Estimating the burden of neural tube defects in low– and middle–income countries

Abstract

Background To provide an estimate for the burden of neural tube defects (NTD) in low– and middle–income countries (LMIC) and explore potential public health policies that may be implemented. Although effective interventions are available to prevent NTD, there is still considerable childhood morbidity and mortality present in LMIC. Methods A search of Medline, EMBASE, Global Health Library and PubMed identified 37 relevant studies that provided estimates of the burden of NTD in LMIC. Information on burden of total NTD and specific NTD types was separated according to the denominator into two groups: (i) estimates based on the number of live births only; and (ii) live births, stillbirths and terminations. The data was then extracted and analysed. Results The search retrieved NTD burden from 18 countries in 6 WHO regions. The overall burden calculated using the median from studies based on livebirths was 1.67/1000 (IQR = 0.98–3.49) for total NTD burden, 1.13/1000 (IQR = 0.75–1.73) for spina bifida, 0.25/1000 (IQR = 0.08–1.07) for anencephaly and 0.15/1000 (IQR = 0.08–0.23) for encephalocele. Corresponding estimates based on all pregnancies resulting in live births, still births and terminations were 2.55/1000 (IQR = 1.56–3.91) for total NTD burden, 1.04/1000 (IQR = 0.67–2.48) for spina bifida, 1.03/1000 (IQR = 0.67–1.60) for anencephaly and 0.21 (IQR = 0.16–0.28) for encephalocele. This translates into about 190 000neonates who are born each year with NTD in LMIC. Conclusion Limited available data on NTD in LMIC indicates the need for additional research that would improve the estimated burden of NTD and recommend suitable aid policies through maternal education on folic acid supplementation or food fortification.

Estimates of global and regional prevalence of neural tube defects for 2015: a systematic analysis

“…The review sought to include publications with data collection after 2000. Three recent systematic reviews summarized the available data on birth prevalence of one or more subgroups of NTDs in LMICs (Table ) . Though each of these applied different inclusion criteria, overall they provided a comprehensive review of the literature, and it was assumed that these search strategies captured all relevant published studies relating to NTD prevalence in LMICs.…”

From disability to ability: comprehensive rehabilitation providing a holistic functional improvement in a child with neglected neural tube defect

“…The situation is worse in developing countries with poor socioeconomic status where not only the incidence of neural tube defects is higher, but also a major cause of health problems in surviving children 1. The social and economic impact of this disease is not well documented.…”

Effects of the popular food additive sodium benzoate on neural tube development in chicken embryo

“…The best known risk factor for fetal NTD is maternal folate deficiency (1,8). Other risk factors for NTD development include a positive family history, smoking and air pollution (3,10).…”

“…Neural tube defects (NTD) are congenital malformations of the central nervous system and they occurred as a result of incomplete closure of the neural tube in between the 3rd and 4th weeks of pregnancy (1,8). The worldwide incidence of NTD ranges from 1.0 to 10.0 per 1000 births (8).…”

“…The worldwide incidence of NTD ranges from 1.0 to 10.0 per 1000 births (8). Of 300 children that are born every year with NTD, survivors remain with lifelong disability (10).…”