PMID- 22037537
OWN - NLM
STAT- MEDLINE
DCOM- 20120817
LR  - 20220317
IS  - 1464-3502 (Electronic)
IS  - 0735-0414 (Linking)
VI  - 47
IP  - 1
DP  - 2012 Jan-Feb
TI  - Universal prevention is associated with lower prevalence of fetal alcohol 
      spectrum disorders in Northern Cape, South Africa: a multicentre before-after 
      study.
PG  - 67-74
LID - 10.1093/alcalc/agr145 [doi]
AB  - AIMS: Prevalence of fetal alcohol spectrum disorders (FASDs) is remarkably high 
      in several provinces of South Africa; yet population-level knowledge of the harms 
      of maternal drinking remains low. In two heavily affected areas, we assessed 
      effectiveness of interventions to heighten awareness of these harms and to alter 
      social norms about drinking in pregnancy. METHODS: FASD prevalence, maternal 
      knowledge and drinking behaviours were investigated in two Northern Cape Province 
      towns, before and after interventions which included highlighting FASD using 
      local media and health promotion talks at health facilities. Independently, two 
      dysmorphologists and a neuropsychometrist examined children at 9 and 18 months. 
      RESULTS: Pre-intervention maternal knowledge of alcohol harms was low and FASD 
      prevalence 8.9% (72/809). Interventions reached high coverage and knowledge 
      levels increased substantially. FASD prevalence was 5.7% post-intervention 
      (43/751; P = 0.02); 0.73 lower odds, controlling for maternal age and ethnicity 
      (95% confidence interval = 0.58-0.90). No change was detected in more severe FASD 
      forms, but in the whole population, median dysmorphology scores reduced from 4 
      [inter-quartile range (IQR) = 2-7] to 3 (IQR = 1-6; P = 0.002). CONCLUSION: This, 
      the first prevention study using FASD outcomes, suggests that universal 
      prevention might reduce FASD by  approximately 30% and have population-level effects. This 
      supports intensifying universal interventions where knowledge of harms of 
      maternal drinking is low. These efforts need to be accompanied by 
      alcohol-dependence treatment to lower more severe FASD forms.
FAU - Chersich, Matthew F
AU  - Chersich MF
AD  - Centre for Health Policy, School of Public Health, Faculty of Health Sciences, 
      University of the Witwatersrand Johannesburg, South Africa. 
      matthew.chersich@wits.ac.za
FAU - Urban, Michael
AU  - Urban M
FAU - Olivier, Leana
AU  - Olivier L
FAU - Davies, Leigh-Anne
AU  - Davies LA
FAU - Chetty, Candice
AU  - Chetty C
FAU - Viljoen, Denis
AU  - Viljoen D
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, P.H.S.
DEP - 20111027
PL  - England
TA  - Alcohol Alcohol
JT  - Alcohol and alcoholism (Oxford, Oxfordshire)
JID - 8310684
SB  - IM
MH  - Adult
MH  - Alcohol Drinking/adverse effects/epidemiology/*prevention & control
MH  - Cohort Studies
MH  - Female
MH  - Fetal Alcohol Spectrum Disorders/*epidemiology/*prevention & control
MH  - *Health Knowledge, Attitudes, Practice
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Male
MH  - Maternal Behavior/psychology
MH  - Patient Education as Topic/*methods
MH  - Pregnancy
MH  - Prenatal Exposure Delayed Effects/epidemiology/prevention & control
MH  - Prevalence
MH  - South Africa/epidemiology
MH  - Young Adult
EDAT- 2011/11/01 06:00
MHDA- 2012/08/18 06:00
CRDT- 2011/11/01 06:00
PHST- 2011/11/01 06:00 [entrez]
PHST- 2011/11/01 06:00 [pubmed]
PHST- 2012/08/18 06:00 [medline]
AID - agr145 [pii]
AID - 10.1093/alcalc/agr145 [doi]
PST - ppublish
SO  - Alcohol Alcohol. 2012 Jan-Feb;47(1):67-74. doi: 10.1093/alcalc/agr145. Epub 2011 
      Oct 27.