c o n d u c t i n g    i n t e r n a t i o n a l    r e s e a r c h

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.” Click the following link for this MMWR article: FETAL ALCOHOL SOUTH AFRICA – 2001 ARTICLE.

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.