Raina Sunil Kumar, Chander Vishav, Bhardwaj Ashok K, Kumar Dinesh, Sharma Seema, Kashyap Vipasha, Singh Mitasha, Bhardwaj Amit
Department of Community Medicine, Dr. R. P. Government Medical College, Tanda, Kangra, Himachal Pradesh, India.
Department of Paediatrics, Dr. R. P. Government Medical College, Tanda, Kangra, Himachal Pradesh, India.
J Neurosci Rural Pract. 2017 Jul-Sep;8(3):368-374. doi: 10.4103/jnrp.jnrp_329_16.
Studies on autism spectrum disorders (ASDs) have largely focused on children in specific settings. The current scenario of research in ASDs is limited largely to clinic-based case reports, case series, and retrospective chart reviews. The present study is the first population-based prevalence study conducted across rural, urban, and tribal populations in India.
A cross-sectional two-phase study was conducted covering children in the age group of 1-10 years of age across geographical regions representing rural, urban, and tribal populations. The first phase (screening phase) involved administration of the Hindi version of the Indian Scale for Assessment of Autism. Those identified as suspected of ASD and 10% of all classified as nonsuspects for autism were also evaluated by the clinical team in second phase (evaluation phase).
Forty-three children out of a total of 28,070 children in rural, urban, and tribal area in the age group of 1-10 years were diagnosed as cases of ASD yielding a prevalence of 0.15% (95% confidence interval [CI] =0.15-0.25). Logistic regression analysis showed a two times significantly higher risk of diagnosing ASD in rural area as compared to tribal (odds ratio [OR]; 95% CI = 2.17 [1.04-4.52], = 0.04). Male sex and upper socioeconomic group of head of family/father had a higher risk of getting diagnosed as autism as compared to lower socioeconomic group (OR; 95% CI - 3.23; 0.24-44.28, = 0.38).
Estimation of true prevalence of ASD in India is going to improve policies on developmental disabilities.
关于自闭症谱系障碍(ASD)的研究主要集中在特定环境中的儿童。目前ASD的研究情况很大程度上局限于基于诊所的病例报告、病例系列和回顾性病历审查。本研究是在印度农村、城市和部落人群中进行的第一项基于人群的患病率研究。
开展了一项横断面两阶段研究,涵盖代表农村、城市和部落人群的不同地理区域中1至10岁的儿童。第一阶段(筛查阶段)采用印地语版的印度自闭症评估量表进行施测。那些被确定为疑似患有ASD的儿童以及所有被归类为非自闭症疑似儿童中的10%也在第二阶段(评估阶段)接受了临床团队的评估。
在1至10岁年龄组的农村、城市和部落地区的28070名儿童中,共有43名儿童被诊断为ASD病例,患病率为0.15%(95%置信区间[CI]=0.15 - 0.25)。逻辑回归分析显示,与部落地区相比,农村地区诊断ASD的风险显著高出两倍(优势比[OR];95%CI = 2.17[1.04 - 4.52],P = 0.04)。与社会经济地位较低的群体相比,男性以及家庭户主/父亲的社会经济地位较高的群体被诊断为自闭症的风险更高(OR;95%CI - 3.23;0.24 - 44.28,P = 0.38)。
印度ASD真实患病率的估计将有助于完善发育障碍相关政策。