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Meta-Analysis
. 2025 Jul 21;25(1):2519.
doi: 10.1186/s12889-025-23651-x.

Estimates of the prevalence of autism spectrum disorder in the Middle East and North Africa region: A systematic review and Meta-Analysis

Aishat F Akomolafe #  1 , Bushra M Abdallah #  1 , Fathima R Mahmood #  1 , Amgad M Elshoeibi  1 , Aisha Abdulla Al-Khulaifi  1 , Elhassan Mahmoud  1 , Yara Dweidri  1 , Nour Darwish  1 , Duaa Yousif  1 , Hafsa Khalid  1 , Majed Al-Theyab  1 , Muhammad Waqar Azeem  2   3 , Durre Shahwar  2 , Madeeha Kamal  2 , Majid Alabdulla  4 , Salma M Khaled  1 , Tawanda Chivese  5
Affiliations
Meta-Analysis

Estimates of the prevalence of autism spectrum disorder in the Middle East and North Africa region: A systematic review and Meta-Analysis

Aishat F Akomolafe et al. BMC Public Health. .

Abstract

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 I2 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 (I2 = 99.8%). Overall ASD prevalence was 0.04% (95%CI 0.00-0.13, I2 = 99.4%) for studies done before 2015 and 0.45% (95%CI 0.17-0.87, I2 = 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, I2 = 97.5%)] while the overall ASD prevalence was 0.14% (95%CI 0.00-0.46, I2 = 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.

Keywords: Autism spectrum disorder; Middle East and North Africa; Prevalence.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: This review used secondary data from peer-reviewed published studies and does not require ethical clearance or consent to participate. Consent for publication: Not Applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flowchart outlining the study selection process
Fig. 2
Fig. 2
Forest plot of overall prevalence of autism spectrum disorder
Fig. 3
Fig. 3
Forest plot of autism spectrum disorder prevalence by diagnostic tool
Fig. 4
Fig. 4
Forest plot of autism spectrum disorder prevalence by method of prevalence calculation
Fig. 5
Fig. 5
Forest plot of autism spectrum disorder prevalence by year
Fig. 6
Fig. 6
Forest plot of autism spectrum disorder prevalence in Iran
See this image and copyright information in PMC

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References

    1. Association AP. Diagnostic and statistical manual of mental disorders: DSM-5. American psychiatric association; 2013.
    1. Bölte S, Girdler S, Marschik PB. The contribution of environmental exposure to the etiology of autism spectrum disorder. Cell Mol Life Sci. 2019;76:1275–97. - PMC - PubMed
    1. Taylor MJ, Rosenqvist MA, Larsson H, Gillberg C, D’Onofrio BM, Lichtenstein P, et al. Etiology of autism spectrum disorders and autistic traits over time. JAMA Psychiatry. 2020;77(9):936–43. - PMC - PubMed
    1. Henninger NA, Taylor JL. Outcomes in adults with autism spectrum disorders: A historical perspective. Autism. 2013;17(1):103–16. - PMC - PubMed
    1. Salari N, Rasoulpoor S, Rasoulpoor S, Shohaimi S, Jafarpour S, Abdoli N, et al. The global prevalence of autism spectrum disorder: a comprehensive systematic review and meta-analysis. Ital J Pediatr. 2022;48(1):112. - PMC - PubMed