Mercadante Marcos T, Evans-Lacko Sara, Paula Cristiane S
Department of Psychiatry, Federal University of São Paulo, São Paulo, SP, Brazil.
Curr Opin Psychiatry. 2009 Sep;22(5):469-74. doi: 10.1097/YCO.0b013e32832eb8c6.
The prevalence of intellectual disability is an estimated 1-4% worldwide. Etiological factors such as malnutrition, lack of perinatal care, and exposure to toxic and infectious agents, which are more common in low-income and middle-income (LAMI) countries, may contribute to a higher prevalence of intellectual disability in Latin America. This review summarizes the data on intellectual disability coming from Latin America, which is published in scientific journals and is available from official websites and discusses potential health policy and services implications of these studies.
Methodologically rigorous studies on intellectual disability in Latin America are lacking. This paucity of basic epidemiological information is a barrier to policy and services development and evaluation around intellectual disability. Only two studies, one from Chile and another from Jamaica, allow for adequate population estimates of intellectual disability. Interestingly, the countries with the highest scientific production in Latin America, Brazil and Mexico, did not produce the most informative research in epidemiology, policy or services related to intellectual disability.
The main conclusion of this review is that a lack of scientific evidence makes it difficult to properly characterize the context of intellectual disability in Latin America. Insufficient data is also a barrier to policy and services development for governments in Latin America. Although recently there have been efforts to develop government programs to meet the needs of the intellectual disability population in Latin America, the effectiveness of these programs is questionable without proper evaluation. There is a need for studies that characterize the needs of people with intellectual disability specifically in Latin America, and future research in this area should emphasize how it can inform current and future policies and services for people with intellectual disability.
全球智力残疾的患病率估计为1%-4%。营养不良、缺乏围产期护理以及接触有毒和感染性因子等病因在低收入和中等收入国家更为常见，可能导致拉丁美洲智力残疾患病率较高。本综述总结了拉丁美洲智力残疾方面的数据，这些数据发表在科学期刊上，可从官方网站获取，并讨论了这些研究对潜在卫生政策和服务的影响。
拉丁美洲缺乏关于智力残疾的方法学严谨的研究。这种基本流行病学信息的匮乏是围绕智力残疾制定政策、开展服务以及进行评估的障碍。仅有两项研究，一项来自智利，另一项来自牙买加，能够对智力残疾进行充分的人群估计。有趣的是，拉丁美洲科研产出最高的国家巴西和墨西哥，在与智力残疾相关的流行病学、政策或服务方面并未产出最具参考价值的研究。
本综述的主要结论是，缺乏科学证据使得难以准确描述拉丁美洲智力残疾的情况。数据不足也是拉丁美洲各国政府制定政策和开展服务的障碍。尽管最近已努力制定政府项目以满足拉丁美洲智力残疾人群的需求，但在没有适当评估的情况下，这些项目的有效性存疑。需要开展研究来明确拉丁美洲智力残疾人群的具体需求，该领域未来的研究应强调如何为当前及未来针对智力残疾人群的政策和服务提供参考。
