Neural Tube Defects in a University Teaching Hospital in Southern Nigeria: Trends and Outcome

Ugwu, RO; Eneh, AU; Oruamabo, R S

doi:10.4314/njm.v16i4.37340

Cited by 20 publications

(25 citation statements)

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“…Other case series from Africa have reported similar findings, with incidence of spina bifida of 0.4–1.99/1000 births, and case fatality rates of 13–23% (Alatise et al . 2006; Ugwu et al . 2007; Njamnshi et al .…”

Section: Discussionmentioning

confidence: 99%

“…Several descriptive case series of spina bifida in the African context have documented an incidence rate of 0.4–1.99/1000 births and have highlighted the need for periconceptual folate supplementation (Alatise et al . 2006; Ugwu et al . 2007; Komolafe et al .…”

Section: Introductionmentioning

confidence: 99%

“…Folate deficiency is prevalent among pregnant women in sub-Saharan Africa (Fleming et al 1986;Coulibaly et al 1987;Fuller et al 1988;Mashako et al 1991;Dop et al 1992;Massawe et al 1999;Friis et al 2001). Several descriptive case series of spina bifida in the African context have documented an incidence rate of 0.4-1.99/1000 births and have highlighted the need for periconceptual folate supplementation (Alatise et al 2006;Ugwu et al 2007;Komolafe et al 2008;Njamnshi et al 2008), but there are as yet few reports of attempts to promote this apparently straightforward strategy. Fortification of staple foods became DOI: 10.1111DOI: 10.…”

Section: Introductionmentioning

confidence: 99%

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Applying a knowledge‐to‐action framework for primary prevention of spina bifida in tropical Africa

Claude

Juvenal

Hawkes

2010

Maternal & Child Nutrition

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Maternal periconceptual folate supplementation reduces the incidence of neural tube defects; however, in settings where population-level food fortification is not available, it is not clear how best to promote this prevention strategy. Guided by a knowledge-to-action methodology, we used mixed quantitative and qualitative methods to define the local disease burden, then designed, implemented and evaluated a culturally tailored educational intervention in eastern Democratic Republic of Congo, where resource limitations and threats to human security contribute to restricted capacity for the prevention and management of congenital malformations. A descriptive case series of 27 patients undergoing surgery for spina bifida demonstrated a short-term mortality of 15% and long-term disability in survivors. A survey of knowledge, attitudes and practices demonstrated a low level of folate awareness (53%) among women of reproductive age. Focus group discussions revealed exotic aetiologic views, significant gender issues and several barriers to folate use. A culturally tailored radio broadcast and an educational video were designed and produced locally based on qualitative and quantitative findings. Evaluation of the video documented high levels of viewer satisfaction and unequivocal knowledge gain (P ≤ 0.001). We conclude that spina bifida poses a significant burden on affected patients and their families in the African context, but folate is underutilized as a prevention strategy. Patient education through video media results in increased awareness and understanding of spina bifida and folate, a first step in empowering women to reduce the risk of spina bifida in their children in the absence of population-wide food fortification.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Applying a knowledge‐to‐action framework for primary prevention of spina bifida in tropical Africa

Claude

Juvenal

Hawkes

2010

Maternal & Child Nutrition

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“…In a study of neural tube defects (NTD) at the University of Port Harcourt Teaching Hospital in Rivers State, it was observed that the incidence of NTD appeared to be on the increase. The most common type of NTD was myelomeningocele with the most common type being thoracolumber region followed by frontal encephalocele and spina bifida (Ugwu et al 2007 (Ritz et al 2002;Vrijheid 2002). Environmental pollution may contribute to the cause of congenital abnormalities in these states.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of congenital malformations in Cross River and Akwa Ibom states of Nigeria from 1980–2003

Ekanem

Okon

Akpantah

et al. 2008

Congenital Anomalies

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A retrospective study was conducted on the prevalence of congenital malformations in Cross River and Akwa Ibom states of Nigeria from 1980-2003. These states lie in the South-South geopolitical zone of Nigeria. The aim of the study was to determine the percentage of occurrence of birth defects and provide reference data for this part of the country. Details of congenital malformations were compiled by reviewing the delivery register of the records departments of maternity sections of University of Calabar Teaching Hospital, St Luke's Hospital Anua and St Mary's Hospital Uruakpan. A total of 127,929 births were recorded, of which 452 cases of malformations were recorded. The anomalies recorded in the skeletal system were the highest with 132 cases (29.2%) detected. Other malformations were found to be associated with the central nervous system with 111 cases (24.6%) detected. Those associated with the urogenital system were found in 83 cases (18.4%). Congenital anomalies of the lip, palate and jaw were found in 56 cases (12.4%), while those of the eye and ear were found in 12 cases (2.7%). Those of the gastrointestinal tract were found in 29 cases (6.4%), while those of the respiratory and cardiovascular systems were found in 28 cases (6.2%) and in one case (0.2%), respectively. Fifteen cases (3.3%) were associated with chromosomal abnormalities, such as Down syndrome. However, these results do not provide a complete incidence of congenital malformations in the two states studies because most anomalies are not recorded in rural health and traditional birth centers.

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“…Although there are few reports documenting the incidence of neural tube defects in Nigeria and other regions of sub-Saharan Africa, a three-year prospective study in Jos, Nigeria recorded an incidence of 7/1000 deliveries [56]. In a more recent three-year retrospective study in southern Nigeria, Ugwu and coworkers [57] found the incidence of NTDs to be 0.95/1000 births. In neighboring Cameroon, an NTD incidence of 1.99/1000 births was reported over a 10-year period [58].…”

Section: Discussionmentioning

confidence: 99%

Assessment of the Vitamin B12 Status of Pregnant Women in Nigeria Using Plasma Holotranscobalamin

VanderJagt

Ujah

Ikeh

et al. 2011

ISRN Obstetrics and Gynecology

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Maternal vitamin B12 deficiency during pregnancy is an independent risk factor for neural tube defects and other neurological problems in infants. We determined the vitamin B12 status of 143 pregnant women in Nigeria representing all trimesters who presented to an antenatal clinic in Jos, Nigeria, using holotranscobalamin II levels (holoTCII), which is a measure of the vitamin B12 that is available for uptake into tissues. The holoTCII concentration ranged from 13 to 128 pmol/L. Using a cutoff of 40 pmol/L, 36% of the women were classified as vitamin B12-deficient. HoloTCII concentrations correlated negatively with plasma homocysteine levels (r = −0.24, P = 0.003) and positively with red blood cell folate concentrations (r = 0.28, P < 0.001). These data underscore the importance of supplementing pregnant women in Nigeria with vitamin B12 in order to ensure adequate vitamin B12 status and decrease the risk for neural tube defects.

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Neural Tube Defects in a University Teaching Hospital in Southern Nigeria: Trends and Outcome

Cited by 20 publications

References 0 publications

Applying a knowledge‐to‐action framework for primary prevention of spina bifida in tropical Africa

Applying a knowledge‐to‐action framework for primary prevention of spina bifida in tropical Africa

Prevalence of congenital malformations in Cross River and Akwa Ibom states of Nigeria from 1980–2003

Assessment of the Vitamin B12 Status of Pregnant Women in Nigeria Using Plasma Holotranscobalamin

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