Neuro-Developmental Disabilities Screening and Assessment in Uganda

描述（由申请人提供）：本申请响应PAR-06-420题为：发展中国家的大脑疾病：跨生命周期的研究（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，以监测2-9岁儿童的中度至重度神经发育障碍（ndd）。将被调查的残疾包括自闭症谱系障碍（ASD）、脑瘫（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设计的筛查工具（10个问题或TQ）的扩展版进行挨家挨户的筛查，该工具经调整后适用于乌干达。将邀请筛查呈阳性的儿童和筛查呈阴性的儿童样本参加全面诊断评估，并在必要时获得有关可行干预措施的建议。筛查和诊断评估的结果将进行统计比较，以确定筛查工具的有效性。从试点研究中获得的初步数据将制成表格，以估计患病率并提供儿童的基本人口统计说明。我们将评估未来将ndd监测扩大到乌干达其他地区的可行性，并确定未来扩大的基础设施要求。为了提高乌干达的临床和研究能力，我们还将对培训要求进行需求评估，并加强和加强乌干达和国际临床医生和流行病学家的网络，以共享信息和资源。这些活动将与为此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）通常导致终身残疾，往往严重，并对全球公共卫生构成重大威胁。目前的估计是，90%或更多受ndd影响的儿童和家庭生活在发展中国家，但用于研究、预防工作和服务的资源中有90%以上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（世卫组织，2006年）。这项为乌干达2-9岁儿童建立非传染性疾病监测系统的建议应对了这一挑战。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.