High burden of neural tube defects in Tigray, Northern Ethiopia: Hospital-based study (original) (raw)
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PLOS ONE, 2022
Background Neural tube defect (NTD) is a structural defect of the central nervous system of the developing embryo during the first month of developmental process. Most congenital malformations are potentially preventable cause of perinatal morbidity and mortality. Worldwide, around 10% of infant mortalities are due to nervous system defects. In Ethiopia there are limited published data regarding the prevalence and established preventive strategy of NTDs. The purpose of this study was to assess the prevalence of NTDs among pregnancy outcomes in Debre Berhan Referral Hospital (DBRH), Ethiopia. Methods Hospital based retrospective cross sectional, descriptive study was conducted on registration of all pregnancy outcomes from August 30, 2017 to August 30, 2019 at DBRH, Ethiopia. The collected data were checked for completeness and consistencies, and cleaned, coded and entered using Epi data version 4.2 and exported to Statistical Package for Social Sciences (SPSS) software version 20 fo...
Frontiers in Pediatrics, 2022
BackgroundNeural tube defects are severe congenital malformations secondary to an abnormal closure of the neural tube between third and fourth weeks of gestational ages. Neural tube defects affect birth outcomes worldwide, with an occurrence of 18.6 per 10,000 live births. In addition, neural tube defects are associated with considerable mortality, morbidity, disability, and socio-economical cost.ObjectiveTo identify factors associated with neural tube defects among newborns delivered at Debre Berhan Comprehensive Specialized Hospital, 2021.MethodsFacility-based case-control study design was conducted among 381 (127 cases and 254 controls) newborns delivered from June 2019 to June 2021 at Debre Berhan Specialized Hospital. Consecutive and systematic random sampling techniques were used to select cases and controls, respectively. Data were collected using semi-structured checklists. Finally, data were entered using Epidata version 4.2.1 and analyzed using SPSS version 25. In the biva...
PLoS ONE, 2021
Introduction Neural tube defects affect the brain and the spinal cord of the developing embryo. The defects occur due to incomplete or failure of closure of the neural tube. The condition eventually causes death and lifelong disability. Worldwide, more than 300,000 babies are born with neural tube defects each year. The highest burden is in low- and middle-income countries. Therefore, this study aims to identify the risk factors associated with neural tube defects among mothers who gave birth in North Shoa Zone Hospitals. Methods A hospital based unmatched case-control study was conducted among 243 (81 cases and 162 controls) study participants in North Shoa Zone Hospitals. The hospitals were selected using simple random sampling and all cases and randomly selected controls in the selected hospitals were included in the study. The data were collected by using pre-tested structured questionnaire. Results Different factors were identified to have association with neural tube defect. F...
Determinants of neural tube defects among newborns in public referral hospitals in Eastern Ethiopia
BMC Nutrition
Background Neural tube defects (NTDs) are serious brain and spine birth defects. Although NTDs are primarily pregnancy complications, such as abortion and stillbirth, they also contribute to under-five morbidity and mortality, as well as long-term disability and psychological impact. Despite these negative outcomes, the determinants of NTDs are not widely studied in Ethiopia, particularly in the country’s east. As a result, we sought to identify the risk factors for NTDs in neonates born in public referral hospitals in eastern Ethiopia. Methods A facility-based unmatched case-control study was carried out at Hiwot Fana Comprehensive Specialized Hospital and Sheik Hassen Yabare Jigjiga University Referral Hospital in Eastern Ethiopia. We included 59 cases identified in the selected facilities between September 10, 2021, and February 5, 2022, and 118 control neonates, with a case-to-control ratio of 1:2. Data were gathered through the use of interviewer-administered questionnaires and...
Maternal risk factors associated with neural tube defects in Tigray regional state of Ethiopia
Brain and Development, 2019
Introduction: Unlike developing countries, including Ethiopia the identification of the risk factors in decreasing the burden of neural tube defects (NTDs) is well established in the developed world. Hence, we sought to determine the factors associated with NTDs in Tigray-Ethiopia. Methods: We undergo a case-control analysis where all NTDs cases were compared to a group of controls derived randomly from the same hospitals where cases were recruited from. The NTDs survey tool which contains a standard questionnaire was prepared. Parental socio-demographic and clinical information such, maternal age, obstetric history, illnesses, drug intake, radiation, occupation, education, history of congenital anomalies, residence, exposure to pollutants such as smoking, chemicals, paternal history, and folic acid utilization was collected and analyzed using SPSS version 20. Result: This study has shown the maternal age, and residency, birth order 3 and 4, unplanned pregnancy, history of breastfeeding above 2 years, history of stillbirths, history of male gender predominance were found to have a strong association with an occurrence of NTDs (p = 0.0001). Though the binary logistic regression analysis showed no significant association in some of the risk factors such as maternal health and drug history, the frequency analysis showed they may have an impact on the incidence of NTDs. Conclusion: This study has shown the majority of the maternal risk factors and other lifestyle patterns had a significant impact on the occurrence of NTDs. Therefore, efficient monitoring of NTDs in Ethiopia is vital, so our study could be groundwork information in Ethiopia for future programs.
Science Journal of Public Health
Neural Tube Defects (NTDs) are congenital structural abnormalities of the brain (anencephaly) and vertebral column (spina bifida) that represented as one of the most common congenital malformations of neonates worldwide. A fouryear and eight months (January 1 st , 2007 to August 31 st , 2011) retrospective record review study on prevalence, trend, and associated demographic factors of NTD was conducted at Orotta National Referral Maternity Hospital, Asmara, Eritrea. The prevalence, trend and associated demographic factors were assessed by data extraction from hospital delivery register and patient cards. Associations between variables of maternal age, parity, and infant gender and primary outcomes were determined using χ 2 analyses and Poisson regression modeled cumulative incidence and controlled for confounders. Out of 39, 803 total deliveries 185 neonates were found to have NTDs related abnormalities, but 156 neonates identified with complete and welldocumented registers, medical records and charts showing a prevalence of 3.9 per 1000 deliveries. The most commonly identified NTDs were Anencephaly 75(48.1%), Hydrocephalus 29 (18.6%), Spina bifida 27 (17.3%), and Multiple NTDs 25 (16.0%). Marital status, ethnicity, religion, and maternal history of abortion were found to have no enough evidence, but women who delivered neonates with NTDs who had parity less than four 125 (80.1%) and age below 30 years 108 (69.2%)were observed to have higher chances. All the Anencephalic neonates were delivered by vaginal delivery, Majority (66 (88%)) with a weight of less than 2000 grams and were female by sex 55(74.3%); whereas 13(44.8%) Hydrocephalic neonates were delivered by Caesarian section and 26 (92.9%) had a weight greater than 2000 grams. The Appearance Pulse Grimace Activity Respiration(APGAR) score results were founded to be zero for all anencephalic neonates and for 17 (74%) of multiple NTD; while 40 percent of and 46 percent of neonates with spina bifida and hydrocephalus, respectively, had no APGAR at five minutes. Over the years of the study a significant increase in the trend of NTDs were observed, mainly that of anencephaly. The increase was 1.5 percent (p < 0.05). The results of Poisson analysis indicated an exceptional statistically significant increase of anencephaly only. The trend of NTDs in neonates was observed to increase significantly, mainly anencephaly. The study findings noted younger women (less than 30 years) and with parity less than four were at higher risk than those of older age and higher parity. NTDs can be prevented and reduced with folic acid supplementation and fortification of principal foods.
Global Pediatric Health
Background: Neural tube defects are a major public health problem and substantially contribute to morbidity and mortality, particularly in low-income countries, including Ethiopia. There are a paucity of data on the magnitude and associated factors of neural tube defects in Ethiopia, particularly in the study setting. Objective: This study aimed to assess the magnitude of neural tube defects and associated factors among neonates admitted to the neonatal intensive care unit in Hiwot Fana Specialized University Hospital, Harar, Ethiopia. Methods: A hospital-based cross-sectional study was employed from October 2019 to January 2020. A total of 420 newborn-mother pairs were included consecutively. Data were collected using a face-to-face interviewer-administered questionnaire and clinical examination. Data were entered into Epi Data version 3.1 and analyzed using the statistical package for Social Sciences version 20.0 software. An adjusted odds ratio (AOR) with 95% confidence interval ...
Background: A neural tube defect is a form of congenital malformation that can occur in the early embryonic period and result in child morbidity and mortality. Little emphasis is given to congenital anomalies, especially neural tube defects, which are significant causes of child death. Ethiopia is one of the countries with a high estimated prevalence of neural tube defects. So, identifying factors contributing to it would be significant for planning risk reduction and preventive strategies. Therefore this study aimed to identify determinants of neural tube defects among neonates admitted to neonatal intensive care units. Methods: A hospital-based, unmatched case control study was conducted on 104 cases and 208 controls selected from neonatal intensive care units of teaching hospitals in Gedeo Zone and Sidama Region, southern Ethiopia. All neural tube defect cases admitted at the time of the data collection period were included, and controls were selected using a simple random sampli...
Child's Nervous System
Purpose The primary aim of this study was to estimate the prevalence of NTDs at ultrasound examination in communities of Addis Ababa and secondarily to provide a description of the dysmorphology of the NTD cases. Methods We enrolled 958 pregnant women from 20 randomly selected health centers in Addis Ababa during the period from October 1, 2018, to April 30, 2019. Of these 958 women, 891 had an ultrasound examination after enrollment, with a special focus on NTDs. We estimated the prevalence of NTDs and compared it with previously reported hospital-based birth prevalence estimates from Addis Ababa. Results Among 891 women, 13 had twin pregnancies. We identified 15 NTD cases among 904 fetuses, corresponding to an ultrasound-based prevalence of 166 per 10,000 (95% CI: 100–274). There were no NTD cases among the 26 twins. Eleven had spina bifida (122 per 10,000, 95% CI: 67–219). Among the 11 fetuses with spina bifida, three had a cervical and one had a thoracolumbar defect while the an...
BMC pediatrics, 2024
Background Neural tube defects (NTDs) account for the largest proportion of congenital anomalies of the central nervous system and result from failure of the neural tube to close spontaneously between the 3rd and 4th weeks of in utero development. Prognosis and treatment outcome depends on the nature and the pattern of the defect. The nature of treatment outcomes and its pattern associated with grave prognosis is not well known in the study area. Objective The aim of study was to determine the patterns and short term neurosurgical management outcomes of newborns with neural tube defects admitted at Felege Hiwot Specialized Hospital. Methods Institutional based retrospective cross-sectional study among neonates, who were admitted at Felege Hiwot Specialized Hospital with neural tube defects from January 1 st to December, 30 th , 2018 was conducted. All Charts of Neonates with confirmed diagnosis of neural tube defects were included as part of the study. Trained data collectors (medical interns) supervised by trained supervisors (general practitioners) collected the data using a pretested data extraction format. Data were coded, entered and analyzed using SPSS version 23 software. Frequency and cross tabulations were used to summarize descriptive statistics of data, and tables and graphs were used for data presentation. Result About 109 patients had complete documentation and imaging confirmed neural tube defects. Myelomeningocele was the commonest pattern 70 (64.2%). Thoracolumbar spine was the commonest site of presentation 49(45%). The most common associated impairment was hydrocephalus 37(33.9%). Forty-five (41.1%) had multiple complications. The mortality rate was 7.3%, 44% were discharged with sequalae and 36.7% were discharged without impairment. The significant causes of death were infection 66.7% and Chiari crisis 33.3%. Myelomeningocele was the most frequent clinical pattern of neural tube defect and thoracolumbar spine was the commonest site. Isolated neural tube defect was the commonest finding. There were multiple complications after surgery accompanied with meningitis and hydrocephalus. The mortality rate among neonates with neural tube defects was considerably high. The commonest causes of death were infection and Chiari crisis.