The epidemiology of fetal alcohol syndrome and partial FAS in a South African community.
OBJECTIVE
The prevalence and characteristics of fetal alcohol syndrome (FAS) and partial fetal alcohol syndrome (PFAS) were determined in a third primary school cohort in a community in South Africa (SA).


METHODS
An active case ascertainment, two-tier screening methodology, and the revised Institute of Medicine diagnostic criteria were employed among 818 first grade pupils. Characteristics of children with FAS and PFAS are contrasted with a randomly selected control group. Data were collected and analyzed for children in the study regarding: (1) physical growth and development, including dysmorphology, (2) intelligence and behavioral characteristics, and (3) their mother's social, behavioral, and physical characteristics.


RESULTS
The rate of FAS and PFAS in this area continues as the highest reported in any overall community and is much higher than rates elsewhere. In this cohort it is 68.0-89.2 per 1000. Severe episodic drinking on weekends among mothers of children with FAS and PFAS accounts for 96% of all alcohol consumed. Various measures of maternal drinking are significantly correlated with negative outcomes of children in the areas of non-verbal intelligence (-0.26), verbal intelligence (-0.28), problem behavior (0.31), and overall dysmorphology score (0.59). Significantly more FAS and PFAS exists among children of rural residents (OR=3.79).


CONCLUSIONS
A high rate of FAS and PFAS was again documented in this community, and it has increased. Given population similarities, we suspect that other communities in the Western Cape Province of South Africa also have high rates. Programs for prevention are needed.
May
Philip A
PA
Department of Sociology and Family and Community Medicine, The University of New Mexico, Center on Alcoholism, Substance Abuse and Addictions, 2650 Yale Blvd. SE, Albuquerque, NM 87106, USA. pmay@unm.edu
Gossage
J Phillip
JP
Marais
Anna-Susan
AS
Adnams
Colleen M
CM
Hoyme
H Eugene
HE
Jones
Kenneth L
KL
Robinson
Luther K
LK
Khaole
Nathaniel C O
NC
Snell
Cudore
C
Kalberg
Wendy O
WO
Hendricks
Loretta
L
Brooke
Lesley
L
Stellavato
Chandra
C
Viljoen
Denis L
DL
D000437:Alcoholism / Q000453:epidemiology; D002648:Child; D015331:Cohort Studies; D002658:Developmental Disabilities / Q000453:epidemiology; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D006128:Growth / Q000502:physiology; D006801:Humans; D008297:Male; D009035:Mothers; D011247:Pregnancy; D015995:Prevalence; D018401:Sample Size; D012574:Schools; D015983:Selection Bias; D013019:South Africa / Q000453:epidemiology