Autism Spectrum Disorder In Africa Research Articles

Genetic etiology of autism spectrum disorder in the African population: a scoping review.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder (NDD) characterized by significant impairments in social, communicative, and behavioral abilities. However, only a limited number of studies address the genetic basis of ASD in the African population. This study aims to document the genes associated with ASD in Africa and the techniques used to identify them. Additionally, genes identified elsewhere but not yet in Africa are also noted. Online databases such as Wiley Online Library, PubMed, and Africa Journal Online were used. The review was conducted using the keyword related to genetic and genomic ASD study in the African population. In this scoping review, 40 genetic studies on ASD in Africa were reviewed. The Egyptian and South African populations were the most studied, with 25 and 5 studies, respectively. Countries with fewer studies included Tunisia (4), East African countries (3), Libya (1), Nigeria (1), and Morocco (1). Some 61 genes responsible for ASD were identified in the African population: 26 were identified using a polymerase chain reaction (PCR)-based method, 22 were identified using sequencing technologies, and 12 genes and one de novo chromosomal aberration were identified through other techniques. No African study identified any ASD gene with genome-wide association studies (GWAS). Notably, at least 20 ASD risk genes reported in non-African countries were yet to be confirmed in Africa's population. There are insufficient genetic studies on ASD in the African population, with sample size being a major limitation in most genetic association studies, leading to inconclusive results. Thus, there is a need to conduct more studies with large sample sizes to identify other genes associated with ASD in Africa's population using high-throughput sequencing technology.

Exploring the autism “diagnostic odyssey” in the Greater Accra region of Ghana

Introduction: Despite the increasing global prevalence of autism spectrum disorders (ASD), there is limited information about ASD in Africa. Existing research on ASD in Africa shows that autistic children are diagnosed relatively late or not at all. The purpose of this study was to understand the barriers to an autism diagnosis and to engage key stakeholders to action plan steps to reduce the barriers. Methods: We conducted a participatory, mixed methods study using semi-structured interviews, a survey, photo elicitation, and focus groups with 11 participants (four parents and seven health professionals) in the Greater Accra region of Ghana. Findings: Neuro-paediatricians in our study reported that it takes, on average, two to six visits over two weeks to two years or more to diagnose a child. Our thematic qualitative analysis yielded three overarching themes, with barriers and facilitators for each: 1) Systemic, 2) Community, and 3) Parent/Family factors that influence the diagnostic process. The action plan of our stakeholder focus group prioritizes community education to dispel myths and encourage autism acceptance within the Ghanaian community. Conclusion: Knowledge about the diagnostic odyssey can help facilitate early diagnosis and intervention. Implications for practice This research study confirmed known challenges to the autism diagnostic process. It contributed nuanced insights into the role of culture, the importance of education, and the need for community involvement in improving the diagnostic process, early occupational therapy intervention, and autism acceptance within the community.

Autism in Africa: prevalence, diagnosis, treatment and the impact of social and cultural factors on families and caregivers: a review.

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.

Mapping Research Evidence on Children Living with Autism Spectrum Disorders in Africa: A Scoping Review Protocol

Mapping Research Evidence on Children Living with Autism Spectrum Disorders in Africa: A Scoping Review Protocol

Autism Spectrum Disorders: Knowledge and Attitudes of Primary Care Givers

Autism Spectrum Disorders (ASDs) are debilitating lifelong neurodevelopmental disorders which have no cure but can be managed if timeously identified and effectively managed. Internationally prevalence is increasing and little is known about ASDs in Africa, although it is suspected the trends are following the international pattern of high prevalence. Various factors that affect the effective management of ASDs have been identified in previous research. These include low knowledge and negative attitudes towards the disorders in primary caregivers. Given that previous research places primary caregivers as key players in the successful management of ASDs and that there is a dearth of research on ASDs in Africa, this current research aimed to establish levels of knowledge of ASDs in primary caregivers in Zimbabwe as well as their attitudes towards ASDs and its treatments using a descriptive ex facto quantitative research design. A general lack of knowledge on ASDs and the legal provisions available for the protection of rights for individuals with ASDs was found in the sample as well as the presence of mixed attitudes towards ASDs and its treatments. Negative attitudes towards mainstream treatment of ASDs as well as negative attitudes towards diagnosis of the disorder itself were more prevalent than positive attitudes. It was recommended that there is need for more awareness campaigns and research on ASDs and a multi-sectoral approach to the management of ASDs.

To raise a child with autism spectrum disorder: A qualitative, comparative study of parental experiences in the United States and Senegal.

Raising a child with Autism Spectrum Disorder (ASD) can often be a difficult and stressful process for families and caregivers. Though research on ASDs in Africa is burgeoning, very little is known about autism in francophone West Africa. Furthermore, no known ASD studies have explored parental experiences in particular from a cross-cultural perspective. This research used Interpretative Phenomenological Analysis to analyze in-depth, semi-structured interviews with seven Senegalese and seven American families to investigate parental experiences within the Senegalese community with further illustration by cross-cultural comparison. Comparative analysis of data across the two countries was undertaken to identify cultural variables previously unreported, especially those that may affect Senegalese family experience. Analysis of interviews revealed thematic differences in social and community support. Although access to effective treatment services was low among Senegalese families compared to the American families, traditional Senegalese household structures and community relations were hypothesized to serve as protective factors against the high social isolation and resulting logistical struggles reported in the U.S. sample. Further targeted research within the Senegalese environment is recommended, particularly to explore social stigma and its possible effects on families with autism, causal beliefs and treatment practices, and parental mental health and wellbeing.

Strategies for Autism Diagnosis and Care in Resource Deprived Settings in Africa: An Overview

Background and Goals: Autism Spectrum Disorders (ASDs) exist in Africa as they do everywhere in the world. Historically they have been under recognized and under studied. The aim of this paper is to review the existing challenges of ASD care and diagnosis in Africa, with a view to describing workable unique strategies deployable within the continent. Methods: We present an overview of the existing medical literature and summarize key findings in relation to the topic of ASD in Africa. First, as a preliminary step, we highlight key findings from previous epidemiological surveys. Second, we undertook a review of relevant available evidence from the various African regions. When the authors were familiar with additional local or regional scientific works, these were also used and referenced. Discussion: There has been a growing awareness of the extent to which ASDs exist and have an impact on affected individuals and their families. There are many barriers to diagnosis and effective interventions. These include lack of trained personnel, stigma and cultural beliefs regarding etiology, disparities in resources between urban and rural areas, and poverty. Nonetheless, partnerships to support research and the development of culturally appropriate interventions can be developed and strengths exist in the communities that can be harnessed to improve care.

Early diagnosis and intervention for autism spectrum disorder in Africa: insights from a case study.

Globally the prevalence of autism spectrum disorder (ASD) has become more apparent. Prevalence on the African continent remains unknown. There is a call for further research into ASD in Africa as well as means to make early diagnosis and intervention possible. The study aimed to raise awareness about ASD in Africa and encourage dialogue on possible intervention strategies for ASD in low resource settings. This was a qualitative mixed method case study. Literature regarding ASD in Africa was reviewed in order to provide context for the research and facilitate data reduction of the case study of Temple Grandin. The case study was conducted through a psychobiographical approach using Erikson's (1950/1973) theory of psychosocial development to interpret the life of Temple Grandin. The findings underwent further data reduction in order to focus on possible interventions for ASD. Four primary interventions were found to be useful in facilitating development in an individual with ASD. Namely; speech therapy, creative endeavours, animals (human-animal interaction), and being mentored. Undiagnosed and untreated cases of ASD place undue psychosocial and economic burden on families and communities. Government support, by including ASD in health policies, is essential. Through creative adaptation of knowledge, communities may provide a valuable resource to ASD intervention strategies.

Assessing an isiZulu questionnaire with educators in primary schools in Pietermaritzburg to establish a baseline of knowledge of Autism Spectrum Disorder.

BackgroundAutism Spectrum Disorder (ASD) is a significant childhood disorder and has a growing prevalence rate across the world. It has been identified in children from a wide range of racial groups, ethnicities and socio-economic groups, making it a globally relevant disorder. However, a lack of research on ASD in Africa makes it difficult to determine the prevalence rate, presentation and level of knowledge regarding the disorder locally. Therefore, assessing knowledge of ASD amongst professionals is a useful starting point for research in countries where research on ASD is limited. Educators in particular are a vital resource due to the likelihood of their early identification of developmental delays in children of school going age. Awareness studies reveal that professionals have poor awareness of ASD and therefore what educators in South Africa know about ASD needs to be established.MethodsThis study translated the Knowledge about Childhood Autism among Health Workers (KCAHW) questionnaire that was originally designed by Bakare and colleagues (Clinical Practice and Epidemiology in Mental Health 4:17, 2008). The isiZulu KCAHW questionnaire was then used to investigate the level of knowledge of ASD amongst educators in Edendale, Pietermaritzburg, South Africa. Fifty (50) educators consented to complete the questionnaire and the data was analysed using the statistical programme SPSS.ResultsThe results suggested that educators have an adequate baseline knowledge of ASD but their knowledge was found to be lacking in specific detail. The mean total score for the educator sample was 13.08 (out of a possible 19) which suggested that educators in Edendale, Pietermaritzburg knew 68% of the symptoms covered in the questionnaire.ConclusionsThe isiZulu KCAHW questionnaire appears to be a useful measure for use in the South African context. It provided significant information regarding educator knowledge of ASD in Edendale, Pietermaritzburg. However, the analysis also showed that whilst the educators had an adequate general knowledge of ASD, they lacked specific insight into the disorder, particularly with regards to etiology and age of onset. Furthermore, the results showed that there is an opportunity for further research and interventions to develop knowledge of ASD within the local context in South Africa.Electronic supplementary materialThe online version of this article (doi:10.1186/s12887-016-0721-8) contains supplementary material, which is available to authorized users.

Thinking globally to meet local needs: autism spectrum disorders in Africa and other low-resource environments.

Most people with autism spectrum disorders (ASDs) live in low and middle-income countries, yet almost everything we know about ASD comes from high-income countries. Here we review recent research from Africa, with some references to research in other low-resource environments. We examine publications on screening and diagnosis, intervention, clinical presentation of ASD, cultural perspectives, and neuroscience and technology. Open-access screening and diagnostic tools represent a positive, but nontrivial, future goal. Recent efforts at 'low intensity' community-based interventions are encouraging, but many significant scalability challenges remain. Proposals that ASD in Africa is more severe and overrepresented in high socioeconomic families are likely to be attributable to ascertainment biases and the absence of standardized phenotyping tools. Cultural perspectives and innovative use of technology and neuroscience have the potential to generate novel strategies of global relevance, but research priorities have to be determined by local needs. To have a real impact on clinical services, training, and research in local communities, clinician-scientists should start by thinking globally. ASD research in Africa and other low-resource environments remains limited and of questionable quality and highlights the need to build high-quality research capacity in these low-resource environments.

Autism Spectrum Disorders in Africa: Current Challenges in Identification, Assessment, and Treatment: A Report on the International Child Neurology Association Meeting on ASD in Africa, Ghana, April 3-5, 2014.

Prevalence of autism spectrum disorders has increased over recent years, however, little is known about the identification and management of autism spectrum disorder in Africa. This report summarizes a workshop on autism spectrum disorder in Africa under the auspices of the International Child Neurology Association and the African Child Neurology Association through guided presentations and working group reports, focusing on identification, diagnosis, management, and community support. A total of 47 delegates participated from 14 African countries. Although there was a huge variability in services across the countries represented, numbers of specialists assessing and managing autism spectrum disorder was small relative to populations served. Strategies were proposed to improve identification, diagnosis, management and support delivery for individuals with autism spectrum disorder across Africa in these culturally diverse, low-resource settings. Emphasis on raising public awareness through community engagement and improving access to information and training in autism spectrum disorder. Special considerations for the cultural, linguistic, and socioeconomic factors within Africa are discussed.

A Systematic Review of Research on Autism Spectrum Disorders in Sub-Saharan Africa.

The burden of autism spectrum disorders (ASDs) in sub-Saharan Africa (SSA) is not well known. We carried out a systematic review of the literature to identify published work from SSA. We have systematically searched four databases, namely, Medline, PsycINFO, CINAHL, and Child Development & Adolescent Studies, through EBSCO and identified studies from across SSA. Based on predefined inclusion criteria, 47 studies were included in this review. Most of the identified studies (74%) were conducted in only 2 African countries, that is, South Africa and Nigeria. Additionally, most of these studies (83%) were carried out in the last decade. These studies had four major themes: development of measurement tools of ASD in Africa, examining the prevalence of ASD, identifying risk factors and risk markers, and examining psychosocial issues. We identified only a single population level study aimed at documenting the prevalence of ASD and could not identify a single case-control study aimed at examining a comprehensive set of potential risk factors. All intervention studies were based on very small sample sizes. Put together, our findings suggest that current evidence base is too scanty to provide the required information to plan adequately for effective intervention strategies for children with ASD in Africa.

Excess of non-verbal cases of autism spectrum disorders (ASDs) presenting to orthodox clinical practice in Africa - a trend possibly resulting from late diagnosis and intervention

<p><strong>Objectives.</strong> Characteristics of children with autism spectrum disorders (ASDs) in Africa are not known because of unavailability of large-scale epidemiological studies in this region. This review explored the age at first presentation to orthodox clinical practice of African children with ASDs and their expressive language ability at presentation.</p><p><strong>Methods.</strong> A literature search of case series and case reports of ASDs from Africa was done through PubMed/MEDLINE, Google Scholar, African Journals Online (AJOL), and archives of the Nigerian Journal of Psychiatry. Six articles included content relating to age of the child at first presentation to orthodox clinical practice and symptoms at presentation related to expressive language ability and therefore fulfilled the inclusion criteria. Suggestions are made to explain the observations emanating from the review.<strong> </strong></p><p><strong>Results.</strong> An excess of non-verbal over verbal cases of ASDs have been presenting to orthodox clinical practice and there is a common denominator of late presentation/diagnosis and in turn late intervention, with most cases presenting for the first time well above 8 years of age. Attempts to explain these observations included low levels of knowledge and awareness about ASDs in Africa; problems with help-seeking behaviour; and lack of mental healthcare facilities and trained personnel.</p><p><strong>Conclusions.</strong> Enhancement of processes directed at ensuring early diagnosis and interventions, especially interventions aimed at improving speech and language development well and sufficiently early, may bring about a shift in the trend of excess non-verbal cases of ASDs over verbal cases presenting to orthodox clinical practice.</p>

Autism spectrum disorders (ASD) in Africa: a perspective

The universal occurrence of autism spectrum disorders (ASD) was queried about twenty-six years ago. It was thought to occur only in western industrialized countries with high technological development. Over the last decade, knowledge about ASD and its prevalence has been documented as being on the rise in different regions of the world, with most literature coming from the western world -- the situation in Africa on aspects of ASD remain unclear. Literature cited in Pubmed over the last decade on aspects of epidemiology, diagnosis, aetiology and knowledge of ASD in the African context were assessed. autism, diagnosis, aetiology, knowledge and Africa were variously combined in the literature search. No study specifically addressed the epidemiology of ASD in Africa. One of the two studies that were relevant addressed epidemiology of ASD in Arab countries, though included two Northern African countries. A higher proportion of non-verbal cases of ASD compared to verbal cases was documented in literature coming from Africa. Associated co-morbid disorders included intellectual disability, epilepsy and oculo-cutaneous albinism. Aetiological factors postulated included post-encephalitic infection, genetic and auto-immune factors, and vitamin D deficiency. Knowledge about ASD in Africa was noted to be low. There is a need for epidemiological studies in Africa to define the magnitude of the problem of ASD and the characteristics of children affected by ASD in this region. This would help in planning and might be helpful in answering the question of aetiology of ASD. Policy making needs to be directed at issues of childhood developmental disorders in Africa.