Clinical characteristics of children with autism spectrum disorders: a cross-sectional study of cases attended at three centers specializing in neurodevelopmental disorders in Kinshasa, Democratic Republic of Congo (DRC)

Context and objective. Autism spectrum disorders (ASD) in sub-Saharan African (SSA) countries are poorly studied. The aim of the present study was to describe the socio demographic and clinical characteristics of children with autism and to identify associated factors. Methods. This was a cross-sectional study of children with ASD attended at three specialized centers in Kinshasa. We confirmed a ASD diagnosis through clinical observation using Diagnostic and Statistical Manuel of Mental Disorders four Text Revision (DSM-VI-TR) criteria and standardized autism diagnostic tools. We analyzed socio-demographic and clinical characteristics and main comorbidities of ASD. The comparison of proportions was done using Pearson's chi-square test. One-way ANOVAs were calculated to test differences in averages. Results. A total of 120 children (72.5 % male) were examined. Their mean age at diagnosis was 7.83 ± 3.4 years, while parents were alerted at 1.8 ±0.78 years. Language delays were the main alert sign (54%) and the main symptom (62%). Social interaction disorders (11.7 %) were underreported by parents. The core signs of ASD were disorders of social interaction (90.5%), behavior (80%) and language (62.5%). The main ASD symptoms were associated with epilepsy(p=0.027), cerebral palsy (p=0.026) and hearing impairment (p=0.045). Conclusion. The diagnostic and language delay co-occurring with epilepsy and hearing impairment are the main clinical features of autism in the DRC. This study suggests that screening children for autism and its main comorbidities using a multidisciplinary approach should be a priority in Kinshasa.

Pathologie developpementale du langage oral

Introduction et objectif : La pathologie developpementale du langage oral est une entite nosologique dont l'etiologie est multiforme. Cette etude avait pour objectif d'en determiner les caracteristiques epidemiologique et clinique a Abidjan. Population et methodes : cette etude retrospective et descriptive a ete realisee au CHU de Cocody et a l'institut national de sante publique ; de 2000 a 2006 (07ans). Resultats : 173 enfants parmi 1942 presentaient un trouble du langage oral (8;9). 124 enfants ont ete inclus dans l'etude. Leur age moyen etait de 3;4 ans. Il y avait 53 garcons pour 71 filles. Les motifs de consultation etaient domines par le retard de langage (39;5). Des antecedents pathologiques ont ete releves : la prematurite (5;64); la souffrance cerebrale (14;51); la meningite (5;64) et les convulsions non febriles (11;29). Ces troubles du langage etaient secondaires (46) a une affection otologique (23;4) ou neurologique (11;3). Conclusion : la pathologie developpementale du langage oral est frequente a Abidjan. Sa prise en charge doit etre codifiee afin de la rendre plus efficace

Childhood Hearing Impairment: How do Parents Feel about it?

"Hearing impairment or deafness is a major disabling condition worldwide. The etiology of hearing loss range from congenital to acquired; and includes common and preventable childhood infections like otitis media and meningoencephalitis. The morbidity and burden of hearing impairment on the children and their parents is enormous. This is because affected children have developmental delay in many domains including speech; cognition as well as behavioural and other aspects of psychosocial development. Early identification and effective treatment of hearing loss improves language; other forms of communication; and cognitive skills. This study was carried out to evaluate and ascertain the perception and attitude of parents of children with hearing impairment.Material and Method: This was a questionnaire based study of parents' perception and attitude about children with hearing impairment in the Port-Harcourt metropolis from 1st June 2011 to 31st May 2012.Results: Thirty seven parents of children with hearing impairment were studied. The parents demonstrated different attitudes towards the children. Majority; 34(94.59) of them felt sad; others expressed anger. Twenty seven (72.97) felt hearing loss was due to punishment from the ""gods"" for an evil deed by a family member. The attitude and feelings of parents included sadness; self-blame and anger. Parents also believe that immediate cause is spiritual.Conclusion: The public should be enlightened about common preventable causes so as to correct all negative attitudes about hearing loss/ impairment."

Excess of non-verbal cases of autism spectrum disorders (ASDs) presenting to orthodox clinical practice in Africa - a trend possibly resulting from late diagnosis and intervention

Objectives. Characteristics of children with autism spectrum disorders (ASDs) in Africa are not known because of unavailability of large-scale epidemiological studies in this region. This review explored the age at first presentation to orthodox clinical practice of African children with ASDs and their expressive language ability at presentation. Methods. A literature search of case series and case reports of ASDs from Africa was done through PubMed/MEDLINE, Google Scholar, African Journals Online (AJOL), and archives of the Nigerian Journal of Psychiatry. Six articles included content relating to age of the child at first presentation to orthodox clinical practice and symptoms at presentation related to expressive language ability and therefore fulfilled the inclusion criteria. Suggestions are made to explain the observations emanating from the review. Results. An excess of non-verbal over verbal cases of ASDs have been presenting to orthodox clinical practice and there is a common denominator of late presentation/diagnosis and in turn late intervention, with most cases presenting for the first time well above 8 years of age. Attempts to explain these observations included low levels of knowledge and awareness about ASDs in Africa, problems with help-seeking behaviour, and lack of mental healthcare facilities and trained personnel. nclusions. Enhancement of processes directed at ensuring early diagnosis and interventions, especially interventions aimed at improving speech and language development well and sufficiently early, may bring about a shift in the trend of excess non-verbal cases of ASDs over verbal cases presenting to orthodox clinical practice