scholarly journals Correction: Screening tools for early identification of children with developmental delay in low- and middle-income countries: a systematic review

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e038182corr1
BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e038182
Author(s):  
Tasnuva Faruk ◽  
Catherine King ◽  
Mohammad Muhit ◽  
Md Kafiul Islam ◽  
Israt Jahan ◽  
...  

ObjectiveTo systematically review, identify and report the screening tools used for early identification of developmental delay in low- and middle-income countries.DesignSystematic review.Data sourcesFour bibliographic databases: Medline (1946 to 13 July 2020), Embase (1974 to 13 July 2020), Scopus (1823 to 11 July 2020) and PsycINFO (1987 to July week 1 2020).Eligibility criteriaPeer-reviewed original articles published in English addressing validated culturally sensitive developmental screening tools among children aged <5 years were included in this review.Data extraction and synthesisOne author (CK, medical librarian) developed the search strategy. Three authors conducted the database search (phase I: CK; phase II: IJ and MKI). Three authors (TF, IJ and MKI) independently screened the title and abstracts. TF, MKI and GK independently performed the full-text review of the screened articles. During each step of the study selection process, disagreements were resolved through discussion. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was used to guide the systematic review. Data extraction and analysis were performed using MS Excel. Meta-analysis was not possible due to heterogeneity of the study findings.ResultsWe identified 3349 articles, of which 18 studies from 10 countries, reporting 16 screening tools, were selected for qualitative synthesis. Six cultural contexts were explored. Twelve general, two motor and two speech-language tools were identified. Seven of them found to be parent-completed ones. Five screening tools (American Speech-Language and Hearing Association, Guide for Monitoring Child Development, Infant Neurological International Battery, New Delhi-Development Screening Questionnaire and Woodside Screening Technique) reported relatively higher sensitivity (82.5%–100%) and specificity (83%–98.93%).ConclusionsLimited number of culturally sensitive developmental screening tools were validated for children aged <5 years in low- and middle-income countries. Revising existing screening tools in different ethnic and cultural settings and subsequent validation with normative value should be a research priority.


Author(s):  
Abebaw Fekadu ◽  
Mekdes Demissie ◽  
Rahel Berhane ◽  
Girmay Medhin ◽  
Teserra Bitew ◽  
...  

ABSTRACTObjectiveDepression is the commonest mental disorder in primary care but is poor identified. The objective of this review was to determine the level of detection of depression by primary care clinicians and its determinants in studies from low-and middle-income countries (LMICs).MethodsDesignSystematic review and meta-analysis. Review protocol was registered in the PROSPERO database (CRD42016039704).DatabasesPubMed, PsycINFO, Medline, EMBASE, LILAC and AJOL.Quality assessmentRisk of bias within studies evaluated with the Effective Public Health Practice Project (EPHPP).Synthesis“Gold standard” diagnosis for the purposes of this review were based on the 9-item Patient Health Questionnaire (PHQ-9; cutoff scores of 5 and 10), structured interview or expert diagnosis. Meta-analysis was conducted excluding studies on special populations. Analysis of pooled data were stratified by diagnostic approaches.ResultsA total of 2223 non-duplicate publications were screened. Ten publications, from two multi-country studies and eight single country studies, making 18 country level reports, were included. One of the multi-country studies used an enriched sample of screen positive participants. Overall methodological quality of the studies was good. Depression detection was 0.0% in five reports and <12% in another five. The pooled detection for two reports that used PHQ-9 at a cutoff point of 5 (combined sample size = 1426) was 3.9% (95% CI = 2.3%, 5.5%); in the four reports that used PHQ-9 cutoff score of 10 (combined sample size =5481), the pooled detection was 7.0% (95% CI = 3.9%, 10.2%). For the enriched sample, the pooled detection was 43.5 % (95% CI: 25.7%, 61.0%). Severity of depression and suicidality were significantly associated with detection.ConclusionsThe extremely low detection of depression by primary care clinicians poses a serious threat to scaling up mental healthcare in LMICs. Interventions to improve detection should be prioritized.Strength and limitation of study▸This is the first review of detection of depression in LMIC settings▸The review was comprehensive in terms of databases searched▸Screening tools were used as gold standards, which may lead to overestimation of prevalence and underestimation of detection▸The small number of studies and the use of different instruments and cutoff▸points precluded exploration of sources of heterogeneity▸The review does not include studies on distress or sub-threshold depression


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