The Global Burden of Neural Tube Defects and Disparities in Neurosurgical Care

Yacob, Alex; Carr, Christopher J.; Foote, Jake; Scullen, Tyler; Werner, Cassidy; Mathkour, Mansour; Bui, Cuong J.; Dumont, Aaron S.

doi:10.1016/j.wneu.2021.01.096

Cited by 13 publications

(5 citation statements)

References 30 publications

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“…Accordingly, the country is aligned with the Sustainable Development Goals of the 2030 Agenda [ 60 ], which focuses on improving nutritional status and reducing inequalities among populations worldwide. Finally, we expect efforts dedicated to enhance the primary prevention of NTDs and provide adequate health actions and services to individuals with NTDs, especially easily accessible neurology services in all regions of Brazil [ 53 , 61 ].…”

Section: Discussionmentioning

confidence: 99%

Prevented cases of neural tube defects and cost savings after folic acid fortification of flour in Brazil

Rodrigues

Silva

Santos³

et al. 2023

PLoS ONE

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Anencephaly, encephalocele, and spina bifida are congenital neural tube defects and are the main causes of neonatal morbidity and mortality and impose a heavy economic burden on health systems. This study to estimates the direct costs of neural tube defects from the perspective of the Brazilian Ministry of Health, and the prevented cases and cost savings during the period in which mandatory folic acid fortification was in effect in the country (2010–2019). It is a top-down cost-of-illness oriented study based on the prevalence of the disorders in Brazil. Data were collected from the Brazilian Ministry of Health’s outpatient and hospital information system databases. The direct cost was estimated from the total patient-years, allocated by age and type of disorder. Prevented cases and cost savings were determined by the difference in the prevalence of the disorders in the pre- and post-fortification periods based on the total number of births and the sum of outpatient and hospital costs during the period. The total cost of outpatient and hospital services for these disorders totaled R$ 92,530,810.63 (Int$ 40,565,896.81) in 10 years; spina bifida accounted for 84.92% of the total cost. Hospital costs were expressive of all three disorders in the first year of the patient’s life. Between 2010 and 2019, mandatory folic acid fortification prevented 3,499 live births with neural tube defects and resulted in R$ 20,381,586.40 (Int$ 8,935,373.25) in hospital and outpatient cost savings. Flour fortification has proved to be a valuable strategy in preventing pregnancies with neural tube defects. Since its implementation, there has been a 30% decrease in the prevalence of neural tube defects and a 22.81% decrease associated in hospital and outpatient costs.

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Section: Discussionmentioning

confidence: 99%

Prevented cases of neural tube defects and cost savings after folic acid fortification of flour in Brazil

Rodrigues

Silva

Santos³

et al. 2023

PLoS ONE

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Section: Background and Rationalementioning

confidence: 99%

“…(2) There exists a paucity of data on NTDs in the LMICs; however, Yacob et al (2021) showed that countries with the highest years lived in disability and death rates due to NTDs were the lowest gross domestic product (GDP) quartile. (3) Surgical treatment for neural tube defects in LMICs is riddled with complexity, high costs, and the limits of a low neurosurgical and multidisciplinary workforce. (4)(5)(6) Public health programs educating women of reproductive age of folic acid importance are almost absent, hence the rising trend of NTDs.…”

Section: Background and Rationalementioning

confidence: 99%

“…(1) Salari et al, 2021 estimate the average prevalence rate of spina bifida and anencephaly as 20 cases per 100,000 live births worldwide. (2) There exists a paucity of data on NTDs in the LMICs; however, Yacob et al (2021) showed that countries with the highest years lived in disability and death rates due to NTDs were the lowest gross domestic product (GDP) quartile. (3) Surgical treatment for neural tube defects in LMICs is riddled with complexity, high costs, and the limits of a low neurosurgical and multidisciplinary workforce.…”

Section: Background and Rationalementioning

confidence: 99%

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Assessing Folic Acid Supplementation Adherence Among Pregnant Women in LMICs and its Impact on Neural Tube Defect Incidence: A Systematic Review Protocol

Daniel,

Sulaiman,

Isiakpona

et al. 2023

Preprint

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IntroductionNeural tube defects (NTDs) are treatable but incurable birth defects, causing permanent disability and potential mortality if neglected. Despite its global significance, there has not been any systematic review exploring the link between folic acid adherence and NTD incidence in low-and-middle-income countries (LMICs), where its impact is disproportionately felt. This systematic review primarily aims to analyze the impact of folic acid supplementation adherence among expectant mothers on the incidence of NTDs in LMICs.Methods and AnalysisFollowing the PRISMA guidelines, we will conduct a comprehensive search of original research articles and observational studies using the electronic databases of PubMed, Scopus, Medline, and Embase from inception till date. Our search comprises keywords related to our PICO framework and objectives. We will analyze data using tables and diagrams for qualitative presentation and conduct a random-effect Bayesian meta-analysis when applicable.Two reviewers will screen titles and abstracts independently, conduct full-text reviews, and extract study data. In case of disagreements, a third reviewer will resolve them. We will present study details and assess bias risk. We will also assess the overall certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation framework.Ethics and DisseminationEthical approval is unnecessary as this study involves a systematic review of published studies. We aim to publish our findings in a peer-reviewed journal.

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“…Neural tube defects (NTDs) are congenital malformations that occur in the development of the central nervous system during embryonic period [ 1 ]. Neural tube formation is central issue to developmental biology with the closure being dependent on the methionine cycle and folate cycle [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Determinants of neural tube defects among women who gave birth in hospitals in Eastern Ethiopia: evidence from a matched case control study

Berhane,

Belachew

2023

BMC Women's Health

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Introduction Neural tube defects (NTDs) are severe birth defects caused by nutritional, genetic or environmental factors. Because NTDs continue to have a significant health and economic impact on children and community at large, it is crucial to investigate potential risk factors in order to develop novel approaches to NTDs prevention. Determinants for the development of NTDs differ by country, region as well as within the country. The objective of this study was to identify the determinants of NTDs among newborns delivered in three hospitals found in eastern Ethiopia. Methods A hospital-based matched case-control study was conducted among 138 cases and 138 control women who delivered in three teaching hospitals in Eastern Ethiopia in 2021. Data were collected using a structured and pre-tested interviewer-administered questionnaire. Cases were mothers who delivered a neonate with any type of NTDs regardless of gestational age or fetal viability, whereas controls were mothers who delivered an apparently healthy newborn. Chi-square was used to assess the significant difference between the two groups. Conditional logistic regression model was used to generate adjusted odds ratio with its corresponding 95% confidence intervals and compare the two groups. Results Anencephaly (51.4%) and spinal bifida (34.1%) were the most frequently observed NTDs. None of study participants took preconception folic acid supplementation. Being a non-formal mothers (AOR = 0.34, 95% CI: 0.12–0.92, P = 0.034), rural residence, (AOR = 3.4, 95% CI: 1.18–9.78, P = 0.023), history of spontaneous abortion (AOR = 2.95, 95% CI: 1.15–7.55, P = 0.023), having severe anemia (AOR = 3.4, 95% CI: 1.17–9.87, P = 0.024), history of fever or cold (AOR = 2.75; 95% CI: 1.05–7.15, P = 0.038), and an exposure to various agro-chemicals (AOR = 3.39, 95% CI: 1.11–10.3, P = 0.032) were independent determinants of NTDs. Conclusion and Recommendation In this study, NTDs were associated to several determinant factors in the area, including residential area, history of spontaneous abortion, severe anemia, fever/cold, antibiotic use before or during early pregnancy, and exposure to agrochemicals. Addressing the identified determinants is critical in averting the incidence of NTDs in the study area. Moreover, more research is needed to investigate women’s dietary practices as well as the practice of preconception folic acid supplementation for pregnant women in Ethiopia’s current health care system.

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The Global Burden of Neural Tube Defects and Disparities in Neurosurgical Care

Cited by 13 publications

References 30 publications

Prevented cases of neural tube defects and cost savings after folic acid fortification of flour in Brazil

Prevented cases of neural tube defects and cost savings after folic acid fortification of flour in Brazil

Assessing Folic Acid Supplementation Adherence Among Pregnant Women in LMICs and its Impact on Neural Tube Defect Incidence: A Systematic Review Protocol

Determinants of neural tube defects among women who gave birth in hospitals in Eastern Ethiopia: evidence from a matched case control study

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