Intergovernmental committee on Drugs working party on Fetal Alcohol Spectrum Disorders
Fetal Alcohol Spectrum Disorders in Australia: An Update
5.2 International prevalence data
The birth prevalence of FAS is high in some Indigenous populations with the highest reported prevalence from South Africa (Table 5.1). In the Western Cape studies, active ascertainment was used to identify cases in a high-risk South African community via examination of all children in the first year of school. The reported prevalence in the initial investigation was between 39 and 43 per 1,000 children aged five to nine years (May et al. 2000). When the study was repeated in the same community five years later, results indicated an alarming rise in the FAS prevalence to between 65 and 74 cases per 1,000 (Viljoen et al. 2005).
Higher prevalence has been reported in a recent study in the Northern Cape province of South Africa involving year one school children in two large towns whose parents consented (Urban et al. 2008). The study screened 1830 children, although the participation rate was not
reported. The estimated prevalence of FAS and partial FAS was 119.4 children per 1000 (95% CI 93.2-149.9) and 74.7 per 100 children (95% CI 61.0-93.3) for the two towns, respectively. The study used a two tiered screening and diagnostic method and utilised the Institute of Medicine (IOM) diagnostic criteria.
Active ascertainment has also been applied to school children in Italy, demonstrating high rates of FAS and related diagnoses (May et al. 2006). The prevalence of FAS in a province of Italy was 4 to 7 per 1,000 children and the rate of FASD was 20 to 41 per 1,000 or between two percent and four percent of all children. Similar to the South African data, a more recent study in Italy found prevalence rates substantially higher than previous estimates. In two wave study with 48% and 50% participation rates, the prevalence of FAS was reportedly between 4.0 to 12.0 per 1,000 children, partial FAS ranges from 18.1 to 46.3 per 1,000 children and the rate of FASD was between 2.3 percent and 6.3 percent of all children (May et al. 2011). Dysmorphology scores were highly correlated with drinks per current drinking day and current drinks per month.
A recent study of Croatian school students in years one to four reported an estimated prevalence of 6.44 per 1000 children for FAS and 34.33 per 1000 children for partial FAS. The estimates were based on 466 children and a 51% participation rate. The revised Institute of Medicine (IOM) diagnostic criteria was used for diagnosis (Petkovic and Barisic 2010).