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全球儿童和青少年发育障碍的患病率:系统综述伞状评价。

Global prevalence of developmental disabilities in children and adolescents: A systematic umbrella review.

机构信息

Centre for Healthy Start Initiative, Lagos, Nigeria.

International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, United Kingdom.

出版信息

Front Public Health. 2023 Feb 16;11:1122009. doi: 10.3389/fpubh.2023.1122009. eCollection 2023.

Abstract

AIM

The provisions of the United Nation's Sustainable Development Goals (SDGs) for disability-inclusive education have stimulated a growing interest in ascertaining the prevalence of children with developmental disabilities globally. We aimed to systematically summarize the prevalence estimates of developmental disabilities in children and adolescents reported in systematic reviews and meta-analyses.

METHODS

For this umbrella review we searched PubMed, Scopus, Embase, PsycINFO, and Cochrane Library for systematic reviews published in English between September 2015 and August 2022. Two reviewers independently assessed study eligibility, extracted the data, and assessed risk of bias. We reported the proportion of the global prevalence estimates attributed to country income levels for specific developmental disabilities. Prevalence estimates for the selected disabilities were compared with those reported in the Global Burden of Disease (GBD) Study 2019.

RESULTS

Based on our inclusion criteria, 10 systematic reviews reporting prevalence estimates for attention-deficit/hyperactivity disorder, autism spectrum disorder, cerebral palsy, developmental intellectual disability, epilepsy, hearing loss, vision loss and developmental dyslexia were selected from 3,456 identified articles. Global prevalence estimates were derived from cohorts in high-income countries in all cases except epilepsy and were calculated from nine to 56 countries. Sensory impairments were the most prevalent disabilities (approximately 13%) and cerebral palsy was the least prevalent disability (approximately 0.2-0.3%) based on the eligible reviews. Pooled estimates for geographical regions were available for vision loss and developmental dyslexia. All studies had a moderate to high risk of bias. GBD prevalence estimates were lower for all disabilities except cerebral palsy and intellectual disability.

CONCLUSION

Available estimates from systematic reviews and meta-analyses do not provide representative evidence on the global and regional prevalence of developmental disabilities among children and adolescents due to limited geographical coverage and substantial heterogeneity in methodology across studies. Population-based data for all regions using other approaches such as reported in the GBD Study are warranted to inform global health policy and intervention.

摘要

目的

联合国可持续发展目标(SDGs)中关于残疾包容教育的规定激发了人们越来越大的兴趣,以确定全球发育障碍儿童的患病率。我们旨在系统总结系统评价和荟萃分析中报告的发育障碍儿童和青少年患病率的估计值。

方法

对于本伞式综述,我们在 2015 年 9 月至 2022 年 8 月期间,在 PubMed、Scopus、Embase、PsycINFO 和 Cochrane Library 中搜索了以英文发表的系统评价。两名审查员独立评估了研究的合格性、提取数据和评估偏倚风险。我们报告了特定发育障碍的全球患病率估计归因于国家收入水平的比例。选择的残疾患病率与 2019 年全球疾病负担研究(GBD)报告的患病率进行了比较。

结果

根据我们的纳入标准,从 3456 篇已确定的文章中选择了 10 篇系统评价报告,这些报告的患病率估计值分别为注意力缺陷多动障碍、自闭症谱系障碍、脑瘫、发育性智力障碍、癫痫、听力损失、视力损失和发育性阅读障碍。除了癫痫,所有全球患病率估计值都来自高收入国家的队列,并且是根据九到 56 个国家计算得出的。基于合格的综述,感官障碍是最常见的残疾(约 13%),脑瘫是最不常见的残疾(约 0.2-0.3%)。视力损失和发育性阅读障碍的地区汇总估计值可用。所有研究的偏倚风险均为中度至高度。除脑瘫和智力障碍外,GBD 患病率估计值均低于所有残疾。

结论

由于研究方法在地理覆盖范围和方法学方面存在很大差异,因此系统评价和荟萃分析中的可用估计值无法提供有关全球和地区儿童和青少年发育障碍患病率的代表性证据。需要使用其他方法(如 GBD 研究中报告的方法)在所有地区进行基于人群的数据收集,以为全球卫生政策和干预措施提供信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/694b/9987263/2e37ef4bb873/fpubh-11-1122009-g0001.jpg

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