Autisminafrica Accra 2-5 April Autism in the Sudan
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1 Autisminafrica Accra 2-5 April 2014 Autism in the Sudan Prof. Haydar El Hadi Babikir M.B.B.S., MD Dean, Faculty of Medicine University of Gezira Sudan Member of INCA, ACNA, BPNA, EPNS, SSNS
2 Welcome to the heart of Africa
3 SUDAN IN BRIEF Area = km 2 [728, 215 miles 2 ] Population = 30, 894, 000 [Density 16.4/km 2 ] Land boundaries =7,687 Km coastline = 853Km Terrain is generally flat, mountains in Northeast & West desert dominates the north
4 The Sudan at a glance
5 Multiethnic: > 500 tribes > 400 Languages and dialects
6 Ethnic groups: Black 52%, Arab 39%, Beja 6%, foreigners 2%, other 1% Religions: Sunni Muslim 70% (in north), indigenous beliefs 25%, Christian 5% (mostly in south and Khartoum) Languages: Arabic (official), Nubian, Ta Bedawie, diverse dialects Literacy: definition: age 15 can read and write total population: 61.1% male: 71.8% female: 50.5% (2003 est.)
7 Gezira State Total Population ~ Children < 15 yrs. = 1,989,615 < 5 yrs. = 757, 131 < 1 yrs. 167, 316
8 Staff Adult neurologists = 38 Paediatric Neurologists = 9 Psychiatrists =163 Resource Sudan Medical council (March 2014)
9 The River Nile starts HERE At this fascinating scene the Blue Nile joins the White Nile to make the River Nile at Khartoum..
10 Autism: Pathway to the diagnosis No definitive medical test Interviews, observation, and specific checklists developed for this purpose. Screening: 1] M-CHAT the Modified Checklist for Autism in Toddlers M-CHAT was applied. 2] DSM-IV Diagnostic Criteria for Autistic Disorder Diagnostic Criteria for Autistic Disorder (299.00) Come under section in DSM-IV-TR
11 Diagnostic Tools Diagnostic Parental Interviews The Gilliam Autism Rating Scale The Parent Interview for Autism The Pervasive Developmental Disorders Screening Test-Stage 3 The Autism Diagnostic Interview-Revised Diagnostic Observation Instruments The Childhood Autism Rating Scale The Screening Tool for Autism in 2-Year-Olds The Autism Diagnostic Observation Schedule-Generic Diagnostic Tools Data from the American Psychiatric Association.[1]
12 NUBA CIVILIZATION Napatan (900 to 270 BC) and Meroitic (270 BC to 350 AD) cultures, of the second kingdom of Kush
13 DSM-IV Diagnostic Criteria for Autistic Disorder 1 0 A. A total of six (or more) items from categories 1, 2 and 3 with at least two from 1 and at least one each from 2 and 3 are required in order to diagnose autism. Categories B and C must also be met. 1. Impairment in social interactions. Marked impairment in the use of multiple nonverbal behaviors, such as eye-to-eye gaze, facial expression, body postures and gestures to regulate social interaction. Failure to develop peer relationships appropriate to developmental level. A lack of spontaneous seeking to share enjoyment, interests or achievements with other people. Lack of social or emotional reciprocity. 2. Impairment in communication. Delay in, or total lack of, the development of spoken language. In individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others. Stereotyped and repetitive use of language or idiosyncratic language. Lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level. 3. Repetitive behaviors and stereotyped behavior patterns. Encompassing preoccupation with one or more stereotyped and restricted pattern(s) of interest that is(are) abnormal either in intensity or focus. Apparently inflexible adherence to specific, non-functional routines or rituals. Stereotyped and repetitive motor mannerisms. Persistent preoccupation with parts of objects. B. Delays or abnormal functioning in at least one of the following areas, with onset before age 3: Social interaction. Language, as used in social communication. Symbolic or imaginative play. C. The disturbance is not better accounted for by Rett disorder or childhood disintegrative disorder.
14 Data on Autism in Sudan No official data on the magnitude of ASD Autistic children are catered for in private daycare centers 11 in Khartoum and 2 in Medani
15 Wild Animals in the Sudan
16 Specific Interests in Autism Correlation between Autistic Spectrum Disorders and Idiopathic Epilepsies among Sudanese Children [accepted for publications] Haydar E.Babikir, George Zarief Mansour, Inaam Levels of Minerals and their Association with Metallothionein Genetic Variants in Sudanese Autistic Children [on progress] Bahga SEA, Hani Z, Haydar E Babikir Epidemiological Parameters of ASD among Children in Gezira State Central Sudan [on progress] Haydar E.Babikir, Abed El Nasir Abu Zaid, Magedah e. a.
17 Correlation between Autistic Spectrum Disorders and Idiopathic Epilepsies among Sudanese Children. Haydar E. Babikir, et al The correlation between ASD and epilepsy was found to be significant (p<0.0001). Epileptic patients who were not known to have ASD, when screened using M-CHAT; 58.3% of them showed the possibility to have ASD. This association seems not to influence the seizures control.
18 What needs to be done in Sudan Lack of reciprocal attention
19 What needs to be done in Sudan Review epidemiology, demography, and etiology of ASD. Review screening and diagnosis recommendations. Review treatment approaches traditional concept. Study the magnitude and the impact of ASD Raise the awareness among people and decision makers Creation of advocacy groups and lay associations
20 Thank you for your attention & Welcome to Sudan
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