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

Mohammed Oumer, Ashenafi Tazebew, Mezgebu Silamsaw, Mohammed Oumer, Ashenafi Tazebew, Mezgebu Silamsaw

Abstract

Background: Neural 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.

Methods: The 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.

Results: Forty-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.

Conclusions: The pooled birth prevalence of neural tube defects in Africa was found to be high. The risk factors evaluated were not found significant.

Keywords: Africa; Neural tube defects; Systematic review and meta-analysis.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Study selection flow diagram, a figure adapted from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) group statement
Fig. 2
Fig. 2
Forest plot showing the pooled prevalence of neural tube defects in Africa, 2020
Fig. 3
Fig. 3
Sensitivity analysis showed the influence of each individual study in overall estimates in Africa, 2020
Fig. 4
Fig. 4
Meta-cumulative analysis showing cumulative effect of neural tube defects in relation to time in Africa, 2020
Fig. 5
Fig. 5
Egger’s publication bias plot, 2020

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