Neural tube defects as a cause of death among stillbirths, infants, and children younger than 5 years in sub-Saharan Africa and southeast Asia: an analysis of the CHAMPS network

Madrid, Lola; Vyas, Kartavya J.; Kancherla, Vijaya; Suchdev, Parminder S.; Bassat, Quique; Sow, Samba O.; Arifeen, Shams El; Madhi, Shabir А.; Onyango, Dickens; Ogbuanu, Ikechukwu U.; Scott, John A.; Blau, Dianna M.; Mandomando, Inácio; Gurley, Emily S.; Mahtab, Sana; Akelo, Victor; Sannoh, Sulaiman; Tilahun, Yenenesh; Varo, Rosauro; Rahman, Ahmed Shafiqur; Adam, Yasmin; Omore, Richard; Lako, Sandra; Wise, Amy; Tippet-Barr, Beth A.; Kaluma, Erick; Ajanovic, Sara; Kotloff, Karen L.; Mutevedzi, Portia; Tapia, Milagritos D.; Moses, Francis; Whitney, Cynthia G.; Assefa, Nega; Ahmed, A.S.M. Nawshad Uddin; Hoque, Mahbubul; Kamal, Mohammed; Mosiur, Mohammad; Begum, Ferdousi; Tasnim, Saria; Flora, Meerjady Sabrina; Arjuman, Farida; Khan, Iqbal Ansary; Shirin, Tahmina; Rahman, Mahbubur; Bari, Sanwarul; Parveen, Shahana; Islam, Farzana; Hossain, Mohammad Zahid; Islam, Kajalie Shehreen; Ahmed, Mohammad Sabbir; Zaman, Khalequ; Rahman, Mustafizur; Ahmed, Dilruba; Chowdhury, Morseda; Alam, Muntasir; Lee, Kyu Han; Islam, Ferdousi; Oundo, Joseph; Temesgen, Fikremelekot; Yeshi, Melisachew Mulatu; Ibrahim, Alexander M.; Gure, Tadesse; Edris, Yunus; Alemu, Addisu; Marami, Dadi; Lemma, Eshetu; Mekonnen, Alemtsehay; Wale, Henok; Tesfaye, Tseyon; Leulseged, Haleluya; Dufera, Tadesse; Belachew, Anteneh; Getnet, Fentabil; Fentaw, Surafel; Acham, Yenework; Orlien, Stian MS; Gizaw, Mahlet Abayneh; Rogena, Emily; Murila, Florence; Revathi, Gunturu; Mitei, Paul K; Kuria, Magdalene; Verani, Jennifer R.; Igunza, Aggrey K.; Nyamthimba, Peter; Oele, Elizabeth; Fairchild, Karen D.; Greene, Carol L.; Koka, Rima; Mehta, Ashka; Tennant, Sharon M.; Johnson, J. Kristie; Keita, Tatiana; Keita, Adama Mamby; Kourouma, Nana; Onwuchekwa, Uma; Traoré, Awa; Sanogo, Doh; Sidibé, Diakaridia; Sissoko, Seydou; Kone, Diakaridia; Kindcardett, Milton; Munguambe, Khátia; Nhacolo, Ariel; Nhampossa, Tacilta; Vitorino, Pio; Xerinda, Elísio; Bramugy, Justina; Monjane, Celso; Nhachungue, Sheila; Hurtado, Juan Carlos; Maixenchs, María; Menéndez, Clara; Ordï, Jaume; Rakislova, Natalia; Valente, Marta; Manhique, Zara; Chitungo, Dercio; Mocumbi, Sibone; Carrilho, Carla; Fernandes, Fabíola; Philipsborn, Rebecca; Koplan, Jeffrey P.; Garel, Mischka; Dewey, Betsy; Nair, Shailesh; Salzberg, N; Liu, Lucy; Alkis-Ramirez, Rebecca; Ritter, Jana M.; Zaki, Sherif R.; Gary, Joy; Winchell, Jonas M.; Witherbee, Jacob; Waller, Jessica L.; Fayorsey, Ruby; Luke, Ronita; Bassey, Iya Eze; Kowuor, Dickens; Sesay, Foday; Kosia, Baindu; Pratt, Samuel Abu; Cain, Carrie Jo; Samura, Solomon; Solomon, Fatima; Fritz, Ashleigh; Dludlu, Noluthando; Ntuli, Constance; Chawana, Richard; Petersen, Karen; Lala, Sanjay G.; Velaphi, Sithembiso; Wadula, Jeannette; Hale, Martin; Swart, Peter J.; Lombaard, Hennie; Moosa, Riyad A.; Sorour, Gillian

doi:10.1016/s2214-109x(23)00191-2

Cited by 8 publications

(6 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The mortality differences across age groups are mainly related to the type and severity of CAs. As mentioned above, most severe CAs such as NTDs would experience pregnancy termination, and less than half of live births with NTDs would survive over 1 year [ 28 ]. For CAs that are less fatal such as Down syndrome, the life expectancy has increased dramatically and reached 60 years in 2002 [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Trend of Mortality Due to Congenital Anomalies in Children Younger Than 5 Years in Eastern China, 2012-2021: Surveillance Data Analysis

Dong,

Guo,

Wang

et al. 2024

JMIR Public Health Surveill

View full text Add to dashboard Cite

Background As one of the leading causes of child mortality, deaths due to congenital anomalies (CAs) have been a prominent obstacle to meet Sustainable Development Goal 3.2. Objective We conducted this study to understand the death burden and trend of under-5 CA mortality (CAMR) in Zhejiang, one of the provinces with the best medical services and public health foundations in Eastern China. Methods We used data retrieved from the under-5 mortality surveillance system in Zhejiang from 2012 to 2021. CAMR by sex, residence, and age group for each year was calculated and standardized according to 2020 National Population Census sex- and residence-specific live birth data in China. Poisson regression models were used to estimate the annual average change rate (AACR) of CAMR and to obtain the rate ratio between subgroups after adjusting for sex, residence, and age group when appropriate. Results From 2012 to 2021, a total of 1753 children died from CAs, and the standardized CAMR declined from 121.2 to 62.6 per 100,000 live births with an AACR of –9% (95% CI –10.7% to –7.2%; P<.001). The declining trend was also observed in female and male children, urban and rural children, and neonates and older infants, and the AACRs were –9.7%, –8.5%, –8.5%, –9.2%, –12%, and –6.3%, respectively (all P<.001). However, no significant reduction was observed in children aged 1-4 years (P=.22). Generally, the CAMR rate ratios for male versus female children, rural versus urban children, older infants versus neonates, and older children versus neonates were 1.18 (95% CI 1.08-1.30; P<.001), 1.20 (95% CI 1.08-1.32; P=.001), 0.66 (95% CI 0.59-0.73; P<.001), and 0.20 (95% CI 0.17-0.24; P<.001), respectively. Among all broad CA groups, circulatory system malformations, mainly deaths caused by congenital heart diseases, accounted for 49.4% (866/1753) of deaths and ranked first across all years, although it declined yearly with an AACR of –9.8% (P<.001). Deaths due to chromosomal abnormalities tended to grow in recent years, although the AACR was not significant (P=.90). Conclusions CAMR reduced annually, with cardiovascular malformations ranking first across all years in Zhejiang, China. Future research and practices should focus more on the prevention, early detection, long-term management of CAs and comprehensive support for families with children with CAs to improve their survival chances.

show abstract

Section: Discussionmentioning

confidence: 99%

Trend of Mortality Due to Congenital Anomalies in Children Younger Than 5 Years in Eastern China, 2012-2021: Surveillance Data Analysis

Dong,

Guo,

Wang

et al. 2024

JMIR Public Health Surveill

View full text Add to dashboard Cite

show abstract

“…14 15 Furthermore, in Ethiopia, out of every 10 000 births, 104 result in death due to NTDs specifically craniorachischisis (it is a severe form of NTDs characterised by openings in both the brain and spinal cord). 16 Globally, various prevention modalities spanning from the advanced genetic test to the simplest micronutrient fortification with folic acid were put forward to avert untoward health consequences of NTDs and circumvent the economic burden imposed on the health system. [17][18][19] Along with the establishment of the surveillance programme, prenatal examination (ie, antenatal ultrasonography, amniocentesis and genetic counselling) is one of the identification platforms that is designed for screening NTD during pregnancy and taking timely measures, including elective termination of the pregnancy.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Birth prevalence and risk factors of neural tube defects in Ethiopia: a systematic review and meta-analysis

Tesfay,

Hailu,

Habtetsion

et al. 2023

BMJ Open

View full text Add to dashboard Cite

ObjectiveThis study aims to estimate the prevalence of neural tube defects (NTDs) and to identify potential risk factors in the Ethiopian context.Study designSystematic review and meta-analysis.Study participantsA total of 611 064 participants were included in the review obtained from 42 studies.MethodsPubMed (Medline), Embase and Cochrane Library databases in combination with other potential sources of literature were systematically searched, whereby studies conducted between January 2010 and December 2022 were targeted in the review process. All observational studies were included and heterogeneity between studies was verified using Cochrane Q test statistics and I2test statistics. Small study effects were checked using Egger’s statistical test at a 5% significance level.ResultThe pooled prevalence of all NTDs per 10 000 births in Ethiopia was 71.48 (95% CI 57.80 to 86.58). The between-study heterogeneity was high (I2= 97.49%, p<0.0001). Birth prevalence of spina bifida (33.99 per 10 000) was higher than anencephaly (23.70 per 10 000), and encephalocele (4.22 per 10 000). Unbooked antenatal care (AOR 2.26, 95% CI (1.30 to 3.94)), preconception intake of folic acid (AOR 0.41, 95% CI (0.26 to 0.66)), having chronic medical illness (AOR 2.06, 95% CI (1.42 to 2.99)), drinking alcohol (AOR 2.70, 95% CI (1.89 to 3.85)), smoking cigarette (AOR 2.49, 95% CI (1.51 to 4.11)), chewing khat (AOR 3.30, 95% CI (1.88 to 5.80)), exposure to pesticides (AOR 3.87, 95% CI (2.63 to 5.71)), maternal age ≥35 (AOR 1.90, 95% CI (1.13 to 3.25)), maternal low educational status (AOR 1.60, 95% CI (1.13 to 2.24)), residing in urban areas (AOR 0.75, 95% CI (0.58 to 0.97))and family history of NTDs (AOR 2.51, 95% CI (1.36 to 4.62)) were associated with NTD cases.ConclusionThe prevalence of NTDs in Ethiopia is seven times as high as in other Western countries where prevention measures are put in place. Heredity, maternal and environmental factors are associated with a high prevalence of NTDs. Mandatory fortification of staple food with folic acid should be taken as a priority intervention to curb the burden of NTDs. To smoothen and overlook the pace of implementation of mass fortification, screening, and monitoring surveillance systems should be in place along with awareness-raising measures.PROSPERO registration numberCRD42023413490.

show abstract

“…FA supplements and fortification were reported to reduce NTDs related to neonatal mortality [11,[28][29][30]. In particular, two exemplary largepopulation, data-based analyses concluded periconceptual maternal FA intake prevents NTD occurrences [31,32]. Another meta-analysis of NTDs in eastern Africa also suggests that mandatory FA supplements could reduce the risk of NTDs [33].…”

Section: Neural Tube Defectsmentioning

confidence: 99%

Advances in Folic Acid Biosensors and Their Significance in Maternal, Perinatal, and Paediatric Preventive Medicine

Movendane,

Sipalo,

Chan

2023

Biosensors

View full text Add to dashboard Cite

Auxotrophic primates like human beings rely on exogenous dietary vitamin B9 supplementation to meet their metabolic demands. Folates play a crucial role in nucleotide synthesis and DNA methylation. Maternal folate deficiency causes several pregnancy-related complications, perinatal defects, and early childhood cognitive impairments. New evidence suggests excess FA is a potential risk factor resulting in unfavourable genomic and epigenomic alterations. Thus, it is essential to revisit the need to consistently monitor maternal folate levels during pregnancy. Yet, to date, no point-of-care folate-monitoring biosensor is commercially available. Here, we critically appraise the advances in folate biosensors to understand the translational gaps in biosensor design. Further, our review sheds light on the potential role of folate biosensors in strengthening maternal, perinatal, and child healthcare.

show abstract

Neural tube defects as a cause of death among stillbirths, infants, and children younger than 5 years in sub-Saharan Africa and southeast Asia: an analysis of the CHAMPS network

Cited by 8 publications

References 28 publications

Trend of Mortality Due to Congenital Anomalies in Children Younger Than 5 Years in Eastern China, 2012-2021: Surveillance Data Analysis

Trend of Mortality Due to Congenital Anomalies in Children Younger Than 5 Years in Eastern China, 2012-2021: Surveillance Data Analysis

Birth prevalence and risk factors of neural tube defects in Ethiopia: a systematic review and meta-analysis

Advances in Folic Acid Biosensors and Their Significance in Maternal, Perinatal, and Paediatric Preventive Medicine

Contact Info

Product

Resources

About