title: The epidemiology of fetal alcohol syndrome and partial FAS in a South African community.
abstract: 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.
authors.affiliation: 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
authors.forename: Philip A
authors.initials: PA
authors.lastname: May
authors.forename: J Phillip
authors.initials: JP
authors.lastname: Gossage
authors.forename: Anna-Susan
authors.initials: AS
authors.lastname: Marais
authors.forename: Colleen M
authors.initials: CM
authors.lastname: Adnams
authors.forename: H Eugene
authors.initials: HE
authors.lastname: Hoyme
authors.forename: Kenneth L
authors.initials: KL
authors.lastname: Jones
authors.forename: Luther K
authors.initials: LK
authors.lastname: Robinson
authors.forename: Nathaniel C O
authors.initials: NC
authors.lastname: Khaole
authors.forename: Cudore
authors.initials: C
authors.lastname: Snell
authors.forename: Wendy O
authors.initials: WO
authors.lastname: Kalberg
authors.forename: Loretta
authors.initials: L
authors.lastname: Hendricks
authors.forename: Lesley
authors.initials: L
authors.lastname: Brooke
authors.forename: Chandra
authors.initials: C
authors.lastname: Stellavato
authors.forename: Denis L
authors.initials: DL
authors.lastname: Viljoen
mesh_terms: 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