中东和北非地区自闭症谱系障碍患病率的估计：一项系统评价和荟萃分析。
Estimates of the prevalence of autism spectrum disorder in the Middle East and North Africa region: A systematic review and Meta-Analysis.
作者信息
Akomolafe Aishat F, Abdallah Bushra M, Mahmood Fathima R, Elshoeibi Amgad M, Al-Khulaifi Aisha Abdulla, Mahmoud Elhassan, Dweidri Yara, Darwish Nour, Yousif Duaa, Khalid Hafsa, Al-Theyab Majed, Azeem Muhammad Waqar, Shahwar Durre, Kamal Madeeha, Alabdulla Majid, Khaled Salma M, Chivese Tawanda
机构信息
College of Medicine, QU Health, Qatar University, Doha, Qatar.
Sidra Medicine, Doha, Qatar.
出版信息
BMC Public Health. 2025 Jul 21;25(1):2519. doi: 10.1186/s12889-025-23651-x.
BACKGROUND
Prevalence estimates for autism spectrum disorder (ASD) in the Middle East and North Africa (MENA) region are not readily available, amid a lack of recent evidence. In this study, we estimated the prevalence of ASD in the MENA region by synthesising evidence from published studies.
METHODS
We conducted a systematic review and meta-analysis, searching PubMed, EMBASE, Scopus, and CINAHL for studies assessing ASD prevalence in the MENA region. Risk of bias was assessed using the Newcastle Ottawa scale. A bias-adjusted inverse variance heterogeneity meta-analysis model was used to synthesize prevalence estimates from included studies. Cochran's Q statistic and the I statistic were used to assess heterogeneity, and publication bias assessed using funnel and Doi plots.
RESULTS
Of 3,739 studies identified, 19 met the inclusion criteria, published during the period 2007-2025, from Iran, Oman, Libya, Egypt, Saudi Arabia, Lebanon, United Arab Emirates, Bahrain, and Qatar, Iraq. Country specific prevalence estimates ranged from 0.01% in Oman in 2009 to 6.50% in one study from Iraq in 2024. The overall prevalence of ASD in the MENA region was 0.14% (95%CI 0.02- 0.36%), with significant heterogeneity (I = 99.8%). Overall ASD prevalence was 0.04% (95%CI 0.00-0.13, I = 99.4%) for studies done before 2015 and 0.45% (95%CI 0.17-0.87, I = 99.4%) for studies after 2015. Overall ASD prevalence was high in studies that used the Modified Checklist for Autism in Toddlers (M-CHAT) only [1.66% (95%CI 0.15-4.33, I = 97.5%)] while the overall ASD prevalence was 0.14% (95%CI 0.00-0.46, I = 99.9%) for studies that used the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for diagnosis.
CONCLUSION
Estimates of the prevalence of ASD vary widely across the MENA region, with variability in ASD prevalence estimates by diagnostic methods and sampling approaches. While the data suggest a possible increase in prevalence during the study period, this observation warrants further investigation through more robust, longitudinal, and methodologically consistent studies.
REGISTRATION
PROSPERO registration ID CRD42024499837.
背景
由于缺乏最新证据，中东和北非（MENA）地区自闭症谱系障碍（ASD）的患病率估计尚无现成数据。在本研究中，我们通过综合已发表研究的证据来估计MENA地区ASD的患病率。
方法
我们进行了一项系统综述和荟萃分析，在PubMed、EMBASE、Scopus和CINAHL中检索评估MENA地区ASD患病率的研究。使用纽卡斯尔渥太华量表评估偏倚风险。采用偏倚调整后的逆方差异质性荟萃分析模型来综合纳入研究的患病率估计值。使用 Cochr an's Q统计量和I统计量评估异质性，并使用漏斗图和Doi图评估发表偏倚。
结果
在识别出的3739项研究中，有19项符合纳入标准，发表于2007年至2025年期间，来自伊朗、阿曼、利比亚、埃及、沙特阿拉伯、黎巴嫩、阿拉伯联合酋长国、巴林、卡塔尔和伊拉克。特定国家的患病率估计值范围从2009年阿曼的0.01%到2024年伊拉克一项研究中的6.50%。MENA地区ASD的总体患病率为0.14%（95%CI 0.02 - 0.36%），存在显著异质性（I = 99.8%）。2015年之前进行的研究中，总体ASD患病率为0.04%（95%CI 0.00 - 0.13，I = 99.4%），2015年之后进行的研究中为0.45%（95%CI 0.17 - 0.87，I = 99.4%）。仅使用《幼儿自闭症修正检查表》（M-CHAT）的研究中，总体ASD患病率较高[1.66%（95%CI 0.15 - 4.33，I = 97.5%）]，而使用《精神疾病诊断与统计手册》第四版（DSM-IV）诊断标准的研究中，总体ASD患病率为0.14%（95%CI 0.00 - 0.46，I = 99.9%）。
结论
MENA地区ASD患病率的估计差异很大，诊断方法和抽样方法导致ASD患病率估计存在差异。虽然数据表明研究期间患病率可能有所上升，但这一观察结果需要通过更有力、纵向且方法学上一致的研究进行进一步调查。
注册
PROSPERO注册编号CRD42024499837。
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