Abstract:
Background: Childhood mortality from infectious diseases has declined steadily in
many low and middle-income (LAMIC) countries, with increased recognition of noncommunicable diseases such as neurodevelopmental disorders (NDD). There is lack of
data on the burden of NDD in LAMIC. Current global burden of these disorders are
largely extrapolated from high-income countries. The main objective of the study was
therefore to estimate the burden of NDD in LAMIC using meta-analytic
techniques. Methods: We systematically searched online databases including
Medline/PubMed, PsychoInfo, and Embase for studies that reported prevalence or
incidence of NDD. Pooled prevalence, heterogeneity and risk factors for prevalence were
determined using meta-analytic techniques. Results: We identified 4,802 records, but
only 51 studies met the eligibility criteria. Most studies were from Asia (52.2%) and
most were on neurological disorders (63.1%). The median pooled prevalence per 1,000
for all NDD was 7.6 (95%CI 7.5-7.7), being 11.3 (11.7-12.0) for neurological disorders
and 3.2 (95%CI 3.1-3.3) for mental conditions such as attention-deficit hyperactivity
disorder (ADHD). The type of NDD was significantly associated with the greatest
prevalence ratio in the multivariable model (PR=2.6(95%CI 0.6-11.6) (P>0.05).
Incidence was only reported for epilepsy (mean of 447.7 (95%CI 415.3-481.9) per
100,000). Perinatal complications were the commonest risk factor for
NDD. Conclusion: The burden of NDD in LAMIC is considerable. Epidemiological
surveys on NDD should screen all types of NDD to provide reliable estimates.