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

IF 3.5 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

BMC Public Health Pub Date : 2025-07-21 DOI:10.1186/s12889-025-23651-x

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

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引用次数: 0

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.

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中东和北非地区自闭症谱系障碍患病率的估计：系统回顾和荟萃分析。

背景：由于缺乏最近的证据，中东和北非（MENA）地区自闭症谱系障碍（ASD）的患病率估计并不容易获得。在这项研究中，我们通过综合已发表研究的证据来估计中东和北非地区ASD的患病率。方法：我们进行了系统回顾和荟萃分析，检索PubMed、EMBASE、Scopus和CINAHL，以评估中东和北非地区ASD患病率的研究。偏倚风险采用纽卡斯尔渥太华量表进行评估。采用偏倚校正逆方差异质性荟萃分析模型综合纳入研究的患病率估计。采用Cochran’s Q统计量和I2统计量评估异质性，采用漏斗图和Doi图评估发表偏倚。结果：在确定的3739项研究中，有19项符合纳入标准，发表于2007-2025年期间，分别来自伊朗、阿曼、利比亚、埃及、沙特阿拉伯、黎巴嫩、阿拉伯联合酋长国、巴林和伊拉克卡塔尔。具体国家的患病率估计从2009年阿曼的0.01%到2024年伊拉克的一项研究中的6.50%不等。中东和北非地区ASD总体患病率为0.14% (95%CI 0.02 ~ 0.36%)，异质性显著（I2 = 99.8%）。2015年之前的研究总体ASD患病率为0.04% (95%CI 0.00-0.13, I2 = 99.4%)， 2015年之后的研究总体ASD患病率为0.45% （95%CI 0.17-0.87, I2 = 99.4%）。在使用幼儿自闭症修正检查表（M-CHAT）的研究中，总体ASD患病率较高[1.66% (95%CI 0.15-4.33, I2 = 97.5%)]，而在使用第四版《精神障碍诊断与统计手册》（DSM-IV）诊断标准的研究中，总体ASD患病率为0.14% （95%CI 0.00-0.46, I2 = 99.9%）。结论：在中东和北非地区，对ASD患病率的估计差异很大，诊断方法和抽样方法对ASD患病率的估计存在差异。虽然数据表明在研究期间患病率可能增加，但这一观察结果值得通过更稳健、纵向和方法学上一致的研究进行进一步调查。注册：普洛斯彼罗注册号CRD42024499837。

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来源期刊

BMC Public Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

6.50

自引率

4.40%

发文量

2108

审稿时长

1 months

期刊介绍： BMC Public Health is an open access, peer-reviewed journal that considers articles on the epidemiology of disease and the understanding of all aspects of public health. The journal has a special focus on the social determinants of health, the environmental, behavioral, and occupational correlates of health and disease, and the impact of health policies, practices and interventions on the community.