Strategies for Autism Diagnosis and Care in Resource Deprived Settings in Africa: An Overview

Author(s): Yewande Olufunmilayo Oshodi*, Elizabeth Adebola Campbell, Foluso Ebun Afolabi Lesi

Journal Name: Adolescent Psychiatry

Volume 9 , Issue 1 , 2019

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Background and Goals: Autism Spectrum Disorders (ASDs) exist in Africa as they do everywhere in the world. Historically they have been under recognized and under studied. The aim of this paper is to review the existing challenges of ASD care and diagnosis in Africa, with a view to describing workable unique strategies deployable within the continent.

Methods: We present an overview of the existing medical literature and summarize key findings in relation to the topic of ASD in Africa. First, as a preliminary step, we highlight key findings from previous epidemiological surveys. Second, we undertook a review of relevant available evidence from the various African regions. When the authors were familiar with additional local or regional scientific works, these were also used and referenced.

Discussion: There has been a growing awareness of the extent to which ASDs exist and have an impact on affected individuals and their families. There are many barriers to diagnosis and effective interventions. These include lack of trained personnel, stigma and cultural beliefs regarding etiology, disparities in resources between urban and rural areas, and poverty. Nonetheless, partnerships to support research and the development of culturally appropriate interventions can be developed and strengths exist in the communities that can be harnessed to improve care.

Keywords: Autism, autism spectrum, Africa, children and adolescents, public policy, epidemiology.

Abasiubong, F., Obembe, A., Ekpo, M. (2008). The opinions and attitudes of mothers to mental retardation in Lagos, Nigeria. Nigerian Journal of Psychiatry, 6, 80-85.
Abiodun, O.A. (1995). Pathways to mental health in Nigeria. Psychiatr. Serv., 46, 823-826.
Abubakar, A., Ssewanyana, D., Newton, C.R. (2016). A systematic review of research on autism spectrum disorders in Sub-Saharan Africa. Behavioural Neurology, 2, 1-14.
[ 10.1155/2016/3501910]
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5TM. 5th ed. Arlington, VA, US: American Psychiatric Publishing, Inc.
Bakare, M.O., Ebigbo, P.O., Agomoh, A.O., Eaton, J., Onwukwe, J.U., Onyeama, G.M. . . . Aguocha, C. M. (2009). Knowledge about childhood autism and opinion among healthcare workers on availability of facilities and law caring for needs and rights of children with childhood autism and other developmental disorders in Nigeria. BMC Pediatr., 9, 12.
Bakare, M.O., Ebigbo, P.O., Ubochi, V.N. (2012). Prevalence of autism spectrum disorders among Nigerian children with intellectual disability: A stopgap assessment. J. Health Care Poor Underserved, 23, 513-518.
Bakare, M.O., Igwe, M.N., Odinka, P.C., Iteke, O. (2011). Neuropsychiatric diagnosis and psychotropic medication prescription patterns in a mental hospital-based child and adolescent psychiatric service in Nigeria. J. Health Care Poor Underserved, 22, 751-755.
Bakare, M.O., Munir, K.M. (2011). Autism spectrum disorders (ASD) in Africa: A perspective. Afr. J. Psychiatry, 14, 208-210.
Bakare, M.O., Munir, K.M. (2011b). Autism spectrum disorders in Africa. In M. R. Mohammadi (Ed.). A comprehensive book on autism spectrum disorders (Ch. 10). London: InTech Open. Retrieved from:
Bakare, M.O., Munir, K.M., Bello-Mojeed, M.A. (2014). Public health and research funding for childhood neurodevelopmental disorders in Sub-Saharan Africa: A time to balance priorities. Healthc. Low Resour. Settings, 2(1), 1559.
[ hls.2014.1559]
Balo, J., Wiggins, L., Christensen, D.L, Maenner, M.J., Daniels, J., Warren, Z., Dowling, N. F. (2018). Prevalence of autism spectrum disorder among children aged 8 years – Autism and Developmental Disabilities Monitoring Network, 11 sites, United States, 2014. Morbidity and mortality weekly report. Surveillance summaries (Washington, DC: 2002), 67(6), 1- 23.
Belhadj, A., Mrad, R., Halayem, M.B. (2006). [A clinic and para-clinic study of Tunisian population of children with autism. About 63 cases]. Tunis. Med., 84(12), 763-767.
Dawson, A.J., Buchan, J., Duffield, C., Homer, C.S.E., Wijewardena, K. (2014). Task shifting and sharing in maternal and reproductive health in low-income countries: A narrative synthesis of current evidence. Health Policy Plan., 29(3), 396-408.
de Vries, P.J. (2016). Thinking globally to meet local needs: Autism spectrum disorders in Africa and other low- resource environments. Curr. Opin. Neurol., 29(2), 130-136.
Durkin, M.S., Elsabbagh, M., Barbaro, J., Gladstone, M., Happe, F., Hoekstra, R.A. … Shih, A. (2015). Autism screening and diagnosis in low resource settings: Challenges and opportunities to enhance research and services worldwide. Autism Res., 8(5), 473-476.
Durkin, M.S., Wang, W., Shrout, P.E., Zaman, S.S., Hasan, Z.M., Desai, P., Davidson, L.L. (1995). Evaluating a ten questions screen for childhood disability: Reliability and internal structure in different cultures. J. Clin. Epidemiol., 48(5), 657-666.
Franz, L., Chambers, N., von Isenburg, M., de Vries, P.J. (2017). Autism spectrum disorder in Sub-Saharan Africa: A comprehensive scoping review Autism Research, 10(5), 723-749.
[ 1766]
Kakooza-Mwesige, A., Ssebyala, K., Karamagi, C., Kiguli, S., Smith, K., Anderson, M.C. . . . Grether, J.K. (2014). Adaptation of the “Ten Questions” to screen for autism and other neurodevelopmental disorders in Uganda. Autism, 18(4), 447-457.
Khan, N.Z., Muslima, H., Shilpi, A.B., Begum, D., Parveen, M., Akter, N. . . . Darmstadt, G.L. (2013) Validation of rapid neurodevelopmental assessment for 2- to 5-year-old children in Bangladesh. Pediatrics, 131(2), e486-e494.
Lesi, F.E., Adeyemi, J.D., Aina, O.F., Oshodi, Y.O., Umeh, C.S., Olagunju, A.T., Oyibo, W. (2014). Autism in Nigeria: A call for action. Journal of Clinical Sciences, 11, 33-34.
Lotter, V. (1978). Childhood autism in Africa. J. Child Psychol. Psychiatry, 19(3), 231-244.
Lotter, V. (1980). Cross cultural perspectives on childhood autism. J. Trop. Pediatr., 26(4), 131-133.
Mankoski, R.E., Collins, M., Ndosi, N.K., Mgalla, E.H., Sarwatt, V.V., Folstein, S.E. (2006). Etiologies of autism in a case-series from Tanzania. J. Autism Dev. Disord., 36(8), 1039-1051.
Mukolo, A., Heflinger, C.A., Wallston, K.A. (2010). The stigma of childhood mental disorders: A conceptual framework. J. Am. Acad. Child Adolesc. Psychiatry, 49(2), 92-103.
Okyere, E., Mwanri, L., Ward, P. (2017). Is task-shifting a solution to the health workers' shortage in Northern Ghana?. PloS One, 12(3), e0174631. doi:10.1371/ journal.pone.0174631 PLOS. Retrieved from
Omigbodun, O.O. (2001). A cost-effective model for increasing access to mental health care at the primary care level in Nigeria. J. Ment. Health Policy Econ., 4(3), 133-139.
Oshodi, Y., Olagunju, A., Oyelohunnu, M., Campbell, E., Umeh, C., Aina, O. . . . Adeyemi, J. (2017). Autism spectrum disorder in a community-based sample with neurodevelopmental problems in Lagos, Nigeria. J. Public Health Africa, 7(2)
Patel, V., Flisher, A.J., Hetrick, S., McGorry, P. (2007). Mental health of young people: A global public-health challenge. Lancet, 369(9569), 1302-1313. Retrieved from
Raina, S.K., Chander, V., Bhardwaj, A.K., Kumar, D., Sharma, S., Kashyap, V. ... Singh M, Bhardwaj, A. (2017). Prevalence of autism spectrum disorder among rural, urban, and tribal children (1-10 years of age). J. Neurosci. Rural Pract., 8, 368-374.
Reichow, B., Servili, C., Yasamy, M.T., Barbui, C., Saxena, S. (2013). Non-specialist psychosocial interventions for children and adolescents with intellectual disability or lower-functioning autism spectrum disorders: A systematic review. PLoS Med., 10(12), e1001572.
Ruparelia, K., Abubakar, A., Badoe, E., Bakare, M., Visser, K., Chugani, D.C. D.C., … Newton, C.R. (2016). Autism spectrum disorders in Africa: Current challenges in identification, assessment, and treatment: A report on the International Child Neurology Association Meeting on ASD in Africa, Ghana, April 3-5, 2014. Journal of Child Neurology, 31(8), 1018-1026.
Seif Eldin, A., Habib, D., Noufal, A., Farrag, S., Bazaid, K., Al-Sharbati, M., Badr, H., Moussa, S., Essali, A. (2008). &. . . Gaddour, N. (2008): Use of M-CHAT for a multinational screening of young children with autism in the Arab countries. Int. Rev. Psychiatry, 20(3), 281-289.
Simmons, R., Fajans, P., Ghiron, L. (2007). Scaling up health service delivery: From pilot innovations to policies and programmes. 2007.. Geneva: World Health Organization. Retrieved from http://www.
Springer, P.E., van Toorn, R., Laughton, B., Kidd, M. (2013). Characteristics of children with pervasive developmental disorders attending a developmental clinic in the Western Cape Province, South Africa. South African Journal of Child Health, 7(3), 95-99.
Van der Merwe, C., Bornman, J., Donohue, D., Harty, M. (2017). The attitudes of typically developing adolescents towards their sibling with autism spectrum disorder. South African Journal of Communication Disorders, 64(1), a184. Retrieved from
World Health Organization (2009). WHO Library Cataloguing- in-Publication Data Task shifting: Rational redistribution of tasks among health workforce teams : global recommendations and guidelines. Retrieved from
World Health Organization (2013, September). Meeting report: Autism spectrum disorders and other developmental disorders from raising awareness to building capacity. World Health Organization, Geneva, Switzerland 16 -18 September 2013. Retrieved from
World Health Organization. (2014, May). Autism spectrum disorders – the way forward. Sixty-Seventh World Health Assembly Agenda item. Retrieved from
World Health Organization (2016). Scaling up projects and initiatives for better health: from concepts to practice. World Health Organization Regional Office for Europe, Copenhagen: Author. Retrieved from

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Article Details

Year: 2019
Page: [58 - 66]
Pages: 9
DOI: 10.2174/2210676609666181220125513

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