Almost one in eight children aged 2-9 years living in India may have at least one neurodevelopmental disorder (NDD), according to prevalence estimates published this week in PLOS Medicine. The study, conducted by Narendra K Arora of the INCLEN Trust International, New Delhi, India, and colleagues, partially addresses the lack of robust evidence regarding burden and risk factors for NDD in India.
Given the widespread prevalence of known NDD risk factors, the NDD burden among children in India is thought to be high-- but data to inform policy and programmatic action have been limited. In their study, Arora and colleagues assessed roughly four thousand 2 to 9-year-olds across five geographically diverse sites in India--Kangra, Dhenkanal, Palwal, North Goa, and Hyderabad--for common NDD, including hearing impairment (HI), speech and language disorders, autism spectrum disorders, and intellectual disability (ID). According to the researchers, prevalence of any NDD in children varied according to site, from roughly 5% (Dhenkanal) to roughly 19% (Palwal), with HI and ID most prevalent. About one-fifth of NDD-affected children had two or more NDD. Due to the site-specific sampling and 15.6% refusal rate, these estimates cannot be assumed to represent India as a whole and may be conservative.
Key risk factors for childhood NDD included home delivery, perinatal asphyxia, low birth weight, neurological infections, and stunting. The authors state, "[t]he data suggest that the NDD burden can be substantially reduced in India by addressing risk factors which are amenable to public health interventions."
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Research Article
Funding:
This work was supported by The National Institutes of Health, USA [NIH 1R21-HD53057-01A1] through Fogarty International Center (FIH), Autism Speaks (USA), and The National Trust, Ministry of Social Justice and Empowerment, Government of India. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing Interests:
The authors have declared that no competing interests exist.
Citation:
Arora NK, Nair MKC, Gulati S, Deshmukh V, Mohapatra A, Mishra D, et al. (2018) Neurodevelopmental disorders in children aged 2-9 years: Population-based burden estimates across five regions in India. PLoS Med 15(7): e1002615. https://doi.org/10.1371/journal.pmed.1002615
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Author Affiliations:
The INCLEN Trust International, New Delhi, India
Kerala University of Health Sciences, Medical College PO, Thrissur, Kerala, India
Department of Paediatrics, All India Institute of Medical Sciences, New Delhi, India
Department of Paediatrics, Maulana Azad Medical College, New Delhi, India
Sangath, Bardez, Goa, India
Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
Department of Community Medicine, Kalinga Institute of Medical Sciences, Bhubaneshwar, Odisha, India
Indian Institute of Public Health, Hyderabad, Telangana, India, 10 Himachal Foundation, Dharamshala, Kangra, Himachal Pradesh, India
Department of Paediatrics, Lady Hardinge Medical College, New Delhi, India
Centre for Applied Research and Education on Neurodevelopmental Impairments and Disability related Health Initiatives (CARENIDHI), New Delhi, India
Department of Paediatrics, Sir Ganga Ram Hospital, New Delhi, India
Department of Social Medicine and Community Health, Jawaharlal Nehru University, New Delhi, India
Department of Paediatrics, Stanford University School of Medicine and Lucile Packard Children's Hospital, California, United States of America
Department of Population Health Sciences and Paediatrics, and Waisman Center, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States of America
University of Pennsylvania School of Nursing and School of Medicine, Philadelphia, United States of America
Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America
Department of Psychiatry, All India Institute of Medical Science, New Delhi, India
Integral Institute of Medical Sciences & Research, Integral University, Lucknow, Uttar Pradesh, India
Department of Psychology, Delhi University, New Delhi, India
Department of Paediatrics, Seth GS Medical College & KEM Hospital, Mumbai, Maharashtra, India
Department of Neurology, Paras Hospital, Gurugram, Haryana, India
Department of Ophthalmology, Lady Hardinge Medical College, New Delhi, India
Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
Department of Paediatric Disciplines, Health City Hospital, Guwahati, Assam, India
Department of Neurology, Institute of Human Behaviour and Allied Sciences & Department of Neurophysiology, Sir Ganga Ram Hospital, New Delhi, India
School of Health Policy and Planning, Kerala University of Health Sciences, Thiruvananthapuram, Kerala, India
Ali Yavar Jung National Institute of Speech and Hearing Disabilities, Department of Empowerment of Persons with Disabilities, Kasturba Niketan, New Delhi, India
Department of ENT & Head Neck Surgery, Medanta Medicity, Gurugram, Haryana, India
Department of Paediatrics, Indraprastha Apollo Hospital, New Delhi, India
Department of Paediatric Neurology, Rainbow Children's Hospital, Hyderabad, Telengana, India
Department of Paediatrics, Mumbai Port Trust Hospital, Mumbai, Maharashtra, India
Department of Paediatrics, King George Medical University, Lucknow, Uttar Pradesh, India
Department of Neonatology, Post Graduate Institute of Medical Education and Research and Dr. Ram Manohar Lohia Hospital, Delhi, India
Department of Community Medicine, Government Medical College, Srinagar, Jammu & Kashmir, India
National Trust, Department of Empowerment of Persons with Disabilities, Ministry of Social Justice & Empowerment, Government of India, Delhi, India
Vidya Sagar (formerly The Spastics Society of India), Chennai, Tamil Nadu, India
Department of Paediatrics, Government Medical College, Nagpur, Maharashtra, India
Social Welfare Department, Government of Bihar, Patna, India
Department of Community Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
Department of Child & Adolescent Psychiatry and Facility for Children with Intellectual Disability, Christian Medical College, Vellore, Tamil Nadu, India
Rashtriya Bal Swasthiya Karyakram, Ministry of Health and Family Welfare, Nirman Bhawan, New Delhi, India
Department of Otorhinolaryngology and Head and Neck Surgery (ENT), Lady Hardinge Medical College, New Delhi, India
Child Development Centre, Medical College Campus, Thiruvananthapuram, Kerala, India
Samarth, Chennai, Tamil Nadu, India
Department of Otolaryngology & Head-Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
Department of Pediatric Neurology, The Hospital for Sick Children (SickKids), The Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada
Department of Paediatrics, M.P. Shah Government Medical College & G.G. Hospital, Jamnagar, Gujarat, India
Department of ENT, Dr. Rajender Prasad Government Medical College, Kangra, Himachal Pradesh, India
RVM Institute of Medical Sciences and Research Center, Laxmakkapally, Telangana, India
Department of Paediatrics, Goa Medical College, Bambolim, Goa, India
Department of Orthopedic Surgery, Goa Medical College, Bambolim, Goa, India
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Journal
PLoS Medicine