Dataset Information

Neurodevelopmental disorders in children aged 2-9 years: Population-based burden estimates across five regions in India.

ABSTRACT:

Background

Neurodevelopmental disorders (NDDs) compromise the development and attainment of full social and economic potential at individual, family, community, and country levels. Paucity of data on NDDs slows down policy and programmatic action in most developing countries despite perceived high burden.

Methods and findings

We assessed 3,964 children (with almost equal number of boys and girls distributed in 2-<6 and 6-9 year age categories) identified from five geographically diverse populations in India using cluster sampling technique (probability proportionate to population size). These were from the North-Central, i.e., Palwal (N = 998; all rural, 16.4% non-Hindu, 25.3% from scheduled caste/tribe [SC-ST] [these are considered underserved communities who are eligible for affirmative action]); North, i.e., Kangra (N = 997; 91.6% rural, 3.7% non-Hindu, 25.3% SC-ST); East, i.e., Dhenkanal (N = 981; 89.8% rural, 1.2% non-Hindu, 38.0% SC-ST); South, i.e., Hyderabad (N = 495; all urban, 25.7% non-Hindu, 27.3% SC-ST) and West, i.e., North Goa (N = 493; 68.0% rural, 11.4% non-Hindu, 18.5% SC-ST). All children were assessed for vision impairment (VI), epilepsy (Epi), neuromotor impairments including cerebral palsy (NMI-CP), hearing impairment (HI), speech and language disorders, autism spectrum disorders (ASDs), and intellectual disability (ID). Furthermore, 6-9-year-old children were also assessed for attention deficit hyperactivity disorder (ADHD) and learning disorders (LDs). We standardized sample characteristics as per Census of India 2011 to arrive at district level and all-sites-pooled estimates. Site-specific prevalence of any of seven NDDs in 2-<6 year olds ranged from 2.9% (95% CI 1.6-5.5) to 18.7% (95% CI 14.7-23.6), and for any of nine NDDs in the 6-9-year-old children, from 6.5% (95% CI 4.6-9.1) to 18.5% (95% CI 15.3-22.3). Two or more NDDs were present in 0.4% (95% CI 0.1-1.7) to 4.3% (95% CI 2.2-8.2) in the younger age category and 0.7% (95% CI 0.2-2.0) to 5.3% (95% CI 3.3-8.2) in the older age category. All-site-pooled estimates for NDDs were 9.2% (95% CI 7.5-11.2) and 13.6% (95% CI 11.3-16.2) in children of 2-<6 and 6-9 year age categories, respectively, without significant difference according to gender, rural/urban residence, or religion; almost one-fifth of these children had more than one NDD. The pooled estimates for prevalence increased by up to three percentage points when these were adjusted for national rates of stunting or low birth weight (LBW). HI, ID, speech and language disorders, Epi, and LDs were the common NDDs across sites. Upon risk modelling, noninstitutional delivery, history of perinatal asphyxia, neonatal illness, postnatal neurological/brain infections, stunting, LBW/prematurity, and older age category (6-9 year) were significantly associated with NDDs. The study sample was underrepresentative of stunting and LBW and had a 15.6% refusal. These factors could be contributing to underestimation of the true NDD burden in our population.

Conclusions

The study identifies NDDs in children aged 2-9 years as a significant public health burden for India. HI was higher than and ASD prevalence comparable to the published global literature. Most risk factors of NDDs were modifiable and amenable to public health interventions.

SUBMITTER: Arora NK

PROVIDER: S-EPMC6057634 | biostudies-literature | 2018 Jul

REPOSITORIES: biostudies-literature

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Publications

Neurodevelopmental disorders in children aged 2-9 years: Population-based burden estimates across five regions in India.

Arora Narendra K NK Nair M K C MKC Gulati Sheffali S Deshmukh Vaishali V Mohapatra Archisman A Mishra Devendra D Patel Vikram V Pandey Ravindra M RM Das Bhagabati C BC Divan Gauri G Murthy G V S GVS Sharma Thakur D TD Sapra Savita S Aneja Satinder S Juneja Monica M Reddy Sunanda K SK Suman Praveen P Mukherjee Sharmila B SB Dasgupta Rajib R Tudu Poma P Das Manoja K MK Bhutani Vinod K VK Durkin Maureen S MS Pinto-Martin Jennifer J Silberberg Donald H DH Sagar Rajesh R Ahmed Faruqueuddin F Babu Nandita N Bavdekar Sandeep S Chandra Vijay V Chaudhuri Zia Z Dada Tanuj T Dass Rashna R Gourie-Devi M M Remadevi S S Gupta Jagdish C JC Handa Kumud K KK Kalra Veena V Karande Sunil S Konanki Ramesh R Kulkarni Madhuri M Kumar Rashmi R Maria Arti A Masoodi Muneer A MA Mehta Manju M Mohanty Santosh Kumar SK Nair Harikumaran H Natarajan Poonam P Niswade A K AK Prasad Atul A Rai Sanjay K SK Russell Paul S S PSS Saxena Rohit R Sharma Shobha S Singh Arun K AK Singh Gautam B GB Sumaraj Leena L Suresh Saradha S Thakar Alok A Parthasarathy Sujatha S Vyas Bhadresh B Panigrahi Ansuman A Saroch Munish K MK Shukla Rajan R Rao K V Raghava KVR Silveira Maria P MP Singh Samiksha S Vajaratkar Vivek V

PLoS medicine 20180724 7

<h4>Background</h4>Neurodevelopmental disorders (NDDs) compromise the development and attainment of full social and economic potential at individual, family, community, and country levels. Paucity of data on NDDs slows down policy and programmatic action in most developing countries despite perceived high burden.<h4>Methods and findings</h4>We assessed 3,964 children (with almost equal number of boys and girls distributed in 2-<6 and 6-9 year age categories) identified from five geographically d ...[more]

PMID: 30040859

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Dataset Information

Neurodevelopmental disorders in children aged 2-9 years: Population-based burden estimates across five regions in India.

Background

Methods and findings

Conclusions

Publications

Neurodevelopmental disorders in children aged 2-9 years: Population-based burden estimates across five regions in India.

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