Title : Clinical-epidemiological characteristics of autism spectrum disorder in the Republic of Kazakhstan
Abstract:
Autism spectrum disorder (ASD) is a complex heterogeneous childhood neuropsychiatric disorders mainly characterized by deficits in verbal and non-verbal communication, reciprocal social interactions, and stereotyped behavior. Despite the increased worldwide interest of scientists and statisticians to the problem of autism, the disorder has not been studied much in Kazakhstan.
In this work, we, for the first time, attempt to summarize the available statistical data and conduct a clinical and epidemiological analysis of ASD in the Republic of Kazakhstan. Overall morbidity and prevalence are important indicators, which allow evaluation of the epidemiological significance of ASD. In the last five years, the number of reported cases of children diagnosed with ASD in Kazakhstan has increased by 1.8 times. According to the official data obtained by the Ministry of Healthcare of the Republic of Kazakhstan, the ASD prevalence rate in 2018 year is 2.6 per 100.000 children, which is lower than the global statistics. WHO estimated that worldwide 1 in 160 children has an ASD with the incidence rate of 6.25 per 100.000 people. We assume that the official data do not reflect the true picture of prevalence in Kazakhstan due to the difficulties of diagnosis of ASD in our country.
A study, involving 22 Kazakhstani families of 23 children diagnosed with autism, evaluated gender differences in ASD. According to obtained results, ASD was observed 3.6 times more often in boys than in girls. Thus, in Kazakhstan, the ratio of the frequency of ASD in male and female children corresponds to that observed in the world statistics (4: 1). On average, the age for having a child with autism was 29.9 for women and 31.9 for men. Interestingly, there was an almost equal ratio between mothers who gave birth to a child with ASD at the age of 20-29 years and 30 and above (1: 1.2). These data are different from those obtained by other authors who showed that women over age of 30 are more likely and more often to have a child with ASD. These differences are likely due to the small number of patients.
Also, we studied the ethnic composition of families with autistic children. Due to the heterogeneity of Kazakhstani population, the ethnic composition was very diverse. Most cases occurred among Kazakh (67%), Russian (16%) and Uighur (12%) families, but there were also cases of ASD in Korean, Tatar, Uzbek families. Thus, ASD has been reported to occur in all ethnic groups of the Kazakhstani population.
Thus, in this work some clinical and epidemiological aspects of ASD in Kazakhstan are evaluated. We show that for a number of characteristics they correspond to the world data. The future direction of our research will be focused on genetic factors relating to the development of ASD within the framework of the state grant "Molecular genetic aspects of autism in Kazakhstan" 2018-2020.
