Etiology of developmental disabilities in Soweto, South Africa.

A retrospective review was undertaken of the records of 725 children who attended the neurodevelopmental clinic at the Baragwanath Hospital in Soweto, South Africa. Most children presented at an early age (less than 2-6 years). The etiological factors were prenatal, 4 per cent; perinatal, 41 per cent; postnatal, 21 per cent. Seventy-one per cent of the perinatal factors were a result of birth related problems in full-term infants; only 22 per cent of this group were represented by premature and low birthweight infants, contrasting sharply with data from industrialized centers. Almost a third of the postnatal causes were a result of acute intracranial infections. Another 13 per cent were a result of the metabolic consequences of acute gastroenteritis. Thus a high proportion of problems were preventable through provision of adequate nutrition, mass immunization campaigns, and adequate primary health care services including antenatal and obstetric management.