Autism Spectrum Disorder in North-Western Nigeria

Aim: To determine the profile of autism spectrum disorder (ASD) cases in a tertiary hospital in Sokoto, over a decade.

Study Design: A descriptive study on the clinical presentations and associated co-morbidities in children with ASD as seen in Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto.

Place and Duration of Study: Department of Paediatrics (Neurology Unit), UDUTH Sokoto, Nigeria, between July 2008 and June, 2018.

Methodology: Children with documented features of ASD (as described in DSM-5) over the study period were enrolled. Relevant information was extracted from the hospital records. The DSM 5 diagnostic criteria for ASD was applied, and all cases whose clinical records conform to the DSM 5 criteria, and having complete clinical records were included. Patients with incomplete data were excluded. Co-morbid conditions were identified based on history and examination records. A descriptive analysis of the data was done and presented as frequencies and proportions.

Results: Out of the 1267 cases seen in Paediatric Neurology clinic over the study period, 18 cases exhibited the symptoms of ASD based on the DSM 5 criteria, giving a hospital prevalence of 1.4%. The mean age at diagnosis was 5.6 ±2.5 (range 2 to 13) years, with a M:F of 1:1.6. All the cases had the core symptoms of impaired social communication, impaired social interactions and restricted/stereotypic behaviours that started before 3 years of age. Majority (55.6%) of the cases were diagnosed after the age of 5 years. Identified co-morbidities include hyperactivity (55.6%), seizures (33.3%) and motor delays (27.8%), occurring alone or in combinations. Only 4 (22.2%) of the cases had no identifiable neuro-developmental co-morbidities.

Conclusion: Autism spectrum Disorder is one of the neurodevelopmental disorders among children with Neurologic problems in our centre and is commonly associated with other co-morbidities. There is need to create more awareness about ASD so as to enhance its early recognition and appropriate interventions.