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Conducting International Research
Prenatal alcohol exposure is a challenging issue both
in the United States and other countries around the world. Reported
prevalence rates of FAS vary widely depending on the population studied
and the research methodology used. CDC studies have documented FAS
prevalence rates ranging from 0.2 to 1.5 per 1,000 live births in
different areas of the United States. Health Canada estimates that at
least one child is born with FAS each day in Canada. An epidemiological
study (American Journal of Public Health, Volume 90, Issue 12,
1905-1912) of a South African community found rates to be 18 to 141
times greater than in the United States.
A study conducted in 2001 and reported in the MMWR
“confirmed that FAS is a serious public health problem in South Africa.”
Rates of FAS in the four communities that were studied were high.
However, the rates of FAS varied by community. Researchers noted that
the differences may be due to “differences in local drinking patterns,
alcohol availability, poverty, unemployment, health problems, and other
risk factors.”
CDC has two collaborative projects with
international partners exploring issues related to surveillance,
epidemiology, diagnosis, and prevention of FAS.
Funded Projects:
Fetal Alcohol Syndrome Surveillance and Prevention Project - Republic of
South Africa
Fetal alcohol syndrome (FAS) is a major public
health problem in South Africa. Some of the highest rates of FAS in the
world come from studies conducted among school children in South African
communities. Identifying children with prenatal alcohol exposure is one
of the many challenges in South Africa. However, providing services to
children once they are diagnosed and developing prevention and treatment
strategies for women are also critical.
CDC and the Foundation for Alcohol Related Research
(FARR), in collaboration with the National Health Laboratory Services (NHLS)
and the University of Witwatersrand (Johannesburg), are working together
to build capacity in case finding and surveillance, epidemiology, data
management and analysis, and FAS prevention in South Africa. The
purposes of this three-year cooperative agreement are to:
-
Develop
ongoing surveillance for FAS.
-
Estimate the
prevalence of FAS in South African provinces.
-
Investigate,
implement, and evaluate prevention strategies.
-
Complete
needs assessments detailing the availability and gaps in alcohol
prevention and treatment services for women and intervention services
for children.
-
Develop local
epidemiology capacity through training of key study staff.
The Danish
Medical Research Council -- Copenhagen, Denmark
While heavy alcohol use during pregnancy is known to
result in facial abnormalities, growth retardation, and serious central
nervous system deficits of the fetus, information on the levels of
alcohol exposure that result in these disabilities is extremely limited.
Information on the full range of central nervous system problems
resulting from prenatal alcohol exposure is also lacking. CDC is
partnering with the Danish Medical Research Council to explore these
issues and specifically, to examine potential central nervous system
vulnerabilities and deficits among children with varying levels of
prenatal alcohol exposure in a population-based cohort of mothers and
children.
This study will examine central nervous system
development of children with varying levels of alcohol exposure
identified through the Danish National Birth Cohort. The Danish National
Birth Cohort is a population-based cohort study of mothers and their
children in Denmark. Through a telephone survey, researchers obtained
medical information (including alcohol use) from women enrolled in the
study prior to pregnancy. Following these women through pregnancy and
birth offers the opportunity to also follow their children, who may have
been prenatally exposed to alcohol. Medical, behavioral, and
intellectual information will be gathered from these children as they
become five years old. A comparison group of children without alcohol
exposure will also be examined.
Related Publications:
Rosenthal J, Christianson A, Cordero J. Fetal
alcohol syndrome prevention in South Africa and other low-resource
countries. American Journal of Public Health
2005;95(7):1099-1101. [Abstract]
Viljoen D, Craig P, Hymbaugh K, Boyle C. Fetal
alcohol syndrome – South Africa, 2001. Morbidity and Mortality Weekly
Report 2003;52(28):660-662. [Full
text]
Kesmodel U, Wisborg K, Olsen SF, Henriksen TB,
Secher NJ. Moderate alcohol intake in pregnancy and the risk of
spontaneous abortion. Alcohol & Alcoholism 2002;37(1):87-92. [Abstract]
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