Developing Standardized Care Pathways for management of autism spectrum disorders in the Ashanti Region (original) (raw)
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Journal of child neurology, 2016
Prevalence of autism spectrum disorders has increased over recent years, however, little is known about the identification and management of autism spectrum disorder in Africa. This report summarizes a workshop on autism spectrum disorder in Africa under the auspices of the International Child Neurology Association and the African Child Neurology Association through guided presentations and working group reports, focusing on identification, diagnosis, management, and community support. A total of 47 delegates participated from 14 African countries. Although there was a huge variability in services across the countries represented, numbers of specialists assessing and managing autism spectrum disorder was small relative to populations served. Strategies were proposed to improve identification, diagnosis, management and support delivery for individuals with autism spectrum disorder across Africa in these culturally diverse, low-resource settings. Emphasis on raising public awareness t...
Journal of Public Health in Africa, 2017
Autism Spectrum Disorder (ASD) is a globally prevalent neurodevelopmental disorder for which early diagnosis and intervention is the mainstay of management. In the African continent, limited data is available regarding the non-clinic based samples. Lack of information available to caregivers and inadequate skilled manpower often limit early detection and access to the few available though under resourced services in the community. Community based screening can be an important drive to create awareness and improve information dissemination regarding services available for those living with this disorder. This is a descriptive cross-sectional study utilizing data obtained from participants of a community-based autism screening exercise. The surveillance exercise was part of the annual Orange Ribbon initiative for autism awareness and screening held in 2014. Data was obtained from 85 participants involved in the Autism Surveillance screening exercise within the Lagos community. Communi...
Strategies for Autism Diagnosis and Care in Resource Deprived Settings in Africa: An Overview
Adolescent Psychiatry
Background and Goals: Autism Spectrum Disorders (ASDs) exist in Africa as they do everywhere in the world. Historically they have been under recognized and under studied. The aim of this paper is to review the existing challenges of ASD care and diagnosis in Africa, with a view to describing workable unique strategies deployable within the continent. Methods: We present an overview of the existing medical literature and summarize key findings in relation to the topic of ASD in Africa. First, as a preliminary step, we highlight key findings from previous epidemiological surveys. Second, we undertook a review of relevant available evidence from the various African regions. When the authors were familiar with additional local or regional scientific works, these were also used and referenced. Discussion: There has been a growing awareness of the extent to which ASDs exist and have an impact on affected individuals and their families. There are many barriers to diagnosis and effective in...
Early diagnosis and intervention for autism spectrum disorder in Africa: insights from a case study
African Health Sciences, 2018
Background: Globally the prevalence of autism spectrum disorder (ASD) has become more apparent. Prevalence on the African continent remains unknown. There is a call for further research into ASD in Africa as well as means to make early diagnosis and intervention possible. Objectives: The study aimed to raise awareness about ASD in Africa and encourage dialogue on possible intervention strategies for ASD in low resource settings. Methods: This was a qualitative mixed method case study. Literature regarding ASD in Africa was reviewed in order to provide context for the research and facilitate data reduction of the case study of Temple Grandin. The case study was conducted through a psychobiographical approach using Erikson's (1950/1973) theory of psychosocial development to interpret the life of Temple Grandin. The findings underwent further data reduction in order to focus on possible interventions for ASD. Results: Four primary interventions were found to be useful in facilitating development in an individual with ASD. Namely; speech therapy, creative endeavours, animals (human-animal interaction), and being mentored. Conclusion: Undiagnosed and untreated cases of ASD place undue psychosocial and economic burden on families and communities. Government support, by including ASD in health policies, is essential. Through creative adaptation of knowledge, communities may provide a valuable resource to ASD intervention strategies.
Background Autism spectrum disorder (ASD) is a neurodevelopmental disability associated with deficiency in social interaction, unusual development of social communication, and restricted or repetitive behaviors, interests and activities. This study aimed to describe management of pediatric ASD in Cameroon, a resource-constrained Central Africa country. Methods A cross-sectional study was conducted between December 2021 and May 2022 at Pediatrics department of a reference hospital in the town of Douala. Data of interest of children with ASD were collected through medical records and telephone discussion with their parents. Results A total of 145 children with ASD aged 2–15 years were included, giving a hospital prevalence of 3.7%. Time delay between parental concerns and hospital management was specified in 69 (47.58%) children among them 38 (55.07%) the mean delay ± SD was less than five months. Children were mainly males (76%) and aged 4–5 years (37.93%), with mean age ± SD of 44.4...
Family Perspectives of Autism Spectrum Disorders in Urban Ghana
Jicna, 2015
Background: Limited research is available on Autism Spectrum Disorder (ASD) in Africa. The purpose of this study is to increase understanding of the diagnosis, treatment and education of children and adults with ASD. Methods: Questionnaires and a structured interview were used to gather information from families of children and young adults (n=25, 19 male, 6 female, age range 3-30 years) with ASD. Descriptive statistics and frequencies were used to describe demographic background information, parent concerns prior to diagnosis, medical and developmental history, associated symptoms, education and treatment history, and perceived treatment needs. Demographic, medical, school, and treatment characteristics are presented alongside case reports to illustrate common themes. Results: Symptom severity measured using the Autism Spectrum Rating Scales revealed that the majority of the sample had ASD severity scores in the "elevated" or "very elevated" ranges. Participants were identified in early childhood, due to concerns about developmental delays. Few sleeping and eating difficulties were reported. While externalizing behaviors were cited as a primary concern, few participants utilized medications for the treatment of hyperactivity or aggression. Conclusions: Caregivers in this sample cite significant concerns about managing behavior, highlighting the need for additional parent training.
BMC Pediatrics, 2009
Background In designing programs to raise the community level of awareness about childhood autism in sub-Saharan Africa, it is logical to use the primary healthcare workers as contact point for education of the general public. Tertiary healthcare workers could play the role of trainers on childhood autism at primary healthcare level. Assessing their baseline knowledge about childhood autism to detect areas of knowledge gap is an essential ingredient in starting off such programs that would be aimed at early diagnosis and interventions. Knowledge of the healthcare workers on availability of facilities and law that would promote the required interventions is also important. This study assessed the baseline knowledge about childhood autism and opinion among Nigerian healthcare workers on availability of facilities and law caring for the needs and rights of children with childhood autism and other developmental disorders. Method A total of one hundred and thirty four (134) consented healthcare workers working in tertiary healthcare facilities located in south east and south-south regions of Nigeria were interviewed with Socio-demographic, Knowledge about Childhood Autism among Health Workers (KCAHW) and Opinion on availability of Facilities and Law caring for the needs and rights of children with Childhood Autism and other developmental disorders (OFLCA) questionnaires. Results The total mean score of participated healthcare workers on KCAHW questionnaire was 12.35 ± 4.40 out of a total score of 19 possible. Knowledge gap was found to be higher in domain 3 (symptoms of obsessive and repetitive pattern of behavior), followed by domains 1 (symptoms of impairments in social interaction), 4 (type of disorder autism is and associated co-morbidity) and 2 (symptoms of communication impairments) of KCAHW respectively among the healthcare workers. Knowledge about childhood autism (KCA) as measured by scores on KCAHW questionnaire was significantly associated with age group distribution of the healthcare workers, with those age group of fourth decades and above more likely to have higher mean score (p = 0.004) and previous experience of managing children with autism spectrum disorders (ASD) (p = 0.000). KCA showed near significant association with area of specialty, with those healthcare workers in psychiatry compared to pediatrics having higher mean score (p = 0.071) and also with years of working experience of the healthcare workers (p = 0.056). More than half of the healthcare workers subscribed to the opinion that facilities and law caring for the needs and rights of children with childhood autism and other developmental disorders are lacking in Nigeria. Conclusion The correlates of KCA may help in selection of those tertiary healthcare workers that would best fit the role of trainers. It is important to update the knowledge gaps of those healthcare workers who scored low in different domains of KCAHW questionnaire. It is imperative for policy makers in Nigeria to advocate and implement multidisciplinary healthcare service system that would ensure early diagnosis and interventions. Nationally representative baseline epidemiological data that would guide policy and planning are also desirable.
Autism Research and Treatment, 2015
Autism is a neurodevelopmental disorder with serious implications in childhood. There is a significant gap in the identification and provision of health and social services for autism in Africa. The knowledge of autism among health care providers and identifying challenges associated with its management could facilitate bridging the gap and ensuring better outcomes. A self-administered tool, the Knowledge about Childhood Autism among Health Workers (KCAHW) questionnaire, was used in assessing knowledge of autism among 175 medical doctors (participants) attending an annual scientific meeting in northwest Nigeria. Other parameters assessed were sociodemographic and professional characteristics of the participants and challenges encountered in the management of autism. Out of 175 questionnaires distributed, 167 (95.4%) were returned. Good knowledge (KCAHW score ≥15) was significantly associated with being a paediatrician or psychiatrist and practicing in a tertiary health facility ( < 0.05), while poor knowledge (KCAHW score <15) was significant among general practitioners ( < 0.05). The highest knowledge gap was associated with onset of autism and its comorbidities (KCAHW Domain 4) while the least was concerning communication impairments (KCAHW Domain 2). Major challenges encountered in autism management were dearth of specialist services, cost of evaluation, and poor caregiver perspectives of autism.
Autism Spectrum Disorder in North-Western Nigeria
International Neuropsychiatric Disease Journal, 2019
This work was carried out in collaboration between all authors Author MMA conceived the idea of the study and was involved in the study design, first draft, literature searches and final reading and approval of the study. Author HA was involved in the study design, protocol writing and final reading and approval of the study. Authors JB, JFL, AMN, MO and AAT were involved in data collection and analysis as well as reading and approval of the study. All authors read and approved the final manuscript.