Adaptation of the " ten questions" to screen for autism and other neurodevelopmental disorders in Uganda
Adaptation of the " ten questions" to screen for autism and other neurodevelopmental disorders in Uganda
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DOI：
10.1177/1362361313475848
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发表时间：
2014-05-01
期刊：
影响因子：
5.2
通讯作者：
Grether, Judith K.
中科院分区：
文献类型：
--
作者：
Kakooza-Mwesige, Angelina;Ssebyala, Keron;Grether, Judith K.
神经发育障碍在发展中国家被认为是相对常见的，但几乎没有数据可用于规划有效的预防和干预战略。特别是缺乏自闭症谱系障碍的数据。为了在乌干达应用，我们开发了一个23个问题的筛选器（23 Q），其中包括十个问题筛选器和自闭症谱系障碍行为的其他问题。然后，我们对1169名2-9岁的儿童进行了家庭筛查，然后对筛查阳性的儿童和筛查阴性的儿童进行了临床评估，以评估筛查的有效性。我们发现，320名儿童（占总数的27%）筛查阳性，68名儿童接受了一种或多种中度至重度神经发育障碍（自闭症谱系障碍;脑瘫;癫痫;认知，言语和语言，听力或视力障碍）的临床诊断，其中包括8名自闭症谱系障碍儿童。在不同的统计假设下评估筛查的患病率和有效性。23 Q的敏感性范围为0.55至0.80，1种神经发育障碍的患病率范围为7.7/100名儿童至12.8/100名儿童，具体取决于使用的假设。自闭症谱系障碍和十个问题项目的筛查阳性相结合，在确定自闭症谱系障碍风险特别高的儿童亚组方面取得了一定的成功。我们建议将自闭症谱系障碍和相关行为障碍纳入低资源环境下的神经发育障碍研究，以获得规划地方和全球公共卫生应对措施的基本数据。
Neurodevelopmental disorders are recognized to be relatively common in developing countries but little data exist for planning effective prevention and intervention strategies. In particular, data on autism spectrum disorders are lacking. For application in Uganda, we developed a 23-question screener (23Q) that includes the Ten Questions screener and additional questions on autism spectrum disorder behaviors. We then conducted household screening of 1169 children, 2-9 years of age, followed by clinical assessment of children who screened positive and a sample of those who screened negative to evaluate the validity of the screener. We found that 320 children (27% of the total) screened positive and 68 children received a clinical diagnosis of one or more moderate to severe neurodevelopmental disorders (autism spectrum disorder; cerebral palsy; epilepsy; cognitive, speech and language, hearing, or vision impairment), including 8 children with autism spectrum disorders. Prevalence and validity of the screener were evaluated under different statistical assumptions. Sensitivity of the 23Q ranged from 0.55 to 0.80 and prevalence for 1 neurodevelopmental disorders from 7.7/100 children to 12.8/100 children depending on which assumptions were used. The combination of screening positive on both autism spectrum disorders and Ten Questions items was modestly successful in identifying a subgroup of children at especially high risk of autism spectrum disorders. We recommend that autism spectrum disorders and related behavioral disorders be included in studies of neurodevelopmental disorders in low-resource settings to obtain essential data for planning local and global public health responses.