Autism spectrum disorder in sub-saharan africa: A comprehensive scoping review

Abstract

Autism spectrum disorder (ASD) is recognized as a global public health concern, yet almost everything we know about ASD comes from high-income countries. Here we performed a scoping review of all research on ASD ever published in sub-Saharan Africa (SSA) in order to identify ASD knowledge gaps in this part of the world. Fifty-three publications met inclusion criteria. Themes included the phenotype, genetics and risk factors for ASD in SSA, screening and diagnosis, professional knowledge, interventions for ASD, parental perceptions, and social-cognitive neuroscience. No epidemiological, early intervention, school-based or adult studies were identified. For each identified theme, we aimed to summarize results and make recommendations to fill the knowledge gaps. The quality of study methodologies was generally not high. Few studies used standardized diagnostic instruments, and intervention studies were typically small-scale. Overall, findings suggest a substantial need for large-scale clinical, training, and research programmes to improve the lives of people who live with ASD in SSA. However, SSA also has the potential to make unique and globally-significant contributions to the etiology and treatments of ASD through implementation, interventional, and comparative genomic science. Autism Res 2017, 10: 723-749. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

Keywords: Africa; LMIC; autism; autism spectrum disorder; low resource environments; low- and middle-income countries.

Figure 1

Flow diagram of studies included in this comprehensive scoping review.

Figure 2

Publications about ASD around the globe. The figure shows the number of publications ever published on ASD by continent.

Figure 3

Publications about ASD in sub-Saharan Africa. The figure shows the number of peer-reviewed, data-containing publications ever published on ASD by country.