S. Telehealth services for children with neuro-developmental disabilities in the Asia-Pacific region: A systematic review. Child Care Health Dev 2024; 50:e13192. [PMID: 38049949 DOI: 10.1111/cch.13192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 08/14/2023] [Accepted: 10/06/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND In recent years telehealth became a popular and a rational health service delivery approach, especially amidst multiple challenges posed while providing health care interventions during the COVID-19 pandemic. AIM We synthesized available evidence on telehealth for managing children with NDDs in the Asia-Pacific region with the aim of identifying successful methods. METHODOLOGY We systematically reviewed six electronic databases: MEDLINE, AMED, EMBASE, PsychInfo, Web of Science, and (CINAHL plus) using the keywords and database-specific subject headings from their inception to 25th August 2021. Review findings were synthesized narratively, and harvest plots were used to demonstrate the effect of interventions. The protocol and reporting the findings of this review adhered to PRISMA 2020 guidelines. PROSPERO registration: CRD 340690. RESULTS We harvested 30,823 records; 17,563 duplicates were removed, and 196 full-text articles were assessed for eligibility. 16 studies with multiple research designs were included in the review. Eight were from the Pacific region and eight represented Asia. The interventions targeted families and children with a variety of NDDs (autism spectrum disorder, Down syndrome, cleft lip and palate, hearing impairment, cerebral palsy etc.) via telehealth. Telehealth packages consisted of direct and indirect methods of synchronous, asynchronous, and hybrid approaches. All studies used parent-led intervention strategies. Telehealth reported a positive effect in 7/16 studies while five showed a neutral effect. CONCLUSIONS According to published evidence telehealth for children with NDDs is an evolving, evidence-based service facilitation modality in the Asia-Pacific region, with only a few published randomized controlled trials. The systematic review shows promising telehealth practices emerging across the region despite the diversity in NDDs studied.
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Affiliation(s)
- Bhagya Devagiri
- Department of Disability Studies, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
- Ayati, National Centre for Children with Disabilities, Faculty of Medicine, University of Kelaniya, Colombo, Sri Lanka
| | | | - Dhammika Deepani Siriwardhana
- Department of Disability Studies, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
- Research Department of Primary Care and Population Health, University College London, London, UK
| | - Samanmali Sumanasena
- Department of Disability Studies, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
- Ayati, National Centre for Children with Disabilities, Faculty of Medicine, University of Kelaniya, Colombo, Sri Lanka
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Maciver D, Rutherford M, Johnston L, Roy AS. Prevalence of neurodevelopmental differences and autism in Scottish primary schools 2018-2022. Autism Res 2023; 16:2403-2414. [PMID: 38009513 DOI: 10.1002/aur.3063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 10/30/2023] [Indexed: 11/29/2023]
Abstract
This study investigated the prevalence of neurodevelopmental needs among children in primary schools in Scotland. Two groups were identified: autistic learners and a larger group of learners who had neurodevelopmental differences. These differences encompassed any need for additional support in various domains, including communication, interaction, emotional regulation, coordination, movement, and cognition. A two-phase process was employed, drawing on data from a cross-sectional study followed by a secondary analysis of a population census. In the first phase, a random sample of 688 children with additional support needs from 22 schools participated. Demographics, support characteristics, and neurodevelopmental needs were identified. Results revealed that 76.89% of children with additional support needs exhibited a need type consistent with a neurodevelopmental difference. In the second phase, data from the Scottish Government Annual Pupil Census, covering all state-provided primary school children between 2018 and 2022, were analyzed. Modeling was conducted using data from the first phase to estimate prevalence of neurodevelopmental differences. Data on autism were directly extracted from the census. Analysis revealed an increase in the prevalence of neurodevelopmental differences and autism. The prevalence of autism rose by 31.98%, with 2.60% of primary school children identified as autistic in 2022. Similarly, the prevalence of neurodevelopmental differences increased by 10.57%, with 16.22% of primary school children exhibiting such differences in 2022. Across 32 localities, regional variations in prevalence were observed. These findings show the substantial number of neurodivergent children within Scottish primary schools and emphasize the need for a neurodevelopmentally informed approach to inclusive education.
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Affiliation(s)
- Donald Maciver
- School of Health Sciences, Queen Margaret University, Edinburgh, Scotland
| | - Marion Rutherford
- School of Health Sciences, Queen Margaret University, Edinburgh, Scotland
| | - Lorna Johnston
- School of Health Sciences, Queen Margaret University, Edinburgh, Scotland
| | - Anusua Singh Roy
- School of Health Sciences, Queen Margaret University, Edinburgh, Scotland
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Ekman AT, Sengeh PA, Webber N, Jalloh MB, Hollander AC, Newby H, Cappa C, Orsini N, Alfvén T, Frielingsdorf H. Prevalence of children under five with disabilities in Sierra Leone in 2017: Insights from a population-based multiple indicator cluster survey. Disabil Health J 2023; 16:101481. [PMID: 37316393 DOI: 10.1016/j.dhjo.2023.101481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 04/16/2023] [Accepted: 04/27/2023] [Indexed: 06/16/2023]
Abstract
BACKGROUND Children with disabilities have been low on the agenda of child health, including in Sierra Leone, and there are still many gaps in our knowledge and understanding of the issue. OBJECTIVE To estimate the prevalence of children with disabilities in Sierra Leone using functional difficulty as a proxy and to understand the factors associated with disabilities among children two to four years living in Sierra Leone. METHODS We used cross-sectional data from the Sierra Leone 2017 Multiple Indicator Cluster Survey. Disability was defined using a functional difficulty definition with additional thresholds used to define children with severe functional difficulty and multiple disabilities. Logistic regression models estimated odds ratios (ORs) of childhood disability and how they were associated with socioeconomic factors and living conditions. RESULTS Prevalence of children with disabilities was 6.6% (95% confidence interval (CI) 5.8-7.6%) and there was a high risk of comorbidity between different functional difficulties. Children with disabilities were less likely to be girls (adjusted odds ratio (AOR) 0.8 (CI 0.7-1.0) and older (AOR 0.3 (CI 0.2-0.4)), but more prone to be stunted (AOR 1.4 (CI 1.1-1.7)) and have younger caregivers (AOR 1.3 (CI 0.7-2.3)). CONCLUSION The prevalence of disabilities in young Sierra Leonean children was comparable to other countries in West and Central Africa when using the same measure of disability. Preventive as well as early detection and intervention efforts are recommended to be integrated with other programs, e.g vaccinations, nutrition, and poverty reducing programs.
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Affiliation(s)
- Anna-Theresia Ekman
- Department of Global Public Health, Karolinska Institutet, SE-171 77, Stockholm, Sweden.
| | - Paul A Sengeh
- FOCUS 1000, 7E Conteh Drive, Off Old Railway Line, Tengbeh Town, Freetown, Sierra Leone.
| | - Nance Webber
- FOCUS 1000, 7E Conteh Drive, Off Old Railway Line, Tengbeh Town, Freetown, Sierra Leone.
| | - Mohammad Bailor Jalloh
- FOCUS 1000, 7E Conteh Drive, Off Old Railway Line, Tengbeh Town, Freetown, Sierra Leone.
| | - Anna-Clara Hollander
- Epidemiology of Psychiatric Conditions, Substance Use and Social Environment (EPiCSS), Department of Global Public Health Karolinska Institutet, SE-171 77, Stockholm, Sweden.
| | | | - Claudia Cappa
- Data & Analytics Section, UNICEF, New York City, USA.
| | - Nicola Orsini
- Department of Global Public Health, Karolinska Institutet, SE-171 77, Stockholm, Sweden.
| | - Tobias Alfvén
- Department of Global Public Health, Karolinska Institutet, SE-171 77, Stockholm, Sweden; Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden.
| | - Helena Frielingsdorf
- Department of Health, Medicine and Caring Sciences, Linköping University, 581 83, Linköping, Sweden.
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Wasay M, Awan S, Shahbaz N, Khan S, Sher K, Malik A, Mustafa S, Siddiqi AI, Barech S, Farooq A, Hameed S, Siddiqui M, Ahmad A, Asif A, Sherin A, Majid H, Nauman A, Soomro B, Subhan M, Rafique I, Saqib MAN. Neurological disorders and disability in Pakistan: A cross-sectional multicenter study. J Neurol Sci 2023; 452:120754. [PMID: 37562167 DOI: 10.1016/j.jns.2023.120754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 07/08/2023] [Accepted: 07/27/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND/OBJECTIVE The aim of this study is to identify frequencies of various neurological disorders (NDs) and associated disability in patients attending neurologic clinics in rural and urban centers in Pakistan. METHODS This is an observational study conducted in 39 neurological centers in both rural and urban areas, public and private health sectors all over Pakistan. This study was conducted between august 2017 to December 2019. RESULTS A total of 28,845 adults were enrolled. Mean age of the study participants was 46.2 ± 17.2 years, 15,252 (52.9%) were men and 13,593 (47.1%) were women. Most common comorbid medical condition was hypertension 7622(26.4%) followed by Diabetes 3409(11.8%). Among neurological diagnoses, vascular diseases (20%) were the most common followed by Headache disorders (18.6%), Epilepsy (12.5%), nerve and root diseases (12.4%), Psychiatric diseases (10%), Dementias (8%) and movement disorders (7.9%). Half of the patients 15,503(53.7%) had no neurological disability, while minor disability was present in 10,442(36.2%) of cases. Moderate to severe disability was present in 2876(10%) cases. Headache disorders, psychiatric diseases, muscle pain/muscle related disorders and demyelinating diseases were more common in women. Vascular diseases, movement disorders and Dementias were more common in 46 years and above age group whereas headache disorders, Epilepsy and Psychiatric disorders were more prevalent in <46 years age groups. CONCLUSION Vascular diseases are the most common presentation of patients in neurology clinics followed by headache disorders and epilepsies. Minor disability was present in 36% while moderate to severe disability was present in 10% cases.
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Affiliation(s)
- Mohammad Wasay
- Section of neurology, Department of Medicine, Aga Khan university, Karachi, Pakistan.
| | - Safia Awan
- Section of neurology, Department of Medicine, Aga Khan university, Karachi, Pakistan.
| | - Naila Shahbaz
- Dow University of Health Sciences, Karachi, Pakistan
| | - Sara Khan
- Section of neurology, Department of Medicine, Aga Khan university, Karachi, Pakistan
| | - Khalid Sher
- Jinnah post graduate medical center, Karachi, Pakistan
| | - Abdul Malik
- Section of neurology, Department of Medicine, Liaquat College of Medicine and Dentistry, Karachi, Pakistan
| | - Shahid Mustafa
- Section of neurology, Department of Medicine, Aga Khan university, Karachi, Pakistan
| | | | - Saleem Barech
- Bolan university of Medical and health Sciences, Quetta, Pakistan
| | - Anjum Farooq
- Bolan university of Medical and health Sciences, Quetta, Pakistan
| | - Sajid Hameed
- Section of neurology, Department of Medicine, Aga Khan university, Karachi, Pakistan
| | - Maimoona Siddiqui
- Shifa International Hospital, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Arsalan Ahmad
- Shifa International Hospital, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Ahmed Asif
- Liaquat National hospital, Karachi, Pakistan
| | - Akhtar Sherin
- Khyber Medical University, Institute of Medical Sciences Kohat, Pakistan
| | - Haris Majid
- Pakistan Institute of Medical sciences, Islamabad, Pakistan
| | - Ahsan Nauman
- King Edward Medical college and mayo hospital, Lahore, Pakistan
| | | | | | - Ibrar Rafique
- Health Research Institute (HRI), National Institutes of Health, Islamabad, Pakistan
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10
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Kamila G, Gulati S. Navigating the Frontiers in Childhood Neurodevelopmental Disorders: Unravelling Challenges in South-East Asia. WHO South East Asia J Public Health 2023; 12:81-84. [PMID: 38848526 DOI: 10.4103/who-seajph.whoseajph_6_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 11/24/2023] [Indexed: 06/09/2024]
Affiliation(s)
- Gautam Kamila
- Department of Pediatrics, Child Neurology Division, Centre of Excellence and Advanced Research for Childhood Neurodevelopmental Disorders, All India Institute of Medical Sciences, New Delhi, India
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11
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Liu X, Xu W, Leng F, Zhang P, Guo R, Zhang Y, Hao C, Ni X, Li W. NeuroCNVscore: a tissue-specific framework to prioritise the pathogenicity of CNVs in neurodevelopmental disorders. BMJ Paediatr Open 2023; 7:e001966. [PMID: 37407247 DOI: 10.1136/bmjpo-2023-001966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/15/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Neurodevelopmental disorders (NDDs) are associated with altered development of the brain especially in childhood. Copy number variants (CNVs) play a crucial role in the genetic aetiology of NDDs by disturbing gene expression directly at linear sequence or remotely at three-dimensional genome level in a tissue-specific manner. Despite the substantial increase in NDD studies employing whole-genome sequencing, there is no specific tool for prioritising the pathogenicity of CNVs in the context of NDDs. METHODS Using an XGBoost classifier, we integrated 189 features that represent genomic sequences, gene information and functional/genomic segments for evaluating genome-wide CNVs in a neuro/brain-specific manner, to develop a new tool, neuroCNVscore. We used Human Phenotype Ontology to construct an independent NDD-related set. RESULTS Our neuroCNVscore framework (https://github.com/lxsbch/neuroCNVscore) achieved high predictive performance (precision recall=0.82; area under curve=0.85) and outperformed an existing reference method SVScore. Notably, the predicted pathogenic CNVs showed enrichment in known genes associated with autism. CONCLUSIONS NeuroCNVscore prioritises functional, deleterious and pathogenic CNVs in NDDs at whole genome-wide level, which is important for genetic studies and clinical genomic screening of NDDs as well as for providing novel biological insights into NDDs.
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Affiliation(s)
- Xuanshi Liu
- Beijing Children's Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory for Genetics of Birth Defects, Beijing Pediatric Research Institute, Beijing, China
- MOE Key Laboratory of Major Diseaseas in Children, Beijing, China
- Genetics and Birth Defects Control Centre, National Centre for Children's Health, Beijing, China
| | - Wenjian Xu
- Beijing Children's Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory for Genetics of Birth Defects, Beijing Pediatric Research Institute, Beijing, China
- MOE Key Laboratory of Major Diseaseas in Children, Beijing, China
- Genetics and Birth Defects Control Centre, National Centre for Children's Health, Beijing, China
| | - Fei Leng
- Beijing Children's Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory for Genetics of Birth Defects, Beijing Pediatric Research Institute, Beijing, China
- MOE Key Laboratory of Major Diseaseas in Children, Beijing, China
- Genetics and Birth Defects Control Centre, National Centre for Children's Health, Beijing, China
| | - Peng Zhang
- Beijing Children's Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory for Genetics of Birth Defects, Beijing Pediatric Research Institute, Beijing, China
- MOE Key Laboratory of Major Diseaseas in Children, Beijing, China
- Genetics and Birth Defects Control Centre, National Centre for Children's Health, Beijing, China
| | - Ruolan Guo
- Beijing Children's Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory for Genetics of Birth Defects, Beijing Pediatric Research Institute, Beijing, China
- MOE Key Laboratory of Major Diseaseas in Children, Beijing, China
- Genetics and Birth Defects Control Centre, National Centre for Children's Health, Beijing, China
| | - Yue Zhang
- Beijing Children's Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory for Genetics of Birth Defects, Beijing Pediatric Research Institute, Beijing, China
- MOE Key Laboratory of Major Diseaseas in Children, Beijing, China
- Genetics and Birth Defects Control Centre, National Centre for Children's Health, Beijing, China
| | - Chanjuan Hao
- Beijing Children's Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory for Genetics of Birth Defects, Beijing Pediatric Research Institute, Beijing, China
- MOE Key Laboratory of Major Diseaseas in Children, Beijing, China
- Genetics and Birth Defects Control Centre, National Centre for Children's Health, Beijing, China
| | - Xin Ni
- Beijing Children's Hospital, Capital Medical University, Beijing, China
- MOE Key Laboratory of Major Diseaseas in Children, Beijing, China
- National Centre for Children's Health, Beijing, China
| | - Wei Li
- Beijing Children's Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory for Genetics of Birth Defects, Beijing Pediatric Research Institute, Beijing, China
- MOE Key Laboratory of Major Diseaseas in Children, Beijing, China
- Genetics and Birth Defects Control Centre, National Centre for Children's Health, Beijing, China
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12
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Francés L, Caules J, Ruiz A, Soler CV, Hervás A, Fernández A, Rodríguez-Quiroga A, Quintero J. An approach for prevention planning based on the prevalence and comorbidity of neurodevelopmental disorders in 6-year-old children receiving primary care consultations on the island of Menorca. BMC Pediatr 2023; 23:32. [PMID: 36670411 PMCID: PMC9852795 DOI: 10.1186/s12887-023-03844-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 01/10/2023] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Few studies have estimated the real prevalence of neurodevelopmental disorders according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) in Spain and worldwide. However, there are disparate prevalence figures. We consider research in this field essential to improve early detection, secondary prevention, and health planning. METHODS The Minikid ADHD and TICS-Mini International Neuropsychiatric Interview for Children and Adolescents, the Autism Spectrum Quotient (Children's version, AQ- Child) and a protocol of general medical questions were administered for screening purposes. The PROLEXIA battery for children aged from 4 to 6 years was used for direct assessments. Parents provided information on emotional, medical, and school aspects. The final population evaluated using these tools consisted of 291 6-year-old subjects. RESULTS The overall risk of presenting with a neurodevelopmental disorder was 55.4%. A 23.4% risk of presenting with attention-deficit/hyperactivity disorder (ADHD) in any modality (inattentive, hyperactive-impulsive and combined), a 2.8% risk of developing autism spectrum disorder (ASD), a 30.6% risk of presenting with a learning disorder with reading difficulties, a 5.5% risk of tics and a 22.5% risk of language problems (incomprehensible language or minor language problems) were detected in the sample. The most common combination of disorders was learning and language difficulties, accounting for 6.9% of the sample. The second most frequent combination was the presence of learning and language difficulties and ADHD, accounting for 4.5% of the sample. CONCLUSIONS The prevalence of risks detected in our sample seems to be consistent with national and international studies. A significant proportion of our sample had never been previously diagnosed (85%), so early detection programs are recommended.
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Affiliation(s)
- Lorena Francés
- Child and Adolescent Psychiatrist, Menorca (Balearic Islands, Spain), Av. Del Metge Camps 20, 07740 Es Mercadal, Balearic Islands Spain
| | | | - Antoni Ruiz
- grid.5841.80000 0004 1937 0247University of Barcelona, Barcelona, Spain
| | - Catalina Virgínia Soler
- grid.487143.d0000 0004 1807 8885Dalt Sant Joan Center (Mahón), Servei de Salut de les Illes Balears, Mahón, Illes Balears Spain
| | - Amaia Hervás
- grid.410458.c0000 0000 9635 9413Child–Adolescent Mental Health Unit at the Mutua Terrasa University Hospital, Barcelona, Catalonia Spain ,grid.7080.f0000 0001 2296 0625the Autonomous University of Barcelona, Barcelona, Catalonia Spain ,Saint George Hospital in London, London, UK ,grid.439833.60000 0001 2112 9549Child–Adolescent Psychiatry at Maudsley Hospital, London, UK
| | - Alberto Fernández
- grid.4795.f0000 0001 2157 7667Department of Legal Medicine, Psychiatry and Pathology at the Complutense University of Madrid, Madrid, Spain
| | | | - Javier Quintero
- Psychiatry Service of the Infanta Leonor Hospital, Madrid, Spain ,grid.4795.f0000 0001 2157 7667Psychiatry Department of the Complutense University of Madrid, Leading Expert in Child and Adolescent Psychiatry, Madrid, Spain
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13
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Giraldo-Ocampo S, Pacheco-Orozco RA, Pachajoa H. A Novel POGZ Variant in a Patient with Intellectual Disability and Obesity. Appl Clin Genet 2022; 15:63-68. [PMID: 35821784 PMCID: PMC9271277 DOI: 10.2147/tacg.s369483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 06/08/2022] [Indexed: 12/03/2022] Open
Abstract
White–Sutton syndrome is a rare type of autosomal dominant neurodevelopmental disorder caused by mutations, mostly de novo, in the POGZ gene. No more than 120 patients have been described so far in the literature. Common clinical manifestations include intellectual disability, developmental delay, autism spectrum disorder, other behavioral abnormalities, sleeping problems, hyperactivity and visual problems. We describe a 20-year-old male patient from Colombia who presented with delayed psychomotor development, intellectual disability, obesity, sleep difficulties, hypotonia, hypogonadism, gynecomastia, visual abnormalities and several facial dysmorphisms. Genetic testing showed a novel heterozygous frameshift variant (c.3308del; p.Leu1103Profs*19) in the POGZ gene (NM_015100.3). This is the first report of a diagnosed patient with WHSUS in Colombia.
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Affiliation(s)
| | | | - Harry Pachajoa
- Genetics Division, Fundación Valle del Lili, Cali, Colombia
- Centro de Investigaciones en Anomalías Congénitas y Enfermedades Raras (CIACER), Cali, Colombia
- Correspondence: Harry Pachajoa, Genetics Division, Fundación Valle del Lili, Carrera 98 # 18-49, Cali, Colombia, Tel +57 5552334 ext 7653, Email
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14
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Gonçalves BP, Procter SR, Paul P, Chandna J, Lewin A, Seedat F, Koukounari A, Dangor Z, Leahy S, Santhanam S, John HB, Bramugy J, Bardají A, Abubakar A, Nasambu C, Libster R, Sánchez Yanotti C, Horváth-Puhó E, Sørensen HT, van de Beek D, Bijlsma MW, Gardner WM, Kassebaum N, Trotter C, Bassat Q, Madhi SA, Lambach P, Jit M, Lawn JE. Group B streptococcus infection during pregnancy and infancy: estimates of regional and global burden. Lancet Glob Health 2022; 10:e807-e819. [PMID: 35490693 PMCID: PMC9090904 DOI: 10.1016/s2214-109x(22)00093-6] [Citation(s) in RCA: 62] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 02/10/2022] [Accepted: 02/24/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND Group B streptococcus (GBS) colonisation during pregnancy can lead to invasive GBS disease (iGBS) in infants, including meningitis or sepsis, with a high mortality risk. Other outcomes include stillbirths, maternal infections, and prematurity. There are data gaps, notably regarding neurodevelopmental impairment (NDI), especially after iGBS sepsis, which have limited previous global estimates. In this study, we aimed to address this gap using newly available multicountry datasets. METHODS We collated and meta-analysed summary data, primarily identified in a series of systematic reviews published in 2017 but also from recent studies on NDI and stillbirths, using Bayesian hierarchical models, and estimated the burden for 183 countries in 2020 regarding: maternal GBS colonisation, iGBS cases and deaths in infants younger than 3 months, children surviving iGBS affected by NDI, and maternal iGBS cases. We analysed the proportion of stillbirths with GBS and applied this to the UN-estimated stillbirth risk per country. Excess preterm births associated with maternal GBS colonisation were calculated using meta-analysis and national preterm birth rates. FINDINGS Data from the seven systematic reviews, published in 2017, that informed the previous burden estimation (a total of 515 data points) were combined with new data (17 data points) from large multicountry studies on neurodevelopmental impairment (two studies) and stillbirths (one study). A posterior median of 19·7 million (95% posterior interval 17·9-21·9) pregnant women were estimated to have rectovaginal colonisation with GBS in 2020. 231 800 (114 100-455 000) early-onset and 162 200 (70 200-394 400) late-onset infant iGBS cases were estimated to have occurred. In an analysis assuming a higher case fatality rate in the absence of a skilled birth attendant, 91 900 (44 800-187 800) iGBS infant deaths were estimated; in an analysis without this assumption, 58 300 (26 500-125 800) infant deaths from iGBS were estimated. 37 100 children who recovered from iGBS (14 600-96 200) were predicted to develop moderate or severe NDI. 40 500 (21 500-66 200) maternal iGBS cases and 46 200 (20 300-111 300) GBS stillbirths were predicted in 2020. GBS colonisation was also estimated to be potentially associated with considerable numbers of preterm births. INTERPRETATION Our analysis provides a comprehensive assessment of the pregnancy-related GBS burden. The Bayesian approach enabled coherent propagation of uncertainty, which is considerable, notably regarding GBS-associated preterm births. Our findings on both the acute and long-term consequences of iGBS have public health implications for understanding the value of investment in maternal GBS immunisation and other preventive strategies. FUNDING Bill & Melinda Gates Foundation.
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Affiliation(s)
- Bronner P Gonçalves
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; Maternal, Adolescent, Reproductive & Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK.
| | - Simon R Procter
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; Maternal, Adolescent, Reproductive & Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Proma Paul
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; Maternal, Adolescent, Reproductive & Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Jaya Chandna
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; Maternal, Adolescent, Reproductive & Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Alexandra Lewin
- Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK
| | - Farah Seedat
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; Maternal, Adolescent, Reproductive & Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Artemis Koukounari
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; Maternal, Adolescent, Reproductive & Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Ziyaad Dangor
- South African Medical Research Council, Vaccines and Infectious Diseases Analytical Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Shannon Leahy
- Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Hima B John
- Neonatology Department, Christian Medical College, Vellore, India
| | - Justina Bramugy
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | - Azucena Bardají
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique; ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Amina Abubakar
- Neuroscience Research Group, Department of Clinical Sciences, Kenyan Medical Research Institute, Wellcome Trust, Kilifi, Kenya; Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Carophine Nasambu
- Neuroscience Research Group, Department of Clinical Sciences, Kenyan Medical Research Institute, Wellcome Trust, Kilifi, Kenya
| | | | | | | | - Henrik T Sørensen
- Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
| | - Diederik van de Beek
- Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Merijn W Bijlsma
- Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands; Department of Paediatrics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - William M Gardner
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Nicholas Kassebaum
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Departments of Global Health and Health Metrics Sciences, University of Washington, Seattle, WA, USA; Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA
| | - Caroline Trotter
- Disease Dynamics Unit, Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - Quique Bassat
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique; ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain; Catalan Institution for Research and Advanced Studies, Barcelona, Spain; Pediatrics Department, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain; Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain
| | - Shabir A Madhi
- South African Medical Research Council, Vaccines and Infectious Diseases Analytical Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Department of Science and Technology and National Research Foundation: Vaccine Preventable Diseases, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Philipp Lambach
- Department of Immunization, Vaccines and Biologicals, WHO, Geneva, Switzerland
| | - Mark Jit
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Joy E Lawn
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; Maternal, Adolescent, Reproductive & Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK
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15
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Francés L, Quintero J, Fernández A, Ruiz A, Caules J, Fillon G, Hervás A, Soler CV. Current state of knowledge on the prevalence of neurodevelopmental disorders in childhood according to the DSM-5: a systematic review in accordance with the PRISMA criteria. Child Adolesc Psychiatry Ment Health 2022; 16:27. [PMID: 35361232 PMCID: PMC8973738 DOI: 10.1186/s13034-022-00462-1] [Citation(s) in RCA: 53] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 03/24/2022] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To interpret the current evidence on the prevalence of neurodevelopmental disorders (NDDs) through a systematic review based on both DSM-5 (2013) and PRISMA criteria. METHOD Empirical studies complying with the PRISMA guidelines were identified from four databases (PubMed, Scopus, Science Direct, and ProQuest) and systematically reviewed. In total, 17 articles were selected for the study. RESULTS In the scientific literature, there have been only a few studies measuring the prevalence of NDDs according to the DSM-5 (2013) criteria in people under 18 years old. The reported prevalence rates were as follows: intellectual disability (ID), 0.63%; attention-deficit/hyperactivity disorder (ADHD), 5-11%; autism spectrum disorder (ASD), 0.70-3%; specific learning disorder (SLD), 3-10%; communication disorders (CDs), 1-3.42%; and motor disorders (MDs), 0.76-17%. Although there is extensive literature on specific disorders, NDDs have rarely been assessed as a whole. All of the reviewed studies support the idea that such disorders can be considered chronic, heterogeneous, underdiagnosed conditions and that comorbidity of multiple NDDs is the norm. Likewise, it is estimated that the prevalence of the most studied disorders, such as ADHD, ASD and SLD, remains stable over time and is consistent in different cultures, ages, ethnicities and sexes. CONCLUSION The studies reviewed lead us to conclude that the prevalence rate of NDDs fluctuates globally between 4.70 and 88.50%; these variations depend on methodological aspects such as estimation procedures, as well as on sociocontextual phenomena. It is also important to consider that the prevalence found is probably highly influenced by the activity of the countries in the diagnosis and training of professionals who care for children and adolescents. Hence, there is a need for a secondary intervention in the fields of public health and education to minimize socioemotional consequences, prevent academic failure, and reduce the economic cost to society.
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Affiliation(s)
- Lorena Francés
- Child and Adolescent Psychiatrist, Menorca (Balearic Islands, Spain). Av. Del Metge Camps 20, 07740, Es Mercadal, Balearic Islands, Spain.
| | - Javier Quintero
- Head of the Psychiatry Service, Infanta Leonor Hospital Madrid, Madrid, Spain ,grid.5515.40000000119578126Department of the Complutense, University of Madrid, Madrid, Spain
| | - Alberto Fernández
- grid.4795.f0000 0001 2157 7667Department of Legal Medicine, Psychiatry and Pathology, Complutense University of Madrid, Madrid, Spain
| | - Antoni Ruiz
- grid.5841.80000 0004 1937 0247University of Barcelona, Barcelona, Spain
| | - Jessica Caules
- Psychopedagogical Center Arrels, Ciutadella, Balearic Islands Spain
| | - Gabriella Fillon
- grid.451052.70000 0004 0581 2008Somerset Foundation Trust–National Health System (NHS), London, UK
| | - Amaia Hervás
- grid.5841.80000 0004 1937 0247University of Barcelona, Barcelona, Spain ,Child–Adolescent Mental Health Unit at the Mutua Terrasa University Hospital, Catalonia, Spain ,Saint George Hospital in London, London, UK ,grid.439833.60000 0001 2112 9549Child-Adolescent Psychiatry at Maudsley Hospital, London, UK
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Abuga JA, Kariuki SM, Abubakar A, Kinyanjui SM, van Hensbroek MB, Newton CR. The burden of neurological impairments and disability in older children measured in disability-adjusted life-years in rural Kenya. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000151. [PMID: 35469292 PMCID: PMC7612656 DOI: 10.1371/journal.pgph.0000151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Neurological impairment (NI) and disability are common in sub-Saharan Africa (SSA), but the overall burden in terms of morbidity and mortality in older children remains unknown. We estimated the burden of NI in disability-adjusted life years (DALYs), years of life lost to premature mortality (YLLs), and years lived with disability (YLDs) for older children in a defined rural setting in Kenya. We used empirical and literature estimates to model the overall burden for children aged 5-14 years in five domains: epilepsy (lifetime and active) and moderate/severe cognitive, hearing, motor, and visual impairments. We obtained internally consistent estimates of prevalence, mortality, and transitional hazards using DisMod II software. Disability weights and life expectancy estimates were based on the global burden of disease (GBD) studies. We used the most plausible parameters to calculate YLLs, YLDs, and DALYs and their bootstrapped 95% uncertainty intervals (95%UI) for the defined area. NI in the five domains resulted in a total of 4587 (95%UI 4459-4715) absolute DALYs or 53 (95%UI 39-67) DALYs per 1000 children aged 5-14 years, of which 83% were YLLs and 17% YLDs. Girls had significantly more YLLs and DALYs than boys (p-values <0.001, respectively). Besides being the leading cause of fatal and non-fatal outcomes, epilepsy accounted for the greatest proportion of the total burden for a single domain (20 DALYs per 1000, 95%UI 11-26, or 38.5% of the total DALYs). Visual impairment accounted for the least proportion of the total burden (6 per 1000, 95%UI 1-17, or 12.1%). Children with NI and disability bear a significantly high burden of fatal and non-fatal outcomes. The burden is highest among girls and those with childhood-onset epilepsy. We recommend active identification, treatment, and rehabilitative support for the affected children to prevent premature mortality and improve their quality of life.
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Affiliation(s)
- Jonathan A. Abuga
- Department of Clinical Research (Neurosciences), KEMRI Wellcome Trust Research Programme, Kilifi, Kenya
- Amsterdam Centre for Global Child Health, Emma Children’s Hospital, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
- * E-mail: ,
| | - Symon M. Kariuki
- Department of Clinical Research (Neurosciences), KEMRI Wellcome Trust Research Programme, Kilifi, Kenya
- Department of Public Health, Pwani University, Kilifi, Kenya
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Amina Abubakar
- Department of Clinical Research (Neurosciences), KEMRI Wellcome Trust Research Programme, Kilifi, Kenya
- Department of Public Health, Pwani University, Kilifi, Kenya
- Institute for Human Development, The Aga Khan University, Nairobi, Kenya
| | - Samson M. Kinyanjui
- Department of Clinical Research (Neurosciences), KEMRI Wellcome Trust Research Programme, Kilifi, Kenya
- Department of Public Health, Pwani University, Kilifi, Kenya
- Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Michael Boele van Hensbroek
- Amsterdam Centre for Global Child Health, Emma Children’s Hospital, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Charles R. Newton
- Department of Clinical Research (Neurosciences), KEMRI Wellcome Trust Research Programme, Kilifi, Kenya
- Department of Public Health, Pwani University, Kilifi, Kenya
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
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17
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Zhang M, Wang C, Zhang X, Song H, Li Y. Association between exposure to air pollutants and attention-deficit hyperactivity disorder (ADHD) in children: a systematic review and meta-analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:207-219. [PMID: 32248699 DOI: 10.1080/09603123.2020.1745764] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Recent studies have reached mixed conclusions regarding the association between exposure to air pollutants and attention-deficit hyperactivity disorder (ADHD). We performed systematic review and meta-analysis to determine whether air pollutants were risk factors for the development of ADHD in children. We systematically searched databases for all relevant studies up to 2 July 2019. Together, the studies indicated that exposure to PAHs (risk ratio (RR): 0.98, 95% confidence interval (CI): 0.82-1.17), NOx (RR: 1.04, 95% CI: 0.94-1.15), and PM (RR: 1.11, 95% CI: 0.93-1.33) did not have any material relationship with an increased risk of ADHD. Heterogeneity of study data was low (I2: 2.7%, P = 0.409) for studies examining PAHs, but was substantial for NOx and PM (I2: 68.4%, P = 0.007 and I2: 60.1%, P = 0.014, respectively). However, these results should be interpreted with caution since the number of epidemiological studies investigating this issue were limited.
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Affiliation(s)
- Mengjie Zhang
- Department of Children, Adolescents and Women Health, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Changhong Wang
- Department of Psychiatry, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, China
| | - Xinxin Zhang
- Department of Children, Adolescents and Women Health, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Huiling Song
- Department of Children, Adolescents and Women Health, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Yan Li
- Department of Children, Adolescents and Women Health, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- School of Physical Education (Main Campus), Zhengzhou University, Zhengzhou, Henan, China
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Haque MA, Salwa M, Sultana S, Tasnim A, Towhid MII, Karim MR, Abdullah Al Mamun M. Parenting stress among caregivers of children with neurodevelopmental disorders: A cross-sectional study in Bangladesh. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2021; 26:17446295211002355. [PMID: 33882755 DOI: 10.1177/17446295211002355] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This cross-sectional study explored stressful situations of caregivers related to life events of their children suffering from neurodevelopmental disorders along with potential contributing factors. A total of 906 caregivers of children with diagnosed neurodevelopmental disorder, from eight administrative districts and two city corporation areas in Bangladesh were interviewed. The Family Stress and Coping Interview scale was used to evaluate parenting stress. The diagnosis of neurodevelopmental disorder at the outset, feelings about the cause of the disorder, future planning for employment and accommodation for the child and dealing with child sexuality were some important stressful situations for parents. Parenting stress is found to be higher among female [regression coefficient (B) = 5.09, p < 0.001] and less educated caregivers [B = 2.69, p < 0.01]. Increasing age of child [B = 0.82, p < 0.001] and diagnosis of neurodevelopmental disorder before child's second birthday [B = 4.22, p < 0.001] are also associated with higher parenting stress.
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Affiliation(s)
- M Atiqul Haque
- 74464Bangabandhu Sheikh Mujib Medical University, Bangladesh
| | - Marium Salwa
- 74464Bangabandhu Sheikh Mujib Medical University, Bangladesh
| | - Sarmin Sultana
- 74464Bangabandhu Sheikh Mujib Medical University, Bangladesh
| | - Anika Tasnim
- 74464Bangabandhu Sheikh Mujib Medical University, Bangladesh
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Abuga JA, Kariuki SM, Kinyanjui SM, Boele van Hensbroek M, Newton CR. Premature Mortality, Risk Factors, and Causes of Death Following Childhood-Onset Neurological Impairments: A Systematic Review. Front Neurol 2021; 12:627824. [PMID: 33897590 PMCID: PMC8062883 DOI: 10.3389/fneur.2021.627824] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 03/11/2021] [Indexed: 12/11/2022] Open
Abstract
Background: Neurological impairment (NI) and disability are associated with reduced life expectancy, but the risk and magnitude of premature mortality in children vary considerably across study settings. We conducted a systematic review to estimate the magnitude of premature mortality following childhood-onset NI worldwide and to summarize known risk factors and causes of death. Methods: We searched various databases for published studies from their inception up to 31st October 2020. We included all cohort studies that assessed the overall risk of mortality in individuals with childhood-onset epilepsy, intellectual disability (ID), and deficits in hearing, vision and motor functions. Comparative measures of mortality such as the standardized mortality ratio (SMR), risk factors and causes were synthesized quantitatively under each domain of impairment. This review is registered on the PROSPERO database (registration number CRD42019119239). Results: The search identified 2,159 studies, of which 24 studies were included in the final synthesis. Twenty-two (91.7%) studies originated from high-income countries (HICs). The median SMR was higher for epilepsy compared with ID (7.1 [range 3.1-22.4] vs. 2.9 [range 2.0-11.6]). In epilepsy, mortality was highest among younger age groups, comorbid neurological disorders, generalized seizures (at univariable levels), untreatable epilepsy, soon after diagnosis and among cases with structural/metabolic types, but there were no differences by sex. Most deaths (87.5%) were caused by non-epilepsy-related causes. For ID, mortality was highest in younger age groups and girls had a higher risk compared to the general population. Important risk factors for premature mortality were severe-to-profound severity, congenital disorders e.g., Down Syndrome, comorbid neurological disorders and adverse pregnancy and perinatal events. Respiratory infections and comorbid neurological disorders were the leading causes of death in ID. Mortality is infrequently examined in impairments of vision, hearing and motor functions. Summary: The risk of premature mortality is elevated in individuals with childhood-onset NI, particularly in epilepsy and lower in ID, with a need for more studies for vision, hearing, and motor impairments. Survival in NI could be improved through interventions targeting modifiable risk factors and underlying causes.
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Affiliation(s)
- Jonathan A. Abuga
- Kenya Medical Research Institute (KEMRI-Wellcome Trust Research Programme), Clinical Research (Neurosciences), Kilifi, Kenya
- Global Child Health Group, Emma Children's Hospital, Academic Medical Centre, University of Amsterdam, Amsterdam, Netherlands
| | - Symon M. Kariuki
- Kenya Medical Research Institute (KEMRI-Wellcome Trust Research Programme), Clinical Research (Neurosciences), Kilifi, Kenya
- Department of Public Health, Pwani University, Kilifi, Kenya
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Samson M. Kinyanjui
- Kenya Medical Research Institute (KEMRI-Wellcome Trust Research Programme), Clinical Research (Neurosciences), Kilifi, Kenya
- Department of Public Health, Pwani University, Kilifi, Kenya
- Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Michael Boele van Hensbroek
- Global Child Health Group, Emma Children's Hospital, Academic Medical Centre, University of Amsterdam, Amsterdam, Netherlands
| | - Charles R. Newton
- Kenya Medical Research Institute (KEMRI-Wellcome Trust Research Programme), Clinical Research (Neurosciences), Kilifi, Kenya
- Department of Public Health, Pwani University, Kilifi, Kenya
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
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Maciver D, Hunter C, Johnston L, Forsyth K. Using Stakeholder Involvement, Expert Knowledge and Naturalistic Implementation to Co-Design a Complex Intervention to Support Children's Inclusion and Participation in Schools: The CIRCLE Framework. CHILDREN-BASEL 2021; 8:children8030217. [PMID: 33799759 PMCID: PMC8001448 DOI: 10.3390/children8030217] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 02/27/2021] [Accepted: 03/09/2021] [Indexed: 01/09/2023]
Abstract
Whist inclusion is recommended for most children most of the time it remains difficult to implement. In this paper, we present the process undertaken to review and redesign a pre-existing complex intervention (The CIRCLE Framework) which was designed to enhance teachers confidence and competence in provision of universal first level supports for 5–12 year old children with additional support needs. The approach presented draws on the Medical Research Council guidance for the development of complex interventions. A series of ten co-design workshops with 70 stakeholders was completed, applying interactive and participatory methods. Analysing outputs of each workshop revealed recurring design ideas that became the main aspects of the new framework and associated manuals. Intervention content, theoretical frameworks, manuals to support use in practice and implementation strategies were developed. On completion, the updated intervention was extended up to 18 years of age and redistributed to all teachers in the participating local authority. We present the main conclusions and interpretations around the design and naturalistic implementation of the framework, and reflections on use in practice, including a detailed list of recommendations for implementation across schools and staff.
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Affiliation(s)
- Donald Maciver
- School of Health Sciences, Queen Margaret University, Edinburgh EH21 6UU, UK; (C.H.); (L.J.); (K.F.)
- Correspondence:
| | - Cathleen Hunter
- School of Health Sciences, Queen Margaret University, Edinburgh EH21 6UU, UK; (C.H.); (L.J.); (K.F.)
| | - Lorna Johnston
- School of Health Sciences, Queen Margaret University, Edinburgh EH21 6UU, UK; (C.H.); (L.J.); (K.F.)
- Additional Support for Learning Service, Communities and Families, City of Edinburgh Council, Edinburgh EH8 8BG, UK
| | - Kirsty Forsyth
- School of Health Sciences, Queen Margaret University, Edinburgh EH21 6UU, UK; (C.H.); (L.J.); (K.F.)
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Koly KN, Martin-Herz SP, Islam MS, Sharmin N, Blencowe H, Naheed A. Parent mediated intervention programmes for children and adolescents with neurodevelopmental disorders in South Asia: A systematic review. PLoS One 2021; 16:e0247432. [PMID: 33705420 PMCID: PMC7951928 DOI: 10.1371/journal.pone.0247432] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 02/07/2021] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE Parent-mediated programmes have been found to be cost effective for addressing the needs of the children and adolescents with Neurodevelopmental Disorders (NDD) in high-income countries. We explored the impact of parent-mediated intervention programmes in South Asia, where the burden of NDD is high. METHODS A systematic review was conducted using the following databases; PUBMED, MEDLINE, PsycINFO, Google Scholar and Web of Science. Predefined MeSH terms were used, and articles were included if published prior to January 2020. Two independent researchers screened the articles and reviewed data. OUTCOMES MEASURES The review included studies that targeted children and adolescents between 1 and 18 years of age diagnosed with any of four specific NDDs that are commonly reported in South Asia; Autism Spectrum Disorder (ASD), Intellectual Disability (ID), Attention Deficit Hyperactivity Disorder (ADHD) and Cerebral Palsy (CP). Studies that reported on parent or child outcomes, parent-child interaction, parent knowledge of NDDs, or child activities of daily living were included for full text review. RESULTS A total of 1585 research articles were retrieved and 23 studies met inclusion criteria, including 9 Randomized Controlled Trials and 14 pre-post intervention studies. Of these, seventeen studies reported effectiveness, and six studies reported feasibility and acceptability of the parent-mediated interventions. Three studies demonstrated improved parent-child interaction, three studies demonstrated improved child communication initiations, five studies reported improved social and communication skills in children, four studies demonstrated improved parental knowledge about how to teach their children, and four studies reported improved motor and cognitive skills, social skills, language development, learning ability, or academic performance in children. CONCLUSION This systematic review of 23 studies demonstrated improvements in parent and child skills following parent-mediated intervention in South Asia. Additional evaluations of locally customized parent-mediated programmes are needed to support development of feasible interventions for South Asian countries.
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Affiliation(s)
- Kamrun Nahar Koly
- Initiative for Non-Communicable Diseases, Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Susanne P. Martin-Herz
- Department of Pediatrics, Division of Developmental Medicine, University of California San Francisco, San Francisco, CA, United States of America
| | - Md. Saimul Islam
- Initiative for Non-Communicable Diseases, Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Nusrat Sharmin
- Initiative for Non-Communicable Diseases, Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
- Department of Psychology, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Dhaka, Bangladesh
| | - Hannah Blencowe
- Maternal Adolescent Reproductive and Child Health Centre, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Aliya Naheed
- Initiative for Non-Communicable Diseases, Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
- * E-mail:
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Mbiydzenyuy NE, Pieme CA, Brown RE, Nguemeni C. Neuroscience education and research in Cameroon: Current status and future direction. IBRO Neurosci Rep 2021; 10:216-224. [PMID: 34179870 PMCID: PMC8211920 DOI: 10.1016/j.ibneur.2021.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 12/22/2020] [Accepted: 02/10/2021] [Indexed: 11/26/2022] Open
Abstract
Neurological disorders comprise 20% of hospital admissions in Cameroon. The burden of neurological disorders is increasing, especially in children and the elderly. However, there are very few neurologists, psychiatrists, gerontologists and neuropsychologists trained in the treatment of neurological disorders in Cameroon and there are very few facilities for training in basic and clinical neuroscience. Although non-governmental organizations such as the International Brain Research Organization (IBRO), International Society of Neurochemistry (ISN), and Teaching and Research in Natural Sciences for Development (TReND) in Africa have stepped in to provide short training courses and workshops in neuroscience, these are neither sufficient to train African neuroscientists nor to build the capacity to train neuroscience researchers and clinicians. There has also been little support from universities and the government for such training. While some participants of these schools have managed to form collaborations with foreign researchers and have been invited to study abroad, this does not facilitate the training of neuroscientists in Cameroon. Moreover, the research infrastructure for training in neuroscience remains limited. This is reflected in the low research output from Cameroonian universities in the field. In this review, we describe the burden of neurological disorders in Cameroon and outline the outstanding efforts of local scientists to develop the discipline of neuroscience, which is still an emerging field in Cameroon. We identify key actionable steps towards the improvement of the scientific capacity in neuroscience in Cameroon: (1) develop targeted neuroscience training programs in all major universities in Cameroon; (2) implement a thriving scientific environment supported by international collaborations; (3) focus on the leadership and the mentorship of both local and senior neuroscientists; (4) develop public awareness and information of policy makers to increase governmental funding for neuroscience research. Improving scientific capacity to tackle the neurological diseases burden in Cameroon is urgent. Neuroscience schools and advocated researchers shape the future of neuroscience in Cameroon. Public-private partnerships are required for sustainable country impact of neuroscience schools.
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Affiliation(s)
- Ngala Elvis Mbiydzenyuy
- Department of Basic Medical Science, School of Medicine, Copperbelt University, Ndola, Zambia
| | | | - Richard E Brown
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Carine Nguemeni
- Department of Neurology, University Hospital of Würzburg, Germany
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Banhela N, Naidoo P, Naidoo S. Association between pesticide exposure and paraoxonase-1 (PON1) polymorphisms, and neurobehavioural outcomes in children: a systematic review. Syst Rev 2020; 9:109. [PMID: 32386510 PMCID: PMC7211330 DOI: 10.1186/s13643-020-01330-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 03/11/2020] [Indexed: 12/27/2022] Open
Abstract
Environmental factors such as pollution, pesticide exposure and socio-demographic location have been implicated as a pressure capable of altering genetic make-up. Altered genetic sequence of genes encoding enzymes may result in single nucleotide polymorphism (SNP). Of peculiar interest is the genetic variance on the paraoxonase-1 gene induced by pre- and postnatal exposure to pesticides. SNP have been reported on the paraoxonase-1 gene and post-xenobiotic exposure and are presumed to alter gene sequence and ultimately enzymatic activity. The altered enzymatic activity may facilitate neurodevelopment disorders. Autism spectrum disorders (ASD) and attention deficit hyperactivity disorder (ADHD) are among the neurodevelopment disorders of which prevalence is concurrently associated with increasing environmental xenobiotic exposure. The variance on xenobiotic metabolising genes is associated with altered neurodevelopment outcome and ultimately altered neurobehavioural outcome. Prime interests of this systematic review were to establish an understanding of the sequences on the paraoxonase-1 gene associated with adverse neurobehavioural outcome. An in-depth literature search was conducted using the term combination "pesticide exposure, pre- and postnatal exposure, organophosphates/organophosphorus, single nucleotide polymorphism, paraoxonase-1 (PON-1), neurodevelopment/neurobehavioural outcome in child/infant". Articles published from the year 2000 to 2018 were considered for review. The result showed that variance on the PON1-108 and 192 alleles could be implicated in the development of altered neurobehavioural outcomes.
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Affiliation(s)
- Nkosinathi Banhela
- Discipline of Public Health Medicine, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Howard College Campus, Durban, 4000, South Africa.
| | - Pragalathan Naidoo
- Discipline of Medical Biochemistry and Chemical Pathology, School of Laboratory Medicine and Medical Science, University of KwaZulu-Natal, Howard College Campus, Durban, 4000, South Africa
| | - Saloshni Naidoo
- Discipline of Public Health Medicine, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Howard College Campus, Durban, 4000, South Africa
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Malik TA, Siddiqui S, Mahmood A. Behavioural and emotional problems among school children in Pakistan: A telephonic survey for prevalence and risk factors. J Paediatr Child Health 2019; 55:1414-1423. [PMID: 30916436 DOI: 10.1111/jpc.14429] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 02/02/2019] [Accepted: 02/17/2019] [Indexed: 11/30/2022]
Abstract
AIM Escalating rates of childhood mental health disorders constitute a serious issue for countries like Pakistan. However, due to a scarce number of studies on childhood behavioural problems, understanding the magnitude and gap of the problem is a challenge. Thus, the present study is intended to bridge this gap. This study provides estimates for prevalence, associated demographic risk factors and the impact of behavioural and emotional problems among school children. METHODS A sample of children (n = 800) from public schools of Islamabad were selected using two-stage cluster random sampling. Data were collected from parents through telephonic interviews using the Strengths and Difficulties Questionnaire. RESULTS Prevalence of overall behaviour problems accounted for 15.9%. For conduct problems, estimates were around 26.6%, for emotional problems 22.5%, for peer problems 13%, for hyperactivity 10.6% and for social problems 3% in the initial analysis. Mother's education also appeared to be a significant predictor for mental health problems of youth, where low maternal education was associated with high prevalence and higher impact of emotional and behavioural problems in the present sample. CONCLUSIONS Prevalence estimates of the current study call for attention towards improving mental health services and access to children who are at risk or are having mental health problems. In the context of scarcity of the data from countries like Pakistan, the findings should be considered a call for mental health service providers, researchers and policymakers to scale up mental health services for youth in Pakistan.
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Affiliation(s)
- Tamkeen A Malik
- Department of Behavioral Sciences, National University of Sciences and Technology, Islamabad, Pakistan
| | - Salma Siddiqui
- Department of Behavioral Sciences, National University of Sciences and Technology, Islamabad, Pakistan
| | - Ayeshah Mahmood
- School of Electrical Engineering and Computer Sciences, National University of Sciences and Technology, Islamabad, Pakistan
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Uddin M, Wang Y, Woodbury-Smith M. Artificial intelligence for precision medicine in neurodevelopmental disorders. NPJ Digit Med 2019; 2:112. [PMID: 31799421 PMCID: PMC6872596 DOI: 10.1038/s41746-019-0191-0] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 10/29/2019] [Indexed: 12/23/2022] Open
Abstract
The ambition of precision medicine is to design and optimize the pathway for diagnosis, therapeutic intervention, and prognosis by using large multidimensional biological datasets that capture individual variability in genes, function and environment. This offers clinicians the opportunity to more carefully tailor early interventions- whether treatment or preventative in nature-to each individual patient. Taking advantage of high performance computer capabilities, artificial intelligence (AI) algorithms can now achieve reasonable success in predicting risk in certain cancers and cardiovascular disease from available multidimensional clinical and biological data. In contrast, less progress has been made with the neurodevelopmental disorders, which include intellectual disability (ID), autism spectrum disorder (ASD), epilepsy and broader neurodevelopmental disorders. Much hope is pinned on the opportunity to quantify risk from patterns of genomic variation, including the functional characterization of genes and variants, but this ambition is confounded by phenotypic and etiologic heterogeneity, along with the rare and variable penetrant nature of the underlying risk variants identified so far. Structural and functional brain imaging and neuropsychological and neurophysiological markers may provide further dimensionality, but often require more development to achieve sensitivity for diagnosis. Herein, therefore, lies a precision medicine conundrum: can artificial intelligence offer a breakthrough in predicting risks and prognosis for neurodevelopmental disorders? In this review we will examine these complexities, and consider some of the strategies whereby artificial intelligence may overcome them.
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Affiliation(s)
- Mohammed Uddin
- Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE
- 2The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON Canada
| | - Yujiang Wang
- 3Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
- 4School of Computing, Newcastle University, Newcastle upon Tyne, UK
| | - Marc Woodbury-Smith
- 2The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON Canada
- 3Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
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Cheraghmakani H, Nasehi MM, Baghbanian SM. Neurodevelopmental retardation in a baby born to a multiple sclerosis patient being treated with fingolimod. Mult Scler Relat Disord 2019; 33:116-120. [DOI: 10.1016/j.msard.2019.05.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 05/17/2019] [Accepted: 05/24/2019] [Indexed: 10/26/2022]
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Verma V, Paul A, Amrapali Vishwanath A, Vaidya B, Clement JP. Understanding intellectual disability and autism spectrum disorders from common mouse models: synapses to behaviour. Open Biol 2019; 9:180265. [PMID: 31185809 PMCID: PMC6597757 DOI: 10.1098/rsob.180265] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Normal brain development is highly dependent on the timely coordinated actions of genetic and environmental processes, and an aberration can lead to neurodevelopmental disorders (NDDs). Intellectual disability (ID) and autism spectrum disorders (ASDs) are a group of co-occurring NDDs that affect between 3% and 5% of the world population, thus presenting a great challenge to society. This problem calls for the need to understand the pathobiology of these disorders and to design new therapeutic strategies. One approach towards this has been the development of multiple analogous mouse models. This review discusses studies conducted in the mouse models of five major monogenic causes of ID and ASDs: Fmr1, Syngap1, Mecp2, Shank2/3 and Neuroligins/Neurnexins. These studies reveal that, despite having a diverse molecular origin, the effects of these mutations converge onto similar or related aetiological pathways, consequently giving rise to the typical phenotype of cognitive, social and emotional deficits that are characteristic of ID and ASDs. This convergence, therefore, highlights common pathological nodes that can be targeted for therapy. Other than conventional therapeutic strategies such as non-pharmacological corrective methods and symptomatic alleviation, multiple studies in mouse models have successfully proved the possibility of pharmacological and genetic therapy enabling functional recovery.
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Affiliation(s)
- Vijaya Verma
- Neuroscience Unit, Jawaharlal Nehru Centre for Advanced Scientific Research , Jakkur, Bengaluru 560 064, Karnataka, India
| | - Abhik Paul
- Neuroscience Unit, Jawaharlal Nehru Centre for Advanced Scientific Research , Jakkur, Bengaluru 560 064, Karnataka, India
| | - Anjali Amrapali Vishwanath
- Neuroscience Unit, Jawaharlal Nehru Centre for Advanced Scientific Research , Jakkur, Bengaluru 560 064, Karnataka, India
| | - Bhupesh Vaidya
- Neuroscience Unit, Jawaharlal Nehru Centre for Advanced Scientific Research , Jakkur, Bengaluru 560 064, Karnataka, India
| | - James P Clement
- Neuroscience Unit, Jawaharlal Nehru Centre for Advanced Scientific Research , Jakkur, Bengaluru 560 064, Karnataka, India
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Hailemariam TG, Nathan S, Seifu CN, Rawstorne P. Uptake of couples HIV testing and counselling among heterosexual couples in Sub-Saharan Africa: a systematic review and meta-analysis. AIDS Care 2019; 32:137-147. [DOI: 10.1080/09540121.2019.1619667] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Tewodros Getachew Hailemariam
- School of Public Health & Community Medicine, University of New South Wales, Sydney, Australia
- School of Public Health, Wolaita Sodo University, Sodo, Ethiopia
| | - Sally Nathan
- School of Public Health & Community Medicine, University of New South Wales, Sydney, Australia
| | | | - Patrick Rawstorne
- School of Public Health & Community Medicine, University of New South Wales, Sydney, Australia
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Early childhood developmental disabilities-data still needed. LANCET GLOBAL HEALTH 2018; 6:e1050-e1051. [PMID: 30172775 DOI: 10.1016/s2214-109x(18)30399-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 08/14/2018] [Indexed: 11/21/2022]
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