Prevalence of autism in mainland China, Hong Kong and Taiwan: a systematic review and meta-analysis.
Prevalence of autism in mainland China, Hong Kong and Taiwan: a systematic review and meta-analysis.
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DOI：
10.1186/2040-2392-4-7
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发表时间：
2013-04-09
期刊：
影响因子：
6.2
通讯作者：
Brayne C
中科院分区：
文献类型：
--
作者：
Sun X;Allison C;Matthews FE;Sharp SJ;Auyeung B;Baron-Cohen S;Brayne C
本研究综合了与这些地区ASC患病率相关的证据，并评估了研究方法对患病率估计的影响。系统检索PubMed、Web of Knowledge、China Web of Knowledge和weiipu数据库，以及1987 - 2011年发表的相关论文，报道了中国大陆、香港和台湾地区ASC或儿童自闭症的患病率估算。用随机效应模型计算患病率的总估计值。使用元回归模型评估研究方法对患病率估计的影响。共纳入25项研究，其中18项适合纳入meta分析。在中国大陆，儿童自闭症的总患病率为11.8 / 10,000（95%可信区间（CI）： 8.2, 15.3）。三个地区的ASC总患病率为26.6 / 10,000 （95% CI: 18.5, 34.6）。研究之间发现了大量的异质性（I2 bb0 75%）。儿童自闭症的患病率估计与筛查工具的选择密切相关。调整年龄组后，使用自闭症行为检查表（ABC）作为筛查工具与使用克兰西自闭症行为量表（CABS）相比，患病率估计的比值比为0.29 (95% CI: 0.12, 0.69)，使用幼儿自闭症检查表（CHAT）与CABS相比，患病率估计的比值比为1.79 （95% CI: 0.70, 4.55； P= 0.20）。在中国大陆、香港和台湾调查ASC患病率的现有研究主要集中在儿童自闭症而不是整个谱系。流行率估计低于发达国家的估计。使用最新开发的筛查工具的研究报告的患病率高于旧的研究。然而，现有的研究在方法上存在弱点，因此这些结果与发达国家的结果缺乏可比性。我们的研究结果表明，中国大陆、香港和台湾地区的ASC存在潜在的诊断和检测不足，需要采用更先进的方法来研究这些地区的ASC。
The prevalence of autism spectrum conditions (ASC) is 1% in developed countries, but little data are available from mainland China, Hong Kong and Taiwan. This study synthesizes evidence relating to the prevalence of ASC in these areas and assesses the effects of research methodology on prevalence estimates. Systematic literature searches were conducted in PubMed, Web of Knowledge, China Web of Knowledge and Weipu databases, as well as relevant papers published from 1987 to 2011, reporting prevalence estimates of ASC or childhood autism in mainland China, Hong Kong and Taiwan. Summary estimates of prevalence were calculated with a random effects model. The effects of research methodology on the prevalence estimates were assessed using a meta-regression model. There were 25 studies eligible for review, 18 of which were suitable for inclusion in a meta-analysis. Pooled prevalence of childhood autism was 11.8 per 10,000 individuals (95% confidence interval (CI): 8.2, 15.3) in mainland China. Pooled prevalence of ASC was 26.6 per 10,000 (95% CI: 18.5, 34.6) in three areas. Substantial heterogeneity was identified between studies (I2>75%). The prevalence estimate of childhood autism was most strongly associated with the choice of screening instrument. After adjustment for age group, the odds ratio for prevalence estimates when using the Autism Behavior Checklist (ABC) as the screening instrument compared with those using the Clancy Autism Behavior Scale (CABS) was 0.29 (95% CI: 0.12, 0.69), and 1.79 (95% CI: 0.70, 4.55; P= 0.20) when using the Checklist for Autism in Toddlers (CHAT) compared to the CABS. The available studies investigating the prevalence of ASC in China, Hong Kong and Taiwan have focused mainly on childhood autism rather than the whole spectrum. The prevalence estimates are lower than estimates from developed countries. Studies using more recently developed screening instruments reported higher prevalence than older ones. However, available studies have methodological weaknesses and therefore these results lack comparability with those from developed countries. Our findings indicate a potential under-diagnosis and under-detection of ASC in mainland China, Hong Kong and Taiwan, and a need to adopt more advanced methods for research of ASC in these areas.
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