The Prevalence, Trends in, and Factors Associated with Neurodevelopmental Disorders (NDDs) in Low- and Low-middle Income Countries (LLMICs): A Systematic Review and Meta-Analysis

This review study aims to systematically examine the prevalence, trend, and associated factors of NDDs in LLMICs. A comprehensive search in nine databases and two search engines was performed. The pooled estimate of NDDs prevalence was 10%. Subgroup analysis ranked ID (12%), ADHD (11%), and ASD (10%) as the most prevalent NDDs. Prevalence was higher in Africa (14%) and low-income countries (13%) compared to Asia (7%) and lower-middle-income countries (9%). Key factors significantly associated with an increased likelihood of NDDs include diagnostic timing, child’s and family’s history of mental health problems, lack of breastfeeding, low maternal education, and low birth weight. Additionally, lower socioeconomic status (SES), male sex, advanced maternal age at childbirth, pregnancy complications, and preterm birth were significantly associated with increasing NDDs. In the multivariate meta-regression, only study quality scores showed a significant inverse association with NDDs. The finding implies the burden of NDDs in LLMICs, particularly in Africa, and underscore the need for interferences addressing at least modifiable factors (e.g., socioeconomic issues, maternal education, and perinatal care) to mitigate risk factors as well as prevalence rates).