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Torty C, Eyong K, Asindi A A, Usun E. Autism Spectrum Disorders in Calabar, Nigeria. IRANIAN JOURNAL OF CHILD NEUROLOGY 2024; 18:75-81. [PMID: 38988844 PMCID: PMC11231682 DOI: 10.22037/ijcn.v18i3.41744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 01/18/2024] [Indexed: 07/12/2024]
Abstract
Objectives Autism spectrum disorder (ASD) is a neurodevelopmental disorder that is prevalent worldwide. The incidence of autism has increased worldwide. However, there is a dearth of data in sub-Saharan Africa. The study is aimed at determining the clinical and socio-developmental profile of children with ASD in a tertiary hospital in Nigeria. Materials & Methods This study is a six-year retrospective review of the medical records of children who presented with clinical autism diagnoses at the Department of Pediatrics, University of Calabar Teaching Hospital. Relevant data were extracted from the medical records of those who met the diagnostic criteria. Descriptive statistics were presented in proportions, percentages, and tables. Results Of the 1806 children with neurological disorders seen in the clinic within the study period, twenty-eight were found to have symptoms of autism based on the American Psychiatric Association›s Diagnostic and Statistical Manual V (DSM -5) criteria, giving a prevalence of 1.6%. The mean age at diagnosis was 3.8 ±1.4 (range 2 to 10) years, with a male-to-female ratio of 3:1. About two-thirds of the children diagnosed were older than three years. Seven percent of the children had siblings with autism, 53.5% of children with autism in the study had hyperactivity as comorbidity, while seizures were found in 7% of cases. Conclusion The prevalence of ASD among children seen in Calabar is 1.6%. Hyperactivity, mental retardation, and seizure disorders are associated comorbidities in the study. Late presentation is a common feature in this facility. Thus, increasing awareness is essential to enhance early recognition, timely diagnosis, and appropriate intervention.
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Affiliation(s)
- Chimaeze Torty
- Department of Paediatrics, University of Calabar
- Department of Paediatrics, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Komomo Eyong
- Department of Paediatrics, University of Calabar
- Department of Paediatrics, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Asindi Asindi A
- Department of Paediatrics, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Edet Usun
- Department of Paediatrics, University of Calabar Teaching Hospital, Calabar, Nigeria
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Duale HA, Gele A. Exploring knowledge of autism, its causes and treatment among immigrant and nonimmigrant parents in Somalia\Somaliland. Child Adolesc Psychiatry Ment Health 2024; 18:22. [PMID: 38326911 PMCID: PMC10851585 DOI: 10.1186/s13034-024-00713-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 01/25/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND The prevalence of autism spectrum disorders (ASDs) has increased over the recent years; however, little is known about the experience of parents of children with autism in Africa such as Somalia. The aim of this study is to understand the knowledge on autism of Somali parents of children with autism and their perceptions of causes and treatment of ASD. METHODS We conducted a qualitative study involving 22 parents of children with autism who lived in Mogadishu and Hargeisa; the two largest cities in Somalia. In-depth interviews were used to collect the data. Of the 22 participants, 9 were returned immigrants and 13 were local people (non-immigrants). Data were analysed using thematic analysis. RESULTS The data revealed that most of the parents hold the belief that their children's autism were caused by the measles vaccine. The findings demonstrated that parents sought diagnosis and treatment care from outside Somalia due to the lack of experience of health providers in the diagnosis and treatment of autism. The data also revealed a lack of knowledge about autism among the public with resultant stigma and discrimination against children with autism and their families. CONCLUSIONS Efforts to increase public knowledge on autism, its causes and treatments are of paramount importance, while a public health campaign designed to eliminate the stigma subjected to children with autism is necessary to improve the quality of life of children with autism and their caregivers. Finally, to counteract vaccine hesitancy, particularly in response to the measles vaccine, health policy makers should take steps to separate the cooccurrence of the onset of autism symptoms and the provision of the measles vaccine.
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Affiliation(s)
- Hodan A Duale
- Department of Maternal and Child Health, Somali Institute for Health Research (SIHR), Hargeisa, Somaliland.
| | - Abdi Gele
- Department of Maternal and Child Health, Somali Institute for Health Research (SIHR), Hargeisa, Somaliland.
- Department of Health Service Research, Norwegian Institute of Public Health, Skøyen, 222, 0213, Oslo, Norway.
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Nwokolo EU, Murphy GH, Langdon PE. Validation of the social communication questionnaire amongst Nigerian adolescents. Autism Res 2024; 17:66-77. [PMID: 37795675 DOI: 10.1002/aur.3038] [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: 03/13/2023] [Accepted: 09/20/2023] [Indexed: 10/06/2023]
Abstract
Few autism spectrum disorder (ASD) screening tools have been developed and validated in Africa. This study aimed to examine the psychometric properties of the Social Communication Questionnaire (SCQ) when used with Nigerian adolescents. Parents and caregivers of two hundred and five adolescents completed the SCQ Lifetime form while the adolescents were assessed for ASD using the Autism Diagnostic Observation Schedule, 2nd Edition (ADOS-2). Factor structure and convergent and discriminative validity were examined, along with the sensitivity and specificity of the SCQ in identifying participants with an autism spectrum disorder. The confirmatory factor analysis (CFA) was used to examine the factor structure, while logistic regression and Pearson's correlation coefficient were used to examine the validities. The SCQ had good internal consistency, discriminative, and convergent validity. A cut-off score of 10 revealed sensitivity = 0.81 and specificity = 0.88 for the identification of autism spectrum disorder. AUC was 0.83, p < 0.001, 95% CI [0.77, 0.90]. The results of this study provide evidence to support the retention of the original four factors of the SCQ. The SCQ has good psychometric properties when used with Nigerian adolescents.
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Affiliation(s)
| | | | - Peter E Langdon
- Centre for Educational Development, Appraisal and Research (CEDAR), and Centre for Mental Health and Wellbeing Research, University of Warwick and Brooklands Hospital, Coventry and Warwickshire Partnership NHS Trust, Coventry, UK
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Koum DCK, Enyama D, Foko LPK, Noukeu D, Nguedia B, Mbono R, Eposse C, Eboumbou PE, Engome CB, Mapoure YN. Diagnosis and treatment challenges of autism spectrum disorder at a reference hospital in Douala, Cameroon. BMC Pediatr 2023; 23:459. [PMID: 37704945 PMCID: PMC10498515 DOI: 10.1186/s12887-023-04242-4] [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: 12/26/2022] [Accepted: 08/10/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Autism spectrum disorder (ASD) is a neurodevelopmental disability associated with deficiency in social interaction, unusual development of social communication, and restricted or repetitive behaviors, interests and activities. This study aimed to describe management of pediatric ASD in Cameroon, a resource-constrained Central Africa country. METHODS A retrospective study was conducted between December 2021 and May 2022 at the Pediatrics department of a reference hospital in the town of Douala. Data of interest of children with ASD were collected through eligible medical records and telephone discussions with their parents/guardians. RESULTS Medical records of 145 children with ASD aged 2-15 years were included in the study, giving a hospital ASD prevalence of 3.7%. Time delay between parental concerns and hospital management was specified in 69 (47.58%) children, and among them 38 (55.07%) had a mean delay ± SD was less than five months. Children were mainly males (76%) and aged 4-5 years (37.93%), with mean age ± SD of 44.4 ± 22.2 months old. The main consultation reason was delayed language development (100%). Mean time delay between parental concerns and the first medical consultation was 18 months (range 1-60 month). Attention deficit hyperactivity disorder were found in 68.18% of children aged ≥ 6 years old. Neuropsychology (66.2%) was the most frequently used intervention. Some children were treated using traditional medicine. CONCLUSIONS Management of pediatric ASD is strongly influenced by socioeconomic and cultural context. It is crucial to implement behavioral change campaigns in community, organize training sessions to medical staff on diagnosis and treatment of ASD, and provide specialized centers with skilled staff and equipped material.
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Affiliation(s)
| | - Dominique Enyama
- Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
- Douala Gyneco-Obstetrics and Pediatrics Hospital, Douala, Cameroon
| | | | - Diomede Noukeu
- Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
- Douala Gyneco-Obstetrics and Pediatrics Hospital, Douala, Cameroon
| | - Belviane Nguedia
- Faculty of Medicine and Pharmaceutical Sciences, The University of Douala, P.O Box: 8037, Douala, Cameroon
| | - Rhita Mbono
- Faculty of Medicine and Pharmaceutical Sciences, The University of Douala, P.O Box: 8037, Douala, Cameroon
| | - Charlotte Eposse
- Faculty of Medicine and Pharmaceutical Sciences, The University of Douala, P.O Box: 8037, Douala, Cameroon
| | - Patricia Epee Eboumbou
- Faculty of Medicine and Pharmaceutical Sciences, The University of Douala, P.O Box: 8037, Douala, Cameroon
| | - Cathy Bebey Engome
- Faculty of Medicine and Pharmaceutical Sciences, The University of Douala, P.O Box: 8037, Douala, Cameroon
| | - Yacouba Njankouo Mapoure
- Faculty of Medicine and Pharmaceutical Sciences, The University of Douala, P.O Box: 8037, Douala, Cameroon
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Aderinto N, Olatunji D, Idowu O. Autism in Africa: prevalence, diagnosis, treatment and the impact of social and cultural factors on families and caregivers: a review. Ann Med Surg (Lond) 2023; 85:4410-4416. [PMID: 37663716 PMCID: PMC10473371 DOI: 10.1097/ms9.0000000000001107] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 07/15/2023] [Indexed: 09/05/2023] Open
Abstract
This paper presents a narrative review of current knowledge on autism in Africa, including prevalence, diagnosis, treatment and the impact of social and cultural factors on families and caregivers. The prevalence of autism in Africa is estimated to be similar to that in other regions. However, diagnosis and treatment access remain limited due to various challenges, such as a shortage of specialised healthcare professionals and resources, a lack of awareness and understanding of autism spectrum disorder (ASD) among healthcare providers, and cultural stigma surrounding mental health and developmental disorders. Alternative therapies are commonly used with other therapies, but their effectiveness is often unproven. The impact of ASD on families and caregivers in Africa is significant, with many facing challenges in accessing support services and coping with stigma. Efforts are being made to increase awareness and reduce the stigma around ASD in African communities, but more research is needed on effective interventions and culturally appropriate treatments. Policy recommendations include increasing resources and training for healthcare professionals, improving access to evidence-based interventions and promoting community awareness and support. With improved understanding and investment, the quality of life of individuals with ASD in Africa can be significantly improved.
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Affiliation(s)
- Nicholas Aderinto
- Department of Medicine and Surgery, Ladoke Akintola University of Technology, Ogbomoso, Cameroon
| | - Deji Olatunji
- Department of Medicine and Surgery, University of Ilorin, Ilorin, Nigeria
| | - Oluwatobi Idowu
- Department of Psychiatry, Chesire and Wirral Partnership NHS Foundation Trust, Chester, UK
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Screening for Intellectual Disabilities and/or Autism Amongst Older Children and Young Adults: a Systematic Review of Tools for Use in Africa. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2022. [DOI: 10.1007/s40489-022-00342-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Abstract
There are many well-developed screening tools for both intellectual disabilities and autism, but they may not be culturally appropriate for use within Africa. Our specific aims were to complete a systematic review to (1) describe and critically appraise short screening tools for the detection of intellectual disabilities and autism for older children and young adults, (2) consider the psychometric properties of these tools, and (3) judge the cultural appropriateness of these tools for use within Africa. Six screening tools for intellectual disabilities and twelve for autism were identified and appraised using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines. We identified two screening tools which appeared appropriate for validation for use within African nations.
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Bakare MO, Frazier TW, Karpur A, Abubakar A, Nyongesa MK, Mwangi PM, Dixon P, Khaliq I, Gase NK, Sandstrom J, Okidegbe N, Rosanoff M, Munir KM, Shih A. Brief report: Validity and reliability of the Nigerian Autism Screening Questionnaire. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:1581-1590. [PMID: 35261274 PMCID: PMC7613535 DOI: 10.1177/13623613221080250] [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] [Indexed: 11/16/2022]
Abstract
Informant-report measures for screening symptoms of autism spectrum disorder (ASD) and other neurodevelopmental disorders (NDDs) are needed for low-resource settings if early identification is to be prioritized because early developmental concerns are likely to be expressed by parents and other caregivers. This paper describes the initial psychometric evaluation of the Nigeria Autism Screening Questionnaire (NASQ). Parents and other caregivers completed the NASQ on 12,311 children ages 1 to 18 in a Nigerian population sample as part of the World Bank National General Household Survey conducted in the country in 2016. Factor analyses indicated a parsimonious three-factor structure with social communication/interaction, repetitive sensory motor, and insistence on sameness dimensions. Measurement invariance was excellent across age and sex. Reliability of the subscales and total scale was good, and item response theory analyses indicated good measurement precision in the range from below average to high scores, crucial for screening, and tracking ASD symptoms. Studies with gold standard ASD diagnostic instruments and clinical confirmation are needed to evaluate screening and diagnostic accuracy. The NASQ appears to be a reliable instrument with a clear factor structure and potential for use in screening and tracking ASD symptoms in future Nigerian samples.
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Affiliation(s)
- Muideen O Bakare
- Federal Neuro Psychiatric Hospital, Nigeria.,Childhood Neuropsychiatric Disorders Initiatives (CNDI), Nigeria.,Ike Foundation for Autism (IFA), Nigeria.,World Psychiatric Association (WPA), Switzerland
| | | | | | - Amina Abubakar
- Aga Khan University, Kenya.,KEMRI-Wellcome Trust Research Programme, Kenya
| | | | | | | | | | | | | | | | | | - Kerim M Munir
- World Psychiatric Association (WPA), Switzerland.,Harvard Medical School, USA
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Adeniyi YC, Adeniyi AF. Development of a community-based, one-stop service centre for children with developmental disorders: changing the narrative of developmental disorders in sub-Saharan Africa. Pan Afr Med J 2020; 36:164. [PMID: 32952808 PMCID: PMC7467891 DOI: 10.11604/pamj.2020.36.164.23402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 05/28/2020] [Indexed: 11/11/2022] Open
Abstract
Sub-Saharan Africa is home to about 15 million children with varying developmental disorders. Services for children with developmental disorders are scarce in Africa. The few available services are limited to the capital cities and are in the private sector, with the cost beyond the reach of most families. In 2016, the Centre for Early Development, Learning and Care was established in Ibadan, South-west, Nigeria. The centre provide services for children with developmental disorders is a one-stop, multidisciplinary team approach. Children are assessed on both structured and unstructured interviews. A total of 584 children were assessed between December 2016 and December 2019. One third (32.4%) of the children assessed within this period met diagnostic criteria for ASD, 29.1% had intellectual disability and 27.6% had cerebral palsy. The remaining clients (10.9%) had other disorders including ADHD, Down's syndrome, hearing impairment and visual impairment. Parents tend to downplay the severity of their children's disability. There are many challenges that are associated with the establishment of a service centre in a low resource setting. These and other experiences are discussed.
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Affiliation(s)
- Yetunde Celia Adeniyi
- Department of psychiatry, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria
- Centre for Early, Development, Learning and Care, Ibadan, Nigeria
| | - Ade Fatai Adeniyi
- Centre for Early, Development, Learning and Care, Ibadan, Nigeria
- Department of Physiotherapy, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria
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Bakare MO, Taiwo OG, Bello-Mojeed MA, Munir KM. Autism Spectrum Disorders in Nigeria: A Scoping Review of Literature and Opinion on Future Research and Social Policy Directions. J Health Care Poor Underserved 2019; 30:899-909. [PMID: 31422978 PMCID: PMC6815667 DOI: 10.1353/hpu.2019.0063] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Research about autism spectrum disorder (ASD) in sub-Saharan Africa is sparse and limited. However, research studies coming from Nigeria in West Africa as a country have contributed significantly to the subject of ASD in sub-Saharan Africa. METHODS AND RESULTS This study is a scoping review of research literature on ASD in Nigeria through June 2017 conducted by searching the key terms autism and Nigeria on PubMed and Google Scholar. Included in the review are works concerning case reports and co-morbidities associated with ASD in Nigeria; prevalence of ASD; genetic study of ASD; clinical characteristics of children with ASD; knowledge and awareness about ASD; socio-cultural factors affecting ASD. Expert opinion on social policy and public health issues affecting ASD in Nigeria are discussed. CONCLUSION Wide research and intervention gaps are noted and we suggest directions for future research, social policy development, and intervention services for individuals with ASD in Nigeria.
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