Prevalence of Specific Learning Disorders (SLD) Among Children in India: A Systematic Review and Meta-Analysis.

Background: Specific learning disorders (SLD) comprise varied conditions with ongoing problems in one of the three areas of educational skills-reading, writing, and arithmetic-which are essential for the learning process. There is a dearth of systematic reviews focused exclusively on the prevalence of SLD in India. Hence, this study was done to estimate the prevalence of SLD in Indian children. Methods: A systematic search of electronic databases of MEDLINE, Embase, PsycINFO, and CINAHL was conducted. Two authors independently assessed the eligibility of the full-text articles. The third author reassessed all selected studies. A standardized data extraction form was developed and piloted. The pooled prevalence of SLDs was estimated from the reported prevalence of eligible studies, using the random-effects model. Results: Six studies of the systematic review included the diagnostic screening of 8133 children. The random-effects meta-analysis showed that the overall pooled prevalence of SLD in India was 8% (95% CI = 4-11). The tools used to diagnose SLD in the studies were the National Institute of Mental Health and Neurosciences (NIMHANS)-SLD index and the Grade Level Assessment Device (GLAD). Conclusions: Nearly 8% of children up to 19 years have SLD. There are only a few high-quality, methodologically sound, population-based epidemiological studies on this topic. There is a pressing need to have large population-based surveys in India, using appropriate screening and diagnostic tools. Constructing standardized assessment tools, keeping in view the diversity of Indian culture, is also necessary.

A Nine-Item Red Flag Sign Card for Identification of Autism Spectrum Disorder among Toddlers Aged 12 to 18 Months.

There is a dearth of validated red flags measures for early identification of autism spectrum disorder (ASD) among toddlers. Hence, a new screening measure was developed. Item generation was done through literature search. Content validity (CVI) assessment was done. Criterion validity was done using Diagnostic and Statistical Manual 5 (DSM-5) as reference standard, data were collected from the case records of children with ASD diagnosis at 2 y, and evaluated for developmental milestones between 12 and 18 mo in a tertiary care setting. Item reduction of the measure from 18 to 9 was done. The area under the curve in the receiver operating characteristic (ROC) curve for new measure was 0.81 (95% CI = 0.73, 0.87); z = 7.874; p < 0.001 against DSM-5 score of ≥ 2 in the new measure; achieved sensitivity of 93.42% (95% CI = 85.3, 97.8) and specificity of 60% (95% CI = 45.9, 73.0). Thus, new validated red flag sign card (Concern-9) can be used effectively for early screening and identification of ASD among children aged 12-18 mo.

Incidence of type 2 diabetes mellitus and prediabetes in Kerala, India: results from a 10-year prospective cohort.

BACKGROUND: Kerala, the southern state of India, has experienced sudden rise in the prevalence estimates of diabetes. A cohort study on the incidence of type 2 diabetes mellitus (T2DM) in Kerala state thus aptly bridges the lacuna of incidence estimate of T2DM from a population at risk. METHODS: A 10-year prospective cohort study was carried out in two urban wards of central Kerala. The individuals who participated in the baseline survey in 2007 were again invited for a follow-up study in 2017. The data was analyzed using IBM SPSS Statistics for windows (version 21.0). Logistic regression analysis was used to estimate odds ratios and 95% confidence intervals. Findings are based on the 10-year follow-up data from 869 participants from the cohort. RESULTS: The overall follow-up and response rate of the study was 68.9 and 86.9% respectively. During the follow-up period, 190 people (21.9%) developed T2DM. The incidence rate of T2DM and impaired fasting glucose (IFG) were 24.5 per 1000 person years and 45.01 per 1000 person years respectively. Nearly 60% of participants with baseline IFG were converted to T2DM group in the follow-up period. Age > 45 years, family history of T2DM, BMI ≥ 25 kg/m2 and presence of central obesity emerged as important risk factors for incident T2DM. CONCLUSION: High incidence of prediabetes over diabetes observed in this study shows an epidemic trend of T2DM in Kerala, India. It requires an immediate public health action.