Neural tube defects are rare among black Americans but not in sub-Saharan black Africans: The case of Yaounde — Cameroon

Management of neural tube defects in a Sub-Saharan African country: The situation in Yaounde, Cameroon

“…They used to be considered as rare pathologies among blacks in general [1,18,19] but recent studies have demonstrated a higher incidence in sub-Saharan black Africans [2,3,14], compared to black Americans [18][19][20]. The prevalence varies from one service to another [6,8,10,12,13,16] according to the degree of specialisation of the hospital.…”

“…The impact of these factors is not well known in Sub-Saharan African countries where malaria is endemic, auto medication is uncontrolled and consanguineous marriages are frequent in some cultures and where antenatal folic acid supplementation is not the rule. Furthermore, in Sub-Saharan countries and other developing countries, there is no policy on the prevention of neural tube defects [2,3,[6][7][8][9][10][11][12][13][14][15] although it is well known that peri-conceptional supplementation of folic acid reduces the incidence of the neural tube defects by about 50% or more [18,[20][21][22][23]. As we have recently suggested [2], in resource-limited and developing countries such as Cameroon, prevention strategies such as folic acid supplementation are an applicable and emergent measure.…”

“…However, recent studies have revealed incidence rates of 1.99 and 7 for 1000 births respectively in Yaounde and the middle belt Nigeria [2,3]. Spina bifida, anencephaly and encephalocele are the most frequent and severe forms.…”

“…Furthermore, there is no policy to prevent these defects in Sub-Saharan Africa and other developing countries [2,3,[6][7][8][9][10][11][12][13][14][15]. More and more hospital series are being reported in Sub-Saharan Africa with many underlying difficulties in management [6,8,10,12,13,16].…”

Awareness and uptake of measures for preventing CNS birth defects among mothers of affected children in a sub-Saharan African neurosurgeon’s practice

“…Indeed, there are a number of contemporary studies from Africa which attempted to address the level of awareness of preventive measures for CNS birth defects. It is just that the sole aspect addressed by these earlier studies was about primary prevention, specifically awareness of the place of FA in this respect [15,28,29]. And, the study participants were either pregnant women in general obstetric prenatal clinics or just about any group of women in the reproductive age.…”