Abstract
BackgroundNeural tube defects are common congenital anomalies that result from early malformation in the development of the spinal cord and brain. It is related to substantial mortality, morbidity, disability, and psychological and economic costs. The aim of this review is to determine the pooled birth prevalence of neural tube defects and associated risk factors in Africa.MethodsThe first outcome of this review was the pooled birth prevalence of the neural tube defects and the second outcome was the pooled measure of association between neural tube defects and associated risk factors in Africa. We systematically searched PubMed, PubMed Central, Joanna Briggs Institute, Google Scopus, Cochrane Library, African Journals Online, Web of Science, Science Direct, Google Scholar, and Medline databases. The heterogeneity of studies was assessed using the Cochrane Q test statistic, I2 test statistic, and, visually, using Forest and Galbraith’s plots. A random-effect model was applied to get the pooled birth prevalence of neural tube defects. Subgroup, sensitivity, meta-regression, time-trend, and meta-cumulative analyses were undertaken. The fixed-effect model was used to analyze the association between neural tube defects and associated risk factors.ResultsForty-three studies with a total of 6086,384 participants were included in this systematic review and meta-analysis. The pooled birth prevalence of the neural tube defects was 21.42 (95% CI (Confidence Interval): 19.29, 23.56) per 10,000 births. A high pooled birth prevalence of neural tube defects was detected in Algeria 75 (95% CI: 64.98, 85.02), Ethiopia 61.43 (95% CI: 46.70, 76.16), Eritrea 39 (95% CI: 32.88, 45.12), and Nigeria 32.77 (95% CI: 21.94, 43.59) per 10,000 births. The prevalence of neural tube defects has increased over time. Taking folic acid during early pregnancy, consanguineous marriage, male sex, and substance abuse during pregnancy were assessed and none of them was significant.ConclusionsThe pooled birth prevalence of neural tube defects in Africa was found to be high. The risk factors evaluated were not found significant.
Highlights
Neural tube defects are common congenital anomalies that result from early malformation in the development of the spinal cord and brain
Fifty-one studies were assessed for eligibility, and 43 studies, were fulfilled the criteria, were included in this systematic review and meta-analysis (Fig. 1)
Ten studies had been conducted in Ethiopia [2, 5, 9,10,11, 17,18,19,20, 64], five in Tunisia [3, 8, 21,22,23], eight in Nigeria [6, 12, 15, 16, 50, 51, 65, 66], two in Algeria [4, 7], six in South Africa [55, 59, 60, 63, 67, 68], two in Sudan [48, 62], and two in Ghana [49, 57]
Summary
Neural tube defects are common congenital anomalies that result from early malformation in the development of the spinal cord and brain. Neural tube defects are common congenital anomalies that result from early malformation in the development of the brain and spinal cord [1,2,3,4,5,6,7,8]. It is the main cause of fetal loss and disabilities in neonates and it is considered a significant public health problem [3, 9,10,11,12,13,14,15,16,17]. In addition to its burden, stigmatization towards neural tube defects by the community has been documented elsewhere in Africa [13, 33, 34], affecting the quality of life of caring families with social, economic, and emotional distress
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