Early detection of neurodevelopmental disorders in African children living in informal settlements in Nairobi.
child psychiatry
epidemiology
health services research
Journal
BMJ paediatrics open
ISSN: 2399-9772
Titre abrégé: BMJ Paediatr Open
Pays: England
ID NLM: 101715309
Informations de publication
Date de publication:
10 2023
10 2023
Historique:
received:
06
06
2023
accepted:
28
09
2023
medline:
30
10
2023
pubmed:
28
10
2023
entrez:
27
10
2023
Statut:
ppublish
Résumé
Children in low-income and middle-income countries (LMICs) are at a substantially increased risk of delayed physical, emotional and sociocognitive outcomes, with consequential neurodevelopmental disorders. Evidence based, cost-effective and culturally appropriate screening tools are recommended for early identification of developmental disorders. The present study aims to assess the feasibility of early screening for neurodevelopmental disorders in children living in informal settlements in Nairobi, Kenya (Korogocho). The selected tools (ie, the CDC checklist and the Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R)), widely used in high-income countries, are applied in two different populations: one from Kenya (LMIC) and one from Italy, to compare the different scores. Of 509 children screened, 8.6% were classified at-risk based on the results of the screening tools. Significant risk factors are history of low birth weight and Apgar score, presence of neurological disorders, malnutrition and/or rickets, younger age of the child and older age of the mother. Caesarean section delivery, first pregnancy and mothers' older age were common risk factors among the Kenyan and the Italian samples. The Italian sample had a significantly greater rate of missed milestones. Our data demonstrate the feasibility of using the CDC and M-CHAT-R tools in informal settlement dwellers. Further studies are needed to explore the opportunity for early diagnosis of developmental disorders in LMICs.
Sections du résumé
BACKGROUND
Children in low-income and middle-income countries (LMICs) are at a substantially increased risk of delayed physical, emotional and sociocognitive outcomes, with consequential neurodevelopmental disorders. Evidence based, cost-effective and culturally appropriate screening tools are recommended for early identification of developmental disorders.
METHODS
The present study aims to assess the feasibility of early screening for neurodevelopmental disorders in children living in informal settlements in Nairobi, Kenya (Korogocho). The selected tools (ie, the CDC checklist and the Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R)), widely used in high-income countries, are applied in two different populations: one from Kenya (LMIC) and one from Italy, to compare the different scores.
RESULTS
Of 509 children screened, 8.6% were classified at-risk based on the results of the screening tools. Significant risk factors are history of low birth weight and Apgar score, presence of neurological disorders, malnutrition and/or rickets, younger age of the child and older age of the mother. Caesarean section delivery, first pregnancy and mothers' older age were common risk factors among the Kenyan and the Italian samples. The Italian sample had a significantly greater rate of missed milestones.
CONCLUSIONS
Our data demonstrate the feasibility of using the CDC and M-CHAT-R tools in informal settlement dwellers. Further studies are needed to explore the opportunity for early diagnosis of developmental disorders in LMICs.
Identifiants
pubmed: 37890890
pii: 10.1136/bmjpo-2023-002117
doi: 10.1136/bmjpo-2023-002117
pmc: PMC10619007
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
Transcult Psychiatry. 2020 Feb;57(1):140-160
pubmed: 31856688
J Dev Behav Pediatr. 2022 Dec 1;43(9):503-510
pubmed: 36443922
Afr J Health Sci. 2020 Mar-Apr;33(2):12-21
pubmed: 33343175
J Autism Dev Disord. 2021 Nov;51(11):3937-3945
pubmed: 33423215
Autism Res. 2012 Jun;5(3):160-79
pubmed: 22495912
Int J Environ Res Public Health. 2020 Sep 25;17(19):
pubmed: 32992729
Child Care Health Dev. 2007 May;33(3):249-56
pubmed: 17439437
Soc Sci Med. 2013 Nov;97:307-15
pubmed: 23294875
Arch Argent Pediatr. 2018 Feb 01;116(1):7-13
pubmed: 29333806
Soc Psychiatry Psychiatr Epidemiol. 2016 Jan;51(1):63-71
pubmed: 26577918
Lancet. 2007 Sep 8;370(9590):878-89
pubmed: 17804062
Acta Psychiatr Scand. 2008 Oct;118(4):305-14
pubmed: 18754833
Indian J Pediatr. 2023 Apr;90(4):377-386
pubmed: 35604589
Lancet Glob Health. 2018 Mar;6(3):e232-e233
pubmed: 29433654
Anesth Analg. 2021 Aug 1;133(2):362-365
pubmed: 34257197
Curr Opin Neurol. 2016 Apr;29(2):130-6
pubmed: 26886354
Autism Res. 2015 Oct;8(5):473-6
pubmed: 26437907
BMC Pediatr. 2020 Feb 19;20(1):80
pubmed: 32075601
J Autism Dev Disord. 2015 Jun;45(6):1797-808
pubmed: 25488122
Autism. 2020 Nov;24(8):2228-2242
pubmed: 32715766
J Trop Pediatr. 2009 Dec;55(6):402-5
pubmed: 19401407
Pediatrics. 2013 Apr;131(4):e1121-7
pubmed: 23530174
Child Psychiatry Hum Dev. 2018 Aug;49(4):659-671
pubmed: 29387998
Lancet. 2013 Aug 3;382(9890):427-451
pubmed: 23746772
J Autism Dev Disord. 2015 Oct;45(10):3244-54
pubmed: 26055985
Lancet. 2011 Oct 22;378(9801):1515-25
pubmed: 22008427
Cell Mol Life Sci. 2019 Apr;76(7):1275-1297
pubmed: 30570672
Lancet. 2007 Jan 20;369(9557):229-42
pubmed: 17240290
J Autism Dev Disord. 2012 Sep;42(9):1967-73
pubmed: 22271196
Soc Sci Med. 2004 Apr;58(7):1323-35
pubmed: 14759679
Behav Neurol. 2016;2016:3501910
pubmed: 27872512
Autism. 2014 May;18(4):447-57
pubmed: 23536263
Gen Psychiatr. 2020 Mar 6;33(2):e100213
pubmed: 32215365
Indian J Pediatr. 2023 Apr;90(4):364-368
pubmed: 36255651
Indian J Public Health. 2022 Apr-Jun;66(2):166-170
pubmed: 35859499
Autism Res. 2019 Feb;12(2):176-199
pubmed: 30707000
Autism Res. 2017 May;10(5):723-749
pubmed: 28266791
Res Dev Disabil. 2019 Feb;85:205-216
pubmed: 30579261
Psychol Med. 2015 Feb;45(3):601-13
pubmed: 25108395
BMC Pediatr. 2019 Apr 12;19(1):108
pubmed: 30979364
Paediatr Perinat Epidemiol. 2014 May;28(3):255-62
pubmed: 24547686
J Autism Dev Disord. 2018 Sep;48(9):3199-3209
pubmed: 29700707
ISRN Neurol. 2012;2012:408694
pubmed: 22811934
Child Psychiatry Hum Dev. 2021 Dec;52(6):1194-1217
pubmed: 33369706
Wellcome Open Res. 2017 Dec 29;2:121
pubmed: 29881784
Child Care Health Dev. 2014 May;40(3):379-88
pubmed: 23461377
Pediatrics. 2017 Apr;139(Suppl 1):S23-S37
pubmed: 28562246
Lancet Psychiatry. 2021 Oct;8(10):919-928
pubmed: 34537102