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Published on: August 25, 2014
Neurodevelopmental disorders at Chris Hani Baragwanath Academic Hospital: a 4-year retrospective database review
Sarah Jane Lowick1,2, Sibongile Mbatha3,2
1Department of Paediatrics and Child Health, Chris Hani Baragwanath Hospital, Johannesburg, Gauteng, South Africa slowick@live.com.
Insights
This study highlights the increasing burden of neurodevelopmental disorders in a South African hospital, with autism and genetic conditions being most common. Greater resources are needed for early diagnosis, genetic testing, and specialized education.
Area of Science:
- Developmental Paediatrics
- Neurodevelopmental Disorders
- Clinical Genetics
Background:
- Developmental paediatrics faces growing global and local demand for resources.
- The Chris Hani Baragwanath Academic Hospital neurodevelopmental clinic serves a significant pediatric population.
- Understanding the clinic's patient demographics and service provision is crucial.
Purpose of the Study:
- To provide a baseline description of the neurodevelopmental clinic population.
- To analyze patient demographics, clinical variables, and management strategies.
- To understand the trends and challenges in neurodevelopmental disorder care over four years.
Main Methods:
- Retrospective review of a developmental database.
- Analysis of patient data from May 2020 to December 2024.
- Inclusion of total patient numbers, demographics, clinical details, and management variables.
Main Results:
- 1877 patients reviewed, with increasing numbers over time.
- Autism (37.1%), intellectual disability (16.6%), and genetic disorders (11.8% confirmed, 18% likely) were prevalent.
- High comorbidity rates including cerebral palsy (11.4%), epilepsy (16.1%), and behavioral disorders (52.8%, predominantly ADHD).
- Significant delays in diagnosis and educational placement were observed, with 44.8% of children in supported schooling placed after age 7.
Conclusions:
- The study reveals the significant regional burden and complex clinical presentation of neurodevelopmental disorders.
- Observed trends mirror global patterns of increasing complex cases.
- There is an urgent need for enhanced resources for early diagnosis, comprehensive genetic testing, and improved educational support.
Background:
Developmental paediatrics is a growing field both globally and locally with increasing demand for medical and educational resources.
Methods:
This retrospective, developmental database review is a baseline description of the Chris Hani Baragwanath Academic Hospital neurodevelopmental clinic population, and the service offered over the past 4 years. The population comprises all patients seen at the clinic from May 2020 to December 2024. Outcomes measured were total patient numbers, demographic, clinical and management variables.
Results:
The cohort comprised 1877 patients. An increase in total patient numbers was observed over the past 4 years. The ratio of male to female patients was 3:1. Median age at referral was 48.8 months with an average waiting period of 12 months. The median, mean and age range at first visit were 60, 66 and 5-192 months, respectively. Autism was diagnosed in 37.1%, non-syndromic intellectual disability in 16.6%, a confirmed genetic diagnosis in 11.8% and a 'likely genetic disorder' in 18% of patients. 98 different genetic conditions were identified. Comorbidity included cerebral palsy (11.4%), epilepsy (16.1%), hearing (5.2%) and visual impairment (5.5%). Associated behavioural disorders occurred in 52.8% of patients, predominantly attention deficit hyperactivity disorder (ADHD) (30%). At least one medication was prescribed in 58.2% of children. Over 40% of children were either at home or at crèche; 14.0% were attending mainstream school; 10.5% an autism school; 26.3% a special needs school. Of the 841 (44.8%) children in supported schooling, 47.8% were placed after 7 years of age.
Conclusions:
This study provides insights into the regional burden and clinical presentation of neurodevelopmental disorders. Trends in this region reflect broader global patterns, with increasing numbers of children presenting with complex conditions. Greater resources are needed for earlier diagnosis and therapy, access to all tiers of genetic testing and upscaling of inclusive and special needs education.
Trial Registration Number:
NHRD GP_202510_105.
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