Neuro-Developmental Disabilities Screening and Assessment in Uganda

描述（由申请人提供）：本申请是对PAR-06-420的回应，标题为：发展中国家的脑疾病：终生研究（R21）。我们建议在乌干达的一个城市和一个农村社区实施一个试点项目，监测2-9岁儿童的中度至重度神经发育障碍。待调查的残疾将包括自闭症谱系障碍（ASD）、脑性麻痹（CP）、癫痫、智力迟钝（MR）、言语和语言障碍、视力障碍和听力障碍。我们将使用专为发展中国家使用的筛查工具（十个问题或TQ）的扩展版本进行挨家挨户的筛查，并将其调整适用于乌干达。筛查阳性的儿童和筛查阴性的儿童样本将被邀请参加全面的诊断评估，并在必要时获得关于可行干预措施的建议。将对筛选和诊断评估的结果进行统计学比较，以确定筛选工具的有效性。初步研究所得的初步数据将制成表格，以估计患病率和提供儿童的基本人口统计描述。我们将评估未来将NDDs监测扩展到乌干达其他地区的可行性，并确定未来扩展的基础设施要求。为了提高乌干达的临床和研究能力，我们还将对培训需求进行需求评估，并加强和改进乌干达和国际临床医生和流行病学家网络，以分享信息和资源。这些活动将与为该项目召集的技术咨询小组协商进行。公共卫生相关性：神经发育障碍（NDD）通常会导致终身残疾，通常是严重的，并对全球公共卫生构成重大威胁。目前的估计是，90%或更多的受NDD影响的儿童和家庭在发展中国家，但90%以上的资源用于研究，预防工作和服务，用于较富裕的发达国家的儿童和家庭。敦促专业人员和规划人员评估这些疾病造成的负担并采取适当行动（WHO 2006）。这项为乌干达2-9岁儿童建立一个全国性腹泻监测系统的建议是对这一挑战的回应。监测系统将为服务和预防规划、政策指示和宣传提供数据。

DESCRIPTION (provided by applicant): This application is in response to PAR-06-420 entitled: Brain Disorders in the Developing World: Research Across the Lifespan (R21). We propose to implement a pilot project in one urban and one rural community in Uganda for surveillance of moderate to severe neuro- developmental disabilities (NDDs) in 2-9 year old children. The disabilities to be investigated will include autistic spectrum disorders (ASD), cerebral palsy (CP), epilepsy, mental retardation (MR), speech and language disorders, visual impairment, and hearing impairment. We will conduct door-to-door screening using an expanded version of a screening tool designed for use in developing countries (Ten Questions or TQ) and adapted for use in Uganda. Children who screen positive and a sample of those who screen negative will be invited to participate in a comprehensive diagnostic assessment and obtain recommendations on feasible interventions, if indicated. Results of the screening and the diagnostic assessments will be statistically compared to establish the validity of the screening tool. Preliminary data obtained from the pilot study will be tabulated to estimate prevalence and provide basic demographic description of the children. We will evaluate the feasibility of future expansion of NDDs surveillance to other areas of Uganda and determine the infrastructure requirements for future expansion. With the goal of increasing clinical and research capacity in Uganda, we will also conduct a needs assessment of training requirements and strengthen and enhance a network of Ugandan and international clinicians and epidemiologists to share information and resources. These activities will be conducted in consultation with a Technical Advisory Group (TAG) convened for this project. PUBLIC HEALTH RELEVANCE: Neuro-developmental disorders (NDDs) typically result in lifelong disability, often severe, and pose a substantial threat to global public health. Current estimates are that 90% or more of children and families affected by NDDs are in developing countries, but over 90% of resources devoted to research, preventive efforts, and services are expended for children and families in wealthier developed countries. Professionals and planners are urged to assess the burden caused by these disorders and to take appropriate action (WHO 2006). This proposal to develop a NDDs surveillance system for children 2-9 years of age in Uganda responds to this challenge. The surveillance system will generate data for service and prevention planning, policy directives, and advocacy.