The frequency and distribution of neural tube defects (NTDs) in Arthur Davison Children Hospital (ADCH) (original) (raw)
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Profiling Children with Neural Tube Defects at the University Teaching Hospital, Lusaka, Zambia
2018
Background: Neural tube defects (NTDs) are the world’s second most common birth defects after cardiovascular defects. In developing countries like Zambia, these defects are unrecognized and under reported. Therefore, the aim of this study was to determine the profile of children with NTDs at the University Teaching Hospital (UTH) in Lusaka. Methodology: A retrospective review of medical records of children with NTDs who were admitted at the UTH between January and December, 2010 was done. Data was collected using a data extraction sheet and descriptive analysis was done using Statistical Package for Social Science (SPSS) version 20. Results: A total of 101 patients with NTDs were identified from the 2010 patients’ register and out of these, only 50 medical records were located, which constituted the study sample. The sample had more boys (58%) than girls (42%). The majority of the children were from Lusaka province with 28%, while the minority were from North-Western and Copperbelt ...
Neural tube defects in Uganda: follow-up outcomes from a national referral hospital
Neurosurgical Focus
OBJECTIVEChildren with neural tube defects (NTDs) require timely surgical intervention coupled with long-term management by multiple highly trained specialty healthcare teams. In resource-limited settings, outcomes are greatly affected by the lack of coordinated care. The purpose of this study was to characterize outcomes of spina bifida patients treated at Mulago National Referral Hospital (MNRH) through follow-up phone surveys.METHODSAll children presenting to MNRH with NTDs between January 1, 2014, and August 31, 2015, were eligible for this study. For those with a documented telephone number, follow-up phone surveys were conducted with the children’s caregivers to assess mortality, morbidity, follow-up healthcare, and access to medical resources.RESULTSOf the 201 patients, the vast majority (n = 185, 92%) were diagnosed with myelomeningocele. The median age at presentation was 6 days, the median length of stay was 20 days, and the median time to surgery was 10 days. Half of the ...
Demographics, referral patterns and outcome of neural tube defect patients in Southwestern Uganda
Research Square (Research Square), 2023
In Uganda, the burden of neural tube defects (NTDs) poses a serious neurosurgical and public health challenge; however, published data on this patient population is lacking. We sought to characterize the NTD patient population, maternal characteristics, referral patterns of these patients, and quantify the burden of NTDs in Southwestern Uganda. Methods A retrospective neurosurgical database at a referral hospital was reviewed to identify all patients with neural tube defects treated between 08/2016 and 05/2022. Descriptive statistics were used to characterize the patient population and maternal risk factors. Results 232 patients were identi ed (121 male, 52.2%). Median age at presentation was 2 days (IQR: 1-8). 86.8% of NTD patients presented with spina bi da (n = 204) and 31 with encephalocele (13.2%). The most common location of dysraphism was lumbosacral (n = 180, 88%). Median length of stay was 12 days (IQR: 7-19). One-third of all patients presented from Isingiro, Mbarara, and Kasese. The median maternal age was 26 years (IQR: 22-30). The majority of mothers received only primary education (n = 100, 43.7%). The majority of mothers reported prenatal folate use (n = 158, 67.2%) and regular antenatal care (ANC) (n = 220, 93.6%), although only 23.4% underwent an antenatal ultrasound (n = 55). Of all patients, 80% were delivered vaginally (n = 188). Overall, 67.4% of patients were discharged (n = 157) and 10% died (n = 23). Conclusions This is the rst study to describe the NTD patient and maternal population in Southwestern Uganda. A prospective case-control study is necessary to identify unique demographic and genetic risk factors associated with NTDs in this region.
The Pan African medical journal, 2014
Neural tube defects such as anencephaly, spina bifida, and encephalocele are congenital anomalies of the central nervous system. Data on the prevalence of neural tube defects in Kenya are limited. This study characterizes and estimates the prevalence of spina bifida and encephalocele reported in a referral hospital in Kenya from 2005-2010. Cases were defined as a diagnosis of spina bifida or encephalocele. Prevalence was calculated as the number of cases by year and province of residence divided by the total number of live-births per province. From a total of 6,041 surgical records; 1,184 (93%) had reported diagnosis of spina bifida and 88 (7%) of encephalocele. Estimated prevalence of spina bifida and encephalocele from 2005-2010 was 3.3 [95% Confidence Interval (CI): 3.1-3.5] cases per 10,000 live-births. The highest prevalence of cases were reported in 2007 with 4.4 (95% CI: 3.9-5.0) cases per 10,000 live-births. Rift Valley province had the highest prevalence of spina bifida and...
The prevalence of neural tube defects in North-West Nigeria
Background: Neural tube defects (NTDs) consist of a variety of central nervous system abnormalities, most of which result from a lack of closure of the neural tube. Aims and Objectives: The study aimed to determine the prevalence of NTDs among women delivering in the labor room suites of a tertiary health institution in North-Western Nigeria. Subjects and Methods: This was a 3-year prospective study carried out in the Department of Obstetrics and Gynecology in association with the Department of Pediatrics. All neonates delivered in the labor rooms were examined for NTDs soon after birth. Those diagnosed with NTDs were admitted into the special care baby unit for observation and documentation. Results: There were 10, 163 deliveries and NTDs were present in 22 cases, thus giving a prevalence of 2.2/1000 deliveries. The common types of NTDs were spina bifida 72.7% (16/22), anencephaly 22.7% (5/22), and encephalocele 4.6%. There was a preponderance of females, with a female to male ratio of 1.4:1. Hydrocephalus was the most common associated anomaly 36.4% (8/22). The mothers were mainly within the age range of 20-35 years 59.1% (13/16), parity 2 or more and of low-socioeconomic status. Diagnoses were made by antenatal ultrasonography 50% (11/22) and clinically (50%) after delivery. The perinatal mortality was 81.8% (18/22). Conclusion: The prevalence of NTDs in this study is in consistent with literature. Improvement in maternal nutrition and antenatal folate intake is recommended. ABSTRACT [Downloaded free from http://www.saudijhealthsci.org on Friday, March 9, 2018, IP: 105.112.22.253]
Introduction: Several congenital malformations affect developing fetuses, among which Neural tube defect (NTD) is most common. Folic acid supplementation brought decline in the incidence of NTDs. The present study aims at finding the incidence of NTDs in a tertiary care hospital and compares the results with the similar Indian studies published earlier. Materials and Methods: The study was done at Chettinad Hospital & Research Institute (CHRI), Kelambakkam. The total number of deliveries was recorded for a period of five years from 2009 to 2013. Fetuses which were still born with neural defect were collected and observed in detail externally for the sex, type of NTD and other associated anomalies. Indian studies published between 1987 and 2014 reporting the incidence of NTDs among the births occurred were retrieved from the Internet and their various observations were used for comparison. R esults: The number of deliveries conducted between 2009 and 2013 at CHRI was 3220. Of these, babies born with NTDs were nine (5 males and 4 females). The incidence of fetuses with meroanencephaly, holoanencephaly, craniorachischisis, encephalocele and myelocele were 0.62, 0.62, 0.93, 0.31 and 0.31 per 1000 births respectively. Overall incidence of NTDs in the present study was 2.79/1000 births. Fetuses with NTDs also had the following anomalies – Club foot, cleft lip and palate and exomphalos. C onclusion: Comparing the results with the previous studies it is clearly evident that the incidence of NTDs have significantly reduced from 11.42/1000 births to 2.79/1000 births. In most of the previous studies NTDs had a female preponderance whereas present study has a male preponderance.In older studies, spina bifida was the most common NTDs followed by anencephaly. But in the present study anencephaly was the common NTD than spina bifida. Incidence of NTDs has reduced due to various reasons like prenatal screening for fetal anomalies and folic acid supplementation.
Magnitude and determinants of neural tube defect in Africa: a systematic review and meta-analysis
BMC Pregnancy and Childbirth, 2021
Background: Neural tube defects (NTDs) are a group of disorders that arise from the failure of the neural tube close between 21 and 28 days after conception. About 90% of neural tube defects and 95% of death due to these defects occurs in low-income countries. Since these NTDs cause considerable morbidity and mortality, this study aimed to determine the prevalence and associated factors of NTDs in Africa. Methods: The protocol of this study was registered in the International Prospective Register of Systematic Reviews (PROSPERO number: CRD42020149356). All major databases such as PubMed/MEDLINE, EMBASE, CINAHL, Web of Science, African Journals Online (AJOL), and Google Scholar search engine were systematically searched. A randomeffect model was used to estimate the pooled prevalence of NTDs in Africa, and Cochran's Q-statistics and I 2 tests were used to assess heterogeneity between included studies. Publication bias was assessed using Begg 's tests, and the association between determinant factors and NTDs was estimated using a random-effect model. Results: Of the total 2679 articles, 37 articles fulfilled the inclusion criteria and were included in this systematic review and meta-analysis. The pooled prevalence of NTDs in Africa was 50.71 per 10,000 births (95% CI: 48.03, 53.44). Folic acid supplementation (AOR: 0.40; 95% CI: 0.19-0.85), maternal exposure to pesticide (AOR: 3.29; 95% CI: 1.04-10.39), mothers with a previous history of stillbirth (AOR: 3.35, 95% CI: 1.99-5.65) and maternal exposure to x-ray radiation (AOR 2.34; 95% CI: 1.27-4.31) were found to be determinants of NTDs. Conclusions: The pooled prevalence of NTDs in Africa was found to be high. Maternal exposure to pesticides and x-ray radiation were significantly associated with NTDs. Folic acid supplementation before and within the first month of pregnancy was found to be a protective factor for NTDs.
Hindawi International Journal of Pediatrics, 2023
Background. Neural tube defects are a type of congenital anomaly caused by an abnormality in the development of the brain and spinal cord during embryogenesis. They cause high rates of mortality, morbidity, and lifelong disability. There are several studies carried out worldwide reporting different findings on the burden and associated factors. The aim of this study is to carry out a systematic review and meta-analysis of the burden of neural tube defects and their associated factors in Africa. Methods. A total of 58 eligible articles were identified systematically using databases such as PubMed, Embase, African Journal Online Library, ProQuest, Cochrane, Google Scopus, Google Scholar, and Grey literature. Extracted data were analyzed using STATA 16.0 statistical software. The heterogeneity of studies was determined using the Cochrane Q test statistic and I 2 test statistics with forest plots. A random effects model was used to examine the pooled burden of neural tube defects, subgroups of the region, subtypes of NTDs, sensitivity analysis, and publication bias. The association between NTDs and associated factors was studied using a fixed-effect model. Results. Fifty-eight studies with a total of 7,150,654 participants in 16 African countries revealed that the pooled burden of neural tube defects was 32.95 per 10,000 births (95% CI: 29.77-36.13). The Eastern African region had the highest burden in the subgroup analysis, with 111.13 per 10,000 births (95% CI: 91.85-130.42). South African countries had the lowest burden, at 11.43 per 10,000 births (95% CI: 7.51-15.34). In subtype analysis, spina bifida had the highest pooled burden at 17.01 per 10,000 births (95 percent CI: 15.00-19.00), while encephalocele had the lowest at 1.66 per 10,000 births (95% CI: 1.
South African Medical Journal
Neural tube defects (NTDs) include anencephaly, encephalocele and spina bifida (SB). Anencephaly is a lethal condition, whereas encephalocele and SB, which may cause long-term disability, are a considerable burden to families and the healthcare system, [1,2] and are relatively common birth defects. In South Africa (SA), studies give estimated population prevalence rates of 0.99-3.8 per 1 000 live-born infants. [3-6] Folic acid supplementation in the peri-conceptional period [7] or fortification of staple foods [8] has been shown to reduce the prevalence of NTDs. In SA, the introduction of folic acid fortification of maize and wheat products in 2003 was associated with a 31% reduction in NTD prevalence at sentinel sites, from 1.41 to 0.98/1 000 births. [9] Another preventive option is prenatal diagnosis by ultrasound, with the choice of termination of pregnancy (TOP), which has become increasingly available in parts of SA. Despite these changes, there are minimal data on NTD prevalence after 2003. Effective surveillance of NTDs and other birth defects is important for various reasons, e.g. to establish burden of disease, monitor trends in birth prevalence, assess impact of preventive measures and detect outbreaks. The last role is highlighted by the recent link between maternal Zika virus infection and microcephaly in offspring, [10] and the possible link between maternal use of the antiretroviral drug dolutegravir and NTDs. [11] The National Department of Health (NDoH) has a populationbased birth defect surveillance system, which appears to be ineffective. [12] Hospital-based surveillance is an easier alternative, but less optimal because of lack of a defined denominator. It therefore works best where it captures most of the population of interest in a geographical region. [13] We anticipated this to be largely true in Western Cape Province, SA, for NTDs, or at least for SB, given that both prenatal diagnosis and paediatric management are centralised at tertiary hospitals with defined catchment areas. Furthermore, most NTDs are readily visible at birth. We therefore aimed to assess the detection of NTDs at a tertiary hospital using a range of prenatal, perinatal and postnatal data sources, and to estimate the impact of prenatal diagnosis and birth prevalence for the referral area. Methods The study was conducted at Tygerberg Academic Hospital (TAH), a tertiary public hospital in the Western Cape. It is a referral centre for This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.