EPIDEMIOLOGY OF INTELLECTUAL DISABILITY IN UPPER RURAL SWAT, KHYBER PAKHTUNKHWA, PAKISTAN

Abstract

Background: Intellectual disability (ID) is a significant public health concern influenced by genetic, socioeconomic, and environmental factors. Epidemiological data from remote, high-consanguinity regions like Upper Swat, Pakistan, is limited. Objective: To investigate the epidemiology, demographics, and etiological factors of ID in Upper Rural Swat, Khyber Pakhtunkhwa, Pakistan. Methods: A cross-sectional study was conducted from December 2024 to May 2025 in Tehsil Bahrain. Data were collected from 209 clinically diagnosed participants using DSM-5 and ICD-11 criteria via snowball sampling. Statistical analysis was performed using SPSS v.27. Results: The highest prevalence was in the 10-19 years age group (38.8%). Moderate ID was most common (46.4%), followed by severe ID (30.6%). Males were significantly more affected (65.5%, p<0.001), and most cases were from rural areas (84.2%, p<0.001). Over half belonged to low-income families (54.5%, p<0.001). Parental consanguinity was a major risk factor, with 32.1% of cases from such unions; of these, 67.2% had a familial history of ID (p<0.001). Prenatal genetic disorders were the leading cause (62.2%). Conclusion: Intellectual disability in Upper Rural Swat is a substantial burden, strongly associated with consanguinity, low socioeconomic status, and rural residence. The findings underscore an urgent need for community-based genetic counseling, early screening, and targeted public health interventions.