Screening young children for neurodevelopmental differences in sub-Saharan Africa: a scoping review

Neurodevelopmental disorders (NDDs) present in approximately 10% of children globally. Awareness of NDDs in sub-Saharan Africa is relatively low and little is known about prevalence. This scoping review aims to understand screening of NDDs in young children in sub-Saharan Africa, which NDDs are screened for, and who administers screening. The review was conducted in accordance with the PRISMA-ScR standards for scoping reviews. PubMed, Web of Science, SCOPUS and PsycInfo were searched according to a defined search strategy with relevant keywords. Studies published in English between 2012 and 2023, where children aged ≥ 2 to < 9 years years, residing in sub-Saharan Africa, were screened for a form of NDD, were included. Due to the flexible nature of a scoping review and its focus on under-explored topics, there were no restrictions on study design. Titles and abstracts were reviewed for selection independently by three researchers and full text articles independently by two researchers. Quality assessment was conducted using the Newcastle-Ottawa Scale. After duplicate removal and title and abstract screening, 546 abstracts were retained for full text review. Twelve publications met the inclusion criteria. These were from South Africa (n = 6), Kenya (n = 3), Uganda (n = 2) and Malawi (n = 1). Only two explicitly screened for multiple NDDs. There was considerable heterogeneity in NDD conceptualisation, study design, screener design, populations of children screened, and persons performing the screening – limiting the possibility for valid comparative analysis. Quality assessment of methodologies yielded ratings ranging from "Very good" to "Unsatisfactory" (cross-sectional studies) and "Good" to "Fair" (cohort- and case-control studies). There are very few published studies on NDD screening in young children in sub-Saharan Africa. Further research examining simple, contextually appropriate screening for a wide range of NDDs amongst this group, is needed. This may inform future screening programmes, policy development and clinical practice throughout the region.