Pauline Samia1, Maureen Kanana1, Julie King2, Kirsten A Donald3, Charles R Newton4, Christy Denckla5. 1. Department of Paediatrics and Child Health, Aga Khan University, Nairobi, Kenya. 2. School of Public Health, Department of Epidemiology and Biostatistics, Boston University School of Public Health, Boston, MA, USA. 3. Division of Developmental Paediatrics, Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa. 4. KEMRI-Wellcome Trust Collaborative Programme, Kilifi, Kenya. 5. School of Public Health, Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
Abstract
INTRODUCTION: Autism spectrum disorder (ASD) is characterized by impairments in behavior, social communication, and interaction. There is little data on ASD from sub-Saharan Africa (SSA) describing clinical characteristics in large cohorts of patients. Preliminary studies report a high male sex ratio, excess of nonverbal cases, possible infectious etiologies, and comorbidities e.g. epilepsy. OBJECTIVE: To describe the clinical characteristics of children diagnosed with ASD in an African context. METHODS: A retrospective medical chart review identified 116 children diagnosed with ASD according to DSM-5 criteria at a pediatric neurology clinic in Nairobi, Kenya. RESULTS: The male to female ratio was 4.3:1. The median age at presentation was 3 years with speech delay as the most common reason for presentation. Expressive language delay was observed in 90% of the population. Sixty percent who obtained imaging had normal MRI brain findings. Only 44% and 34% of children had access to speech therapy and occupational therapy respectively. Epilepsy and ADHD were the most prevalent comorbidities. CONCLUSION: An early median age at presentation and preponderance of male gender is observed. Access to speech therapy and other interventions was low. A prospective study would help determine outcomes for similar children following appropriate interventions.
INTRODUCTION: Autism spectrum disorder (ASD) is characterized by impairments in behavior, social communication, and interaction. There is little data on ASD from sub-Saharan Africa (SSA) describing clinical characteristics in large cohorts of patients. Preliminary studies report a high male sex ratio, excess of nonverbal cases, possible infectious etiologies, and comorbidities e.g. epilepsy. OBJECTIVE: To describe the clinical characteristics of children diagnosed with ASD in an African context. METHODS: A retrospective medical chart review identified 116 children diagnosed with ASD according to DSM-5 criteria at a pediatric neurology clinic in Nairobi, Kenya. RESULTS: The male to female ratio was 4.3:1. The median age at presentation was 3 years with speech delay as the most common reason for presentation. Expressive language delay was observed in 90% of the population. Sixty percent who obtained imaging had normal MRI brain findings. Only 44% and 34% of children had access to speech therapy and occupational therapy respectively. Epilepsy and ADHD were the most prevalent comorbidities. CONCLUSION: An early median age at presentation and preponderance of male gender is observed. Access to speech therapy and other interventions was low. A prospective study would help determine outcomes for similar children following appropriate interventions.
Entities:
Keywords:
Autism; birth history; comorbidities; intellectual disability; language delay; sub-Saharan Africa
Authors: Julie A Carter; Janet A Lees; Joseph K Gona; Gladys Murira; Kenneth Rimba; Brian G R Neville; Charles R J C Newton Journal: Dev Med Child Neurol Date: 2006-01 Impact factor: 5.449