“…Together with the Balrampur District in India (Cherian et al, 2005) 14 , this poor coal mining region has one of the highest NTD prevalence rates in the world with rates ranging between 60 and 150 NTDs per 10 000 births (Xiao, 1989;Moore et al, 1997;Dai et al, 2002;Li et al, 2006), up to an NTD rate of 199 (Gu et al, 2007). This high incidence is correlated with the high folate deficiency rates of pregnant women (43.8 %) and the limited use of folic acid pills in this region Li et al, 2007;Ren et al, 2007;Zhang et al, 2008) (see section 5.1.1.). …”