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Autism in Africa

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Virginia Hughes
7 February 2012

Mental illness is the leading cause of disability in the world, according to the World Health Organization. Even more troubling: Four out of five people with psychiatric disorders live in developing countries, where they have few opportunities for treatment.

That's certainly the case for autism in Africa, though, like in other resource-poor areas of the world, awareness is beginning to improve. In the past few years, a handful of researchers in various African countries have investigated children with autism. A new review of these reports finds that these children tend to be diagnosed much later than their counterparts in the U.S., and are more likely to be nonverbal.

The review, published in the December issue of the South African Journal of Psychiatry, analyzes six studies: three from Nigeria, the most populous country in Africa, and one each from Tunisia, Tanzania and Kenya.

The studies, published between 1982 and 2010, each identified only a few dozen children with autism, from clinics thousands of miles apart. Yet the cases are strikingly similar. Nearly all of the children were diagnosed relatively late: many at around 8 years old and some into their teenage years. Two of the studies reported nonverbal rates among children with autism of 51 and 71 percent, respectively, compared with around 25 percent in the U.S.

There are many factors that could account for these numbers, not least of which is a weak medical infrastructure and lack of resources. For example, compared with the rest of the world, the prevalence of treatable disease — malaria, tuberculosis, HIV — is high, while the number of doctors and medical facilities is low. Cultural and educational factors may play a role, too.

The authors cite research showing that autism awareness is low not only in the general African population, but also in the medical community.

One survey asked Nigerian nurses who specialize in psychiatry or pediatrics about the causes of autism. Some 40 percent fingered preternatural or supernatural causes, such as ancestral spirits, enemies, sinning or the action of the devil.

These attitudes, the researchers suggest, mean that when a child has a mental or neurodevelopmental problem, help may first be sought from traditional healers or religious leaders, rather than from a medical clinic, which could account for the late diagnoses. These lost years may also contribute to the lack of language in many of the children with autism, perhaps because they did not have access to early interventions or speech therapy.

The good news is that mental health issues in Africa are starting to get more attention.

For example, in 2005, the World Health Organization launched the Mental Health and Poverty Project, which aims to bring psychiatric care to poor communities in Ghana, South Africa, Uganda and Zambia. And just last week, a large group of public health experts called on the United Nations General Assembly to host a special session on the issue of global mental health.

Comments

Name: Tania Melnyczuk
8 February 2012 - 8:07PM

Things are not improving fast enough. South Africa's main autism charity, Autism SA, has only two months left if it doesn't get funds to continue. http://www.sowetanlive.co.za/news/2012/02/08/autism-sa-battles-for-funds The majority of doctors, psychologists and other healthcare practitioners in South Africa and the rest of Africa are not trained to diagnose autism.

Name: Catherine Crowley
7 March 2012 - 1:14AM

http://www.youtube.com/watch?v=MyrGWtoU4bI Part of the mission of the KNUST Disability Center in KUMASI, Ghana is to spread awareness about disabilities. They have done workshops on autism for families and teachers. In Accra, Ghana, Autism Awareness Care and Training is a private school for students with disabilities. The Ministry of Education's Unit Schools throughout Ghana have students enrolled with autism. http://autismfamily.com/autism-awareness-care-training-aact-accra-ghana.html

Name: Casey McFeely
13 July 2012 - 5:29PM

While still relatively behind in diagnosis and services, Ghana is really leading the way for autism awareness in all of West Africa. The Autism Awareness, Care and Training Centre, that is mentioned in the above comment, was founded in 1998! Since its establishment, many others have popped up in Ghana and throughout all of West Africa. I feel sadened that so many people tend to focus on what "Africans" are lacking versus highlighting progress and the champions that exist. Mental health awareness definitely needs to be improved all over the world, but why not challenge ourselves to do it by positively reinforcing the one's actually out there making it happen.

Name: Anonymous
4 July 2013 - 1:46PM

It is interesting. They ask nurses and doctors about the cause of autism. I doubt that any US nurses or doctors are aware about the cause of autism.

Name: YESUTOR
18 July 2013 - 1:04PM

the unit schools in Ghana take children with autism but do not use interventions to help them because the teachers don't know how. Pursuing a programme at Cape coast i ask some students in Education if they knew about autism and they told me it was a mental disorder. my heart sunk because in Ghana i have heard people say that it is a term given to a mentally handicapped child from a rich home.

doctors, nurses, teachers must all be exposed to what autism is and the interventions and stop thinking they have to be in an asylum. these kids (and adults) are not crazy. they only see the world from a different perspective. and we have to learn to wear their lens sometimes.

Name: Miki
5 June 2014 - 7:47PM

"Four out of five people with psychiatric disorders live in developing countries" where did you get that report from????

Name: Miki
5 June 2014 - 7:52PM

please do some more researches (including very recent once) that suggest the opposite of that statement. Again, please let us know what report is quoted on your article. I am very curious to know!

Name: Virginia Hughes
5 June 2014 - 8:25PM

Hi, Miki,

Approximately 80 percent of the world's population lives in developing countries (http://www.worldbank.org/depweb/beyond/beyondco/beg_03.pdf). Because most experts believe that strongly genetic psychiatric disorders such as autism and schizophrenia have the same prevalence everywhere (even though they are undiagnosed in many places), it stands to reason that most people with psychiatric disorders live in developing countries.

Name: usethebrainsgodgiveyou
6 June 2014 - 12:14AM

http://www.independent.co.uk/news/mentally-ill-do-better-in-third-world-than-in-west-1320282.html

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