Nutritional Status and ASD Severity of Autistic Spectrum Disorder Children in Addis Ababa, Ethiopia; Case Control Study (ASD)

Assessment of Nutrient Profile, Nutritional Status, Development and Severity of Children With Autistic Spectrum Disorder in Comparison With Typically Developing Children in Addis Ababa, Ethiopia

The study conducts a case control analysis of the nutritional status and intake of autistic spectrum disorder diagnosed children as compared to typically developing children in Addis Ababa, Ethiopia. It included analysis of anthropometric measurements, three days food diary food intake, urinary iodine analysis, childhood autism rating scale diagnosis, food frequency and eating behavior questioner and proximate analysis of one day major meals of selected subjects.

Study Overview

• Status: Completed
• Conditions: Autistic Spectrum Disorder
• Intervention / Treatment: Other: Nutritional status; Behavioral: Eating behavior; Other: Urine iodine concentration; Other: Nutrient intake; Other: Dietary assessment; Other: Childhood autism rating scale

Detailed Description

Sample population was Addis Ababa city in which subjects were selected from one of the two autism centers in the country. Random sampling method was applied to select subject from the total enrolled children in the center using Ryan 2013 sample size calculation formula.

Subjects already diagnose with autistic spectrum disorder that didn't have any other chronic disease that affect diet and nutrition were included in the study. Subjects were selected randomly from each grade level in the center. They were registered and taken for data collection. Sample and Data was collected with the help of each child's center caregiver and parent. Childhood autism rating scale diagnosis, eating behavior analysis were analyzed for the ASD and anthropometric indices Z scores, urine iodine concentration, three days food diary analysis, major meals proximate analysis, food frequency and dietary diversity was assessed and compared to typically developing children in Addis Ababa.

Data entry and analysis was conducted using Emergency Nutrition Assessment software, Microsoft excel and Statistical Package for the Social Sciences software.

• Study Type: Observational
• Enrollment (Actual): 52

Contacts and Locations

Study Locations

• Ethiopia
  • Addis Ababa, Ethiopia, 0000
    • Addis Ababa Science and Technology University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 2 years to 16 years (Child, Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

The target population of this study were school-aged (i.e. 4-17 years old) children with ASD residing in Addis Ababa, Ethiopia. The study was conducted in one of the two selected autism center in Addis Ababa Ethiopia , one of the two autism centers in Ethiopia. Controls were selected from typically developing children's population of the same area as of ASD population.

Description

Inclusion Criteria:

• Children already diagnosed with ASD
• school aged children (4-18 years old)

Exclusion Criteria:

• children with chronic illnesses ( such as cancer..)
• children taking heavy medications that may affect diet and nutrition

Study Plan

How is the study designed?

Design Details

• Observational Models: Case-Control
• Time Perspectives: Prospective

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
ASD ( autistic spectrum disorder); Children already diagnosed with autistic spectrum disorder	Other: Nutritional status; Nutritional status of children as analyzed by anthropometric indices was under study; Behavioral: Eating behavior; The eating behavior of ASD children as analyzed by frequency of refusal of new food, sensitivity to food, food allergy and gastrointestinal systems was under study; Other: Urine iodine concentration; the 24 urine iodine concentration of all subjects was under study; Other: Nutrient intake; The nutrient intake as analyzed by three days food diary and major meal proximate analysis of subjects was under study; Other: Dietary assessment; The food frequency and dietary diversity of all subjects as analyzed by food frequency questioner, dietary diversity score and food variety score was under study; Other: Childhood autism rating scale; The autistic severity of ASD diagnosed children was under study as analyzed by childhood autism rating scale diagnosis
TDC (typically developing children); Children within the typically development	Other: Nutritional status; Nutritional status of children as analyzed by anthropometric indices was under study; Other: Urine iodine concentration; the 24 urine iodine concentration of all subjects was under study; Other: Nutrient intake; The nutrient intake as analyzed by three days food diary and major meal proximate analysis of subjects was under study; Other: Dietary assessment; The food frequency and dietary diversity of all subjects as analyzed by food frequency questioner, dietary diversity score and food variety score was under study

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Body Mass Index for age z-scores	Body Mass Index and age will be combined to report Body mass index for age z-score in Kg/m2 for age in months	1 day
Height for age z-scores	Height and age will be combined to report height for age z-scores in centimeter for age in months	1 day
Weight for age z-scores	weight and age will be combined to report weight for age z-scores in kg for age in months	1 day
Zinc intake using three days food diary questioner	Three days food diary questioner will be used to report intake of zinc in mg/day	5 days
Energy intake using three days food diary questioner	Three days food diary questioner will be used to report intake of energy in kcal/day	5 days
Protein intake using three days food diary questioner	Three days food diary questioner will be used to report intake of protein in gm/day	5 days
Lipid intake using three days food diary questioner	Three days food diary questioner will be used to report intake of lipid in gm/day	5 days
Carbohydrate intake using three days food diary questioner	Three days food diary questioner will be used to report intake of carbohydrate in gm/day	5 days
Calcium intake using three days food diary questioner	Three days food diary questioner will be used to report intake of calcium in mg/day	5 days
Iron intake using three days food diary questioner	Three days food diary questioner will be used to report intake of Iron in mg/day	5 days
Thiamine intake using three days food diary questioner	Three days food diary questioner will be used to report intake of Thiamine in mg/day	5 days
Vitamin C intake using three days food diary questioner	Three days food diary questioner will be used to report intake of vitamin C in mg/day	5 days
Vitamin B2 intake using three days food diary questioner	Three days food diary questioner will be used to report intake of vitamin B2 in mg/day	5 days
Niacin intake using three days food diary questioner	Three days food diary questioner will be used to report intake of niacin in mg/day	5 days
Vitamin A intake using three days food diary questioner	Three days food diary questioner will be used to report intake of vitamin A in mg/day	5 days
Urine iodine concentration of children	Urine iodine concentration of children in µg /L	2 month
Autism symptom severity of children using Childhood Autism rating Scale diagnosis	Childhood autism rating scale assessed by total raw scores by age. for age 0-12, scores of 15-29.5 indicate limited behavior related to autism, score of 30-36.5 indicate mild to moderate level of behavior related to autism, score 37-60 indicate sever level behavior related to autism. for age 13 years and older, 15-27.5 indicate limited behavior related to autism, score of 28-34.5 indicate mild to moderate level of behavior related to autism, score 35-60 indicate sever level behavior related to autism.	2 days

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
energy intake using proximate analysis of one day major meals	proximate analysis of one day major meals will be used to report intake of energy in k cal /100gm	2 months
Ash intake using proximate analysis of one day major meals	proximate analysis of one day major meals will be used to report intake of Ash in gm/100gm	2 months
Lipid intake using proximate analysis of one day major meals	proximate analysis of one day major meals will be used to report intake of lipid in gm/100gm	2 months
protein intake using proximate analysis of one day major meals	proximate analysis of one day major meals will be used to report intake of protein in gm/100gm	2 months
Carbohydrate intake using proximate analysis of one day major meals	proximate analysis of one day major meals will be used to report intake of carbohydrate in gm/100gm	1 week
frequency of food group consumption using food frequency questioner	percentage of children consuming from each food groups using a food frequency questioner	5 days
dietary diversity score of children using three days food diary	consumption of 1-3 food groups is scored as low dietary diversity score, consumption of 4-5 food groups is scored as medium dietary diversity score, consumption of >5 food groups is scored as high dietary diversity score.	5 days
frequency of food refusal in children using a questioner	frequency is scored as never to seldom, mild and sever	5 days
frequency of sensitivity to food	frequency is scored as never to seldom, mild and sever	5 days
frequency of gastrointestinal symptoms	frequency is scored as never to seldom, mild and sever	5 days
frequency of food allergic reactions	frequency is scored as never to seldom, mild and sever	5 days

Collaborators and Investigators

• Sponsor: Addis Ababa University
• Investigators: Principal Investigator: Feven Yirgu Tamire, Addis Ababa Science and Technology University

Study record dates

Study Major Dates

• Study Start (Actual): August 14, 2021
• Primary Completion (Actual): November 23, 2021
• Study Completion (Actual): February 8, 2022

Study Registration Dates

• First Submitted: August 19, 2022
• First Submitted That Met QC Criteria: August 23, 2022
• First Posted (Actual): August 25, 2022

Study Record Updates

• Last Update Posted (Actual): August 25, 2022
• Last Update Submitted That Met QC Criteria: August 23, 2022
• Last Verified: August 1, 2022

More Information

Terms related to this study

• Keywords: Nutritional status; Autistic spectrum disorder (ASD); Typically developing children (TDC); Nutrient intake; Urine Iodine; Autistic severity
• Additional Relevant MeSH Terms: Mental Disorders; Pathologic Processes; Neurodevelopmental Disorders; Disease; Autistic Disorder; Autism Spectrum Disorder; Child Development Disorders, Pervasive
• Other Study ID Numbers: AASTUASD

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: Undecided
• IPD Plan Description: Due to Ethical issue, sharing data to 3rd party is not decided yet.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No