Mpaka Davin Mbeya, Okitundu Daniel Luwa E-Andjafono, Ndjukendi Ally Omba, N'situ Adelin Mankubu, Kinsala Sebastien Yabassi, Mukau Joachim Ebwel, Ngoma Valentin Malanda, Kashala-Abotnes Espérance, Ma-Miezi-Mampunza Samuel, Vogels Annick, Steyaert Jeans
Department of psychiatry, Center for Neuro- Psycho- Pathology, School of Medicine, University of Kinshasa, Democratic Republic of the Congo.
Department of Neurology, Center for Neuro- Psycho- Pathology, School of Medicine, University of Kinshasa, Democratic Republic of the Congo.
Pan Afr Med J. 2016 Oct 17;25:82. doi: 10.11604/pamj.2016.25.82.4151. eCollection 2016.
Autism spectrum disorders (ASD) is a neurodevelopmental disorder that has been rarely diagnosed in Sub-Saharan Africa. Although a proportion of children do present features of ASD in the Democratic Republic of Congo (DRC), little is known about it prevalence. Often, the co-morbidities constitute the upfront symptoms and therefore may it recognition and management difficult, aggravating as such the prognosis. The present study therefore aimed at studying the clinical profile of autism spectrum disorder (ASD) and the associated morbidities among children and adolescents in outpatient clinics in Kinshasa, the Democratic Republic of Congo.
We conducted a cross sectional study in the three outpatients centers receiving patients referred for neurodevelopmental disorders in Kinshasa, DRC, from June 2008 to June 2010. A total of 450 subjects aged from 1-18 years old were referred and included in the study. The clinical diagnosis for ASD was made using the DSM-IV-R and the ADIR. Co-morbidities were identified using DSM-IV-R criteria together with an extensive clinical interview and observation. All patients were subject to an intellectual quotient evaluation and an electroencephalogram reporting.
Of the 450 subjects referred, 120 (29.3%) received the diagnosis of ASD, with boys outnumbering girls (OR 3:1. The mean age was 7.9 years (SD 3.4) (p< 0.001). Intellectual disability (75.83 %) and epilepsy (72.50%) were the main co-morbidities significantly associated with autism (p< 0.001). It was also found that co-morbidities were most frequent in subjects with an IQ<70 (p=0.05).
ASD is frequent among patients referred for neurodevelopmental disorders in the three outpatients' centers for neurodevelopmental disorders in Kinshasa. Males seem to be more affected than female. The main co-morbidities were epilepsy and intellectual disabilities. Our findings suggest that it is important to screen for ASD and co-morbidities among all subjects referred for neurodevelopmental disorders and to undertake survey on ASD in various structures of rejected children from the society in Kinshasa DRC. This will help to identify and manage ASD and associated co-morbidities at an early stage for a better prognosis.
自闭症谱系障碍（ASD）是一种神经发育障碍，在撒哈拉以南非洲地区很少被诊断出来。尽管在刚果民主共和国（DRC）有一部分儿童确实表现出ASD的特征，但对其患病率知之甚少。通常，合并症构成了最初的症状，因此可能使其识别和管理变得困难，从而加重了预后。因此，本研究旨在研究刚果民主共和国金沙萨门诊诊所中儿童和青少年自闭症谱系障碍（ASD）的临床特征及其相关合并症。
我们于2008年6月至2010年6月在刚果民主共和国金沙萨的三个接收神经发育障碍转诊患者的门诊中心进行了一项横断面研究。共有450名年龄在1至18岁之间的受试者被转诊并纳入研究。使用DSM-IV-R和ADIR对ASD进行临床诊断。使用DSM-IV-R标准以及广泛的临床访谈和观察来确定合并症。所有患者都接受了智商评估和脑电图报告。
在转诊的450名受试者中，120名（29.3%）被诊断为ASD，男孩人数多于女孩（OR为3:1）。平均年龄为7.9岁（标准差为3.4）（p<0.001）。智力残疾（75.83%）和癫痫（72.50%）是与自闭症显著相关的主要合并症（p<0.001）。还发现，智商<70的受试者中合并症最为常见（p=0.05）。
在金沙萨的三个神经发育障碍门诊中心转诊的患者中，ASD很常见。男性似乎比女性受影响更大。主要合并症是癫痫和智力残疾。我们的研究结果表明，对所有转诊的神经发育障碍受试者进行ASD和合并症筛查，并在刚果民主共和国金沙萨社会中被排斥儿童的各种机构中对ASD进行调查非常重要。这将有助于早期识别和管理ASD及其相关合并症，以获得更好的预后。
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