Autism Spectrum Disorders in Calabar, Nigeria

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

Keywords: Autism, neurodevelopmental disorder, late diagnosis. References

1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington, DC: American Psychiatric Association, 2013:50-9.
2. Chakrabarti, S, Fombonne E. Pervasive developmental disorders in preschool children confirmation of high prevalence. Am J Psychiatry. 2005; 162: 1133–1141
3. World Health Organization. Autism spectrum disorders & other developmental disorders: From raising awareness to building capacity. Geneva, Switzerland 2013.
4. Christensen DL, Baio J, Van Naarden Braun J. et al. Prevalence and characteristics of autism spectrum disorder among children aged eight years—Autism and Developmental Disabilities Monitoring Network, 11 sites, United States, 2012. MMWR Surveill Summ, 2016; 65(No. SS-3), 1–23.
5. Blumberg, SJ, Bramlett, MD, Kogan M.D, Scieve LA, Jones JR et al. Changes in Prevalence of Parent-Reported Autism Spectrum Disorders in School Aged U.S. Children: 2007 to 2010-2011. CDC: Nat Health Statistics Report. 2013; 65: 1-12
6. Durkin MS, Wolfe BL. Trends in autism prevalence in the US: A lagging economic indicator? J Autism Dev Disord. 2020;50 (3):1095–6.
7. Nevison CD, Blaxill M. Diagnostic substitution for intellectual disability: a flawed explanation for the rise in autism. J Autism Dev Disord. 2017;47(9):2733–42
8. Salari N, Rasoulpoor S, Rasoulpoor S, Shohaimi S, Jafarpour S, Abdoli N, Khaledi‑Paveh N and Mohammadi M. The global prevalence of autism spectrum disorder: a comprehensive systematic review and meta‑analysis. Italian Journal of Pediatrics. 2022 48:112
9. Bakare MO, Onu JU, Bello-Majeed MA, Okidegbe N, Onu NN, Munir K,M. Picture of Autism Spectrum Disorder (ASD) Research in West Africa – A Scoping review. Resarch in Autism Spectrum Disorders. 2022: 90;
10. Bakare MO, Agomoh AO, Ebigbo PO, Eaton J, Okonkwo KO, Onwukwe JU, Onyeama GM. Etiological explanation, treatability and preventability of childhood autism: A survey of Nigerian healthcare workers’ opinion. Annals of General Psychiatry 2009; 8:6.
11. Ahmad MM, Ahmed H, Baba J, Legbo JF, Nauzo AM, Omar M, Tahir AA. Autism Spectrum Disorder in North-Western Nigeria International Neuropsychiatric Disease Journal. 2018; 12(2): 1-5,
12. Essien PU, Akpan MU, Ekanem EE, Autism Spectrum Disorders Among Pre-primary and Primary School Pupils in Uyo, Nigeria American Journal of Psychiatry and Neuroscience. 2017; 5(6): 60-65
13. Al-Mamri W, Idris AB, Dakak S, Al-Shekaili M, Al-Harthi Z, Alnaamani AM, et al. Revisiting the prevalence of autism spectrum disorder among Omani children: a multicentre study. Sultan Qaboos Univ Med J. 2019;19(4):e305
14. Becerra TA, Von Ehrenstein OS, Heck JE, Olsen J, Arah O, Jeste SS et al Autism Spectrum disorders and race, ethnicity, and Nativity: a population based study.paediatrics 2014; 134:e63-e71
15. Lagunju IA, Bella-Awusah TT, Omigbodun OO.“Autistic disorder in Nigeria: profile and challenges to management,” Epilepsy & Behavior. 2014;39:126–129
16. Izuwah DN, Alikor EAD. Autism In Port Harcourt: Social Impairment At Presentation. Nig J Paediatr 2011; 38(1): 32.
17. Bakare, MO, Munir KM. Autism spectrum disorders (ASD) in Africa: a perspective. Afr J Psychiatry. 2011; 14: 208-10.
18. Autism Spectrum Disorder Among Children And Youth In Canada. A Report Of The National Autism Spectrum Disorder Surveillance System. 2018
19. Hyman SL, Levy SE, Myers SM. Identification, evaluation, and management of children with autism spectrum disorder. Pediatrics. 2020;145(1):e20193447. https://doi.org/10.1542/peds.2019-3447
20. Daniels AM, Mandell DS. Explaining differences in age at autism spectrum disorder diagnosis: a critical review. Autism. 2014;18:583–597
21. Juliana Höfer, Falk Hofmann , Inge Kamp Becker , Luise Poustka , Veit Roessner , Sanna Stroth , Nicole Wolf and Christian J. Bachmann. Pathways to a diagnosis of autism spectrum disorder in Germany: a survey of parents. Child Adolesc Psychiatry Ment Health 2019; 13:16
22. Brett D, Warnell F, McConachie H, Parr JR. Factors afecting age at ASD diagnosis in UK: no evidence that diagnosis age has decreased between 2004 and 2014. J Autism Dev Disord. 2016; 46(6):1974–84.
23. Crane L, Chester JW, Goddard L, Henry LA, Hill E. Experiences of autism diagnosis: A survey of over 1000 parents in the United Kingdom. Autism. 2016; 20(2): 153– 162.
24. Clark MLE, Vinen Z, Barbaro J, Dissanayake C. School age outcomes of children diagnosed early and later with autism spectrum disorder. Journal of Autism and Developmental Disorders. 2018; 48(1): 92–102.
25. Dawson G, Burner K. Behavioral interventions in children and adolescents with autism spectrum disorder. Current Opinion in Pediatrics.2011; 23(6): 616–620.
26. Hordlicka M, Vacova M, Oslejskova H, Gondzova V, Vadlejchova I, Kocourkova J, Koutek J, Dudova I. Age at diagnosis of autism spectrum disorders: is there an association with socioeconomic status and family self-education about autism Neuropsychiatric Disease and Treatment 2016;12: 1639–1644
27. Ekanem EE, Akpan MU, Essien PU. Intelligence Quotient of primary school pupils with autism spectrum disorders in Uyo, Nigeria. American Journal of Psychiatry and Neuroscience. 2017;5(6): 83
28. Oshodi YO, Olagunju AT,Oyelohunnu MA, Campbell EA, Umeh CS, Aina OF, Oyibo W, Lesi F, Adeyemi JD. Autism spectrum disorder in a community-based sample with neurodevelopmental problems in Lagos, Nigeria Journal of Public Health in Africa 2016; 7:559
29. Rommelse NNJ, Franke B, Geurts HM, Hartman CA, Buitelaar JK. Shared heritability of attention-deficit/hyperactivity disorder and autism spectrum disorder. Eur Child Adolesc Psychiatry. 2010;19:281-95
30. El Sawy MA, Awadalla HI, Mohamed RR, Zaki OK, Mohamed OA Study of some environmental and genetic determinants of autism in Egyptian children. International Journal of Psychology and Counselling. 2011; 3(8); 130-136,
31. Buysse V, Bailey DB. Behavioral and developmental outcomes in young children with disabilities in integrated and segregated settings: A Review of comparative studies. The Journal of Special Education. 1993;26(4): 434-461.

Comments (0)

No login
gif