{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T17:58:44Z","timestamp":1789063124155,"version":"build-2803163510"},"reference-count":50,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2015,5,2]],"date-time":"2015-05-02T00:00:00Z","timestamp":1430524800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Substance Abuse Directorate, Department of Social Development, Northern Cape Province, South Africa","award":["-"],"award-info":[{"award-number":["-"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Alcoholism Clin &amp;amp; Exp Res"],"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Fetal alcohol spectrum disorder (<jats:styled-content style=\"fixed-case\">FASD<\/jats:styled-content>) and fetal alcohol syndrome (<jats:styled-content style=\"fixed-case\">FAS<\/jats:styled-content>) are common in some South African populations, notably those of mixed ancestry descent in rural areas and small towns. Little is known about <jats:styled-content style=\"fixed-case\">FAS<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">FASD<\/jats:styled-content> prevalence in the majority of South Africans: city dwellers of Black African ethnicity. This study describes the prevalence of <jats:styled-content style=\"fixed-case\">FAS<\/jats:styled-content> in a South African city, comparing 2 suburbs with predominantly mixed ancestry (Roodepan) and Black African (Galeshewe) populations that house over 60% of the city population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a tiered, active case ascertainment study for the prevalence of <jats:styled-content style=\"fixed-case\">FAS<\/jats:styled-content> and also detected some less clinically specific <jats:styled-content style=\"fixed-case\">FASD<\/jats:styled-content> cases. All first\u2010grade learners in the 2 suburbs were eligible for anthropometric screening, and screen\u2010positive learners were assessed for dysmorphic features of <jats:styled-content style=\"fixed-case\">FAS<\/jats:styled-content>. Those with suggestive clinical features received neurocognitive assessment, and maternal or collateral interview. Final diagnosis was made following a case conference.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Complete ascertainment of <jats:styled-content style=\"fixed-case\">FAS<\/jats:styled-content> status was made in 1,503 (94.7%) of 1,587 eligible learners (435 in Roodepan and 1,152 in Galeshewe). Overall, <jats:styled-content style=\"fixed-case\">FAS<\/jats:styled-content> was diagnosed in 83 (5.5%, 95% <jats:styled-content style=\"fixed-case\">confidence interval [CI]<\/jats:styled-content>\u00a0=\u00a04.4 to 6.8) learners and <jats:styled-content style=\"fixed-case\">FASD<\/jats:styled-content> in 96 (6.4%, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u00a0=\u00a05.2 to 7.7). Levels of <jats:styled-content style=\"fixed-case\">FAS<\/jats:styled-content> were high in both areas: 26 (6.3%, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u00a0=\u00a04.2 to 9.2) learners from Roodepan, compared to 57 (5.2%, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u00a0=\u00a04.0 to 6.7) from Galeshewe (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.39). No cases were previously diagnosed. The mortality rate for mothers of <jats:styled-content style=\"fixed-case\">FASD<\/jats:styled-content> children from Galeshewe was 19 of 65 (29%), compared to 3 of 31 (9.7%; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.03) for Roodepan. Interviewed mothers in Galeshewe were older and had higher <jats:styled-content style=\"fixed-case\">body mass index<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Prevalence of <jats:styled-content style=\"fixed-case\">FAS<\/jats:styled-content> is high in both Galeshewe and Roodepan, and the lack of prior diagnoses indicates that awareness remains low. The maternal mortality rate was especially high in Galeshewe. The unexpectedly high burden of <jats:styled-content style=\"fixed-case\">FAS<\/jats:styled-content> in an urban area with predominantly Black African population mandates extension of surveillance and intervention measures in southern Africa.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acer.12726","type":"journal-article","created":{"date-parts":[[2015,5,2]],"date-time":"2015-05-02T06:17:27Z","timestamp":1430547447000},"page":"1016-1026","source":"Crossref","is-referenced-by-count":38,"title":["Prevalence of Fetal Alcohol Syndrome in a South African City with a Predominantly Black African Population"],"prefix":"10.1111","volume":"39","author":[{"given":"Michael F.","family":"Urban","sequence":"first","affiliation":[{"name":"Division of Molecular Biology and Human Genetics Faculty of Health Sciences University of Stellenbosch Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leana","family":"Olivier","sequence":"additional","affiliation":[{"name":"Division of Molecular Biology and Human Genetics Faculty of Health Sciences University of Stellenbosch Cape Town South Africa"},{"name":"Foundation for Alcohol Related Research (FARR) Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denis","family":"Viljoen","sequence":"additional","affiliation":[{"name":"Division of Molecular Biology and Human Genetics Faculty of Health Sciences University of Stellenbosch Cape Town South Africa"},{"name":"Foundation for Alcohol Related Research (FARR) Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chanelle","family":"Lombard","sequence":"additional","affiliation":[{"name":"Division of Molecular Biology and Human Genetics Faculty of Health Sciences University of Stellenbosch Cape Town South Africa"},{"name":"Foundation for Alcohol Related Research (FARR) Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacobus G.","family":"Louw","sequence":"additional","affiliation":[{"name":"Foundation for Alcohol Related Research (FARR) Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lian\u2010Marie","family":"Drotsky","sequence":"additional","affiliation":[{"name":"Foundation for Alcohol Related Research (FARR) Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marleen","family":"Temmerman","sequence":"additional","affiliation":[{"name":"International Centre for Reproductive Health Department of Obstetrics and Gynaecology University of Ghent Ghent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew F.","family":"Chersich","sequence":"additional","affiliation":[{"name":"International Centre for Reproductive Health Department of Obstetrics and Gynaecology University of Ghent Ghent Belgium"},{"name":"Wits Reproductive Health and HIV Research Institute Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,5,2]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/0892-0362(95)98055-6"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530-0277.2001.tb02250.x"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2010.06.014"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00038-009-0095-x"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/0376-8716(87)90041-X"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2008.08.011"},{"key":"e_1_2_8_8_1","unstructured":"Centers for Disease Control(2000)CDC clinical growth charts. 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