Data_Sheet_3_Global prevalence of developmental disabilities in children and adolescents: A systematic umbrella review.PDF

AimThe provisions of the United Nation's Sustainable Development Goals (SDGs) for disability-inclusive education have stimulated a growing interest in ascertaining the prevalence of children with developmental disabilities globally. We aimed to systematically summarize the prevalence estimates of developmental disabilities in children and adolescents reported in systematic reviews and meta-analyses.
MethodsFor this umbrella review we searched PubMed, Scopus, Embase, PsycINFO, and Cochrane Library for systematic reviews published in English between September 2015 and August 2022. Two reviewers independently assessed study eligibility, extracted the data, and assessed risk of bias. We reported the proportion of the global prevalence estimates attributed to country income levels for specific developmental disabilities. Prevalence estimates for the selected disabilities were compared with those reported in the Global Burden of Disease (GBD) Study 2019.
ResultsBased on our inclusion criteria, 10 systematic reviews reporting prevalence estimates for attention-deficit/hyperactivity disorder, autism spectrum disorder, cerebral palsy, developmental intellectual disability, epilepsy, hearing loss, vision loss and developmental dyslexia were selected from 3,456 identified articles. Global prevalence estimates were derived from cohorts in high-income countries in all cases except epilepsy and were calculated from nine to 56 countries. Sensory impairments were the most prevalent disabilities (approximately 13%) and cerebral palsy was the least prevalent disability (approximately 0.2–0.3%) based on the eligible reviews. Pooled estimates for geographical regions were available for vision loss and developmental dyslexia. All studies had a moderate to high risk of bias. GBD prevalence estimates were lower for all disabilities except cerebral palsy and intellectual disability.
ConclusionAvailable estimates from systematic reviews and meta-analyses do not provide representative evidence on the global and regional prevalence of developmental disabilities among children and adolescents due to limited geographical coverage and substantial heterogeneity in methodology across studies. Population-based data for all regions using other approaches such as reported in the GBD Study are warranted to inform global health policy and intervention.

研究目标：联合国《可持续发展目标（Sustainable Development Goals, SDGs）》中关于包容性残疾教育的相关条款，推动了全球范围内针对发育性残疾儿童患病率开展调查的日益增长的研究兴趣。本研究旨在系统性汇总现有系统综述与荟萃分析中报道的儿童青少年发育性残疾患病率估算结果。
研究方法：本伞状综述（umbrella review）检索了PubMed、Scopus、Embase、PsycINFO及Cochrane Library数据库，纳入2015年9月至2022年8月间发表的英文系统综述。由两名研究者独立评估研究的纳入资格、提取数据并评价偏倚风险。本研究报告了针对特定发育性残疾，按国家收入水平划分的全球患病率估算占比，并将所选残疾的患病率估算结果与2019年全球疾病负担（Global Burden of Disease, GBD）研究的报道结果进行了对比。
研究结果：基于纳入标准，我们从3456篇检出文献中筛选出10篇系统综述，分别报道了注意缺陷多动障碍（attention-deficit/hyperactivity disorder）、孤独症谱系障碍（autism spectrum disorder）、脑性瘫痪、发育性智力障碍、癫痫、听力损失、视力损失及发育性阅读障碍的患病率估算结果。除癫痫外，所有残疾的全球患病率估算均基于高收入国家队列，数据覆盖范围为9至56个国家。基于符合纳入标准的综述，感觉障碍为患病率最高的残疾（约13%），脑性瘫痪患病率最低（约0.2%~0.3%）。针对视力损失与发育性阅读障碍，已有按地理区域划分的合并估算结果。所有研究均存在中度至高度偏倚风险。除脑性瘫痪与智力障碍外，其余残疾的GBD患病率估算结果均更低。
研究结论：由于现有研究的地理覆盖范围有限，且各研究间方法学异质性显著，现有系统综述与荟萃分析的估算结果无法为儿童青少年发育性残疾的全球及区域患病率提供具有代表性的证据。需采用如全球疾病负担研究中报道的其他方法，获取覆盖所有区域的基于人群的数据，以为全球卫生政策制定与干预措施提供科学依据。