Prevalence of Spina Bifida among Newborns in Africa: A Systematic Review and Meta-Analysis

Mohammed Oumer, Molla Taye, Hailu Aragie, Ashenafi Tazebew, Mohammed Oumer, Molla Taye, Hailu Aragie, Ashenafi Tazebew

Abstract

Spina bifida is an abnormal closure of the neural tube during the fourth week of development. It is the major cause of fetal loss and considerable disabilities in newborns. The aim of this review is to determine the pooled prevalence of spina bifida among newborns in Africa. PubMed/Medline, Google Scholar, Science Direct, Joanna Briggs Institute (JBI) Library, Cochrane Library, Web of Science, African Journals Online, and Embase databases were systematically searched. Cochran Q test and I 2 test statistics were applied to assess heterogeneity across studies. A random-effect model was applied to calculate the pooled prevalence of spina bifida. Forest plot and Galbraith's plot were used to visualize heterogeneity. Subgroup, sensitivity, meta-regression, and meta-cumulative analyses were performed. All essential data were extracted using a standardized data extraction format, and the JBI quality appraisal checklist was used to assess the quality of studies. Egger's test and Begg's test were used in order to detect the publication bias. In the present systematic review and meta-analysis, 6,587,298 births in twenty-seven studies were included. The pooled birth prevalence of spina bifida in Africa was 0.13% with a range between 0.12% and 0.14%. In Africa, the highest burden of spina bifida was detected in Algeria (0.43%), Ethiopia (0.32%), Tanzania (0.26%), Cameron (0.12%), Egypt (0.10%), and South Africa (0.10%). The lowest burden of spina bifida was detected in Libya (0.006%) and Tunisia (0.009%). The high birth prevalence of spina bifida was detected in Africa. There was a significant variation in the prevalence of spina bifida among study countries in Africa. The authors recommend that special awareness creation with the help of health education intervention should be provided for mothers to focus on prevention in order to reduce the burden of spina bifida.

Conflict of interest statement

The authors declare that they have no conflicts of interest.

Copyright © 2020 Mohammed Oumer et al.

Figures

Figure 1
Figure 1
Study selection flow diagram, a figure adapted from the PRISMA group statement.
Figure 2
Figure 2
Forest plot showing the pooled prevalence of spina bifida in Africa, 2020.
Figure 3
Figure 3
Galbraith plot showing the variability of the pooled prevalence of spina bifida in Africa, 2020.
Figure 4
Figure 4
Sensitivity analysis to see the influence of each individual study in Africa, 2020.
Figure 5
Figure 5
Time trend analysis of the prevalence of spina bifida in relation to the publication year in Africa, 2020.
Figure 6
Figure 6
Meta-cumulative analysis of the prevalence of spina bifida in Africa, 2020.
Figure 7
Figure 7
Egger's publication bias plot, 2020.
Figure 8
Figure 8
Funnel plot showing the results of the publication bias among studies, 2020.
Figure 9
Figure 9
Trim and fill analyses to trim publication bias among studies, 2020.

References

    1. Moore K. L., Persaud T. V. N. The developing Human: Clinically Oriented Embryology. 8th. Ajax, Amsterdam: Elsevier; 2007.
    1. Sadler T. W. Langman’s Medical Embryology: Chapter Clinical Correlates in Central Nervous System Embryology. 12th. Philadelphia, PA, USA: Lippincott Williams & Wilkins Company; 2011.
    1. Gedefaw A., Teklu S., Tilahun B. T. Magnitude of neural tube defects and associated risk factors at three teaching hospitals in Addis Ababa, Ethiopia. BioMed Research International. 2018;2018:10. doi: 10.1155/2018/4829023.4829023
    1. Nasri K. Epidemiology of neural tube defect subtypes in Tunisia, 1991–2011. Pathology—Research and Practice. 2014;210 doi: 10.1016/j.prp.2014.06.027.
    1. Anyanwu L.-J., Danborno B., Hamman W. The prevalence of neural tube defects in live born neonates in Kano, north-western Nigeria. Sub-Saharan African Journal of Medicine. 2015;2(3):105–109. doi: 10.4103/2384-5147.164417.
    1. Houcher B., Bourouba R., Djabi F., Houcher Z. The prevalence of neural tube defects in sétif university maternity hospital, Algeria-3 years review (2004–2006) Walter de Gruyter. 2013;19:12–18. doi: 10.1515/pteridines.2008.19.1.12.
    1. Nasri K. An increase in spina bifida cases in Tunisia, 2008–2011. Pathology—Research and Practice. 2015;211 doi: 10.1016/j.prp.2014.12.011.
    1. Berihu B. A., Welderufael A. L., Berhe Y., et al. High burden of neural tube defects in tigray, northern Ethiopia: hospital-based study. PLoS One. 2018;13(11) doi: 10.1371/journal.pone.0206212.e0206212
    1. Taye M., Afework M., Fantaye W., Diro E., Worku A. Congenital anomalies prevalence in Addis Ababa and the Amhara region, Ethiopia: a descriptive cross-sectional study. BMC Pediatrics. 2019;11(10) doi: 10.1186/s12887-019-1596-2.
    1. Abebe S., Gebru G., Amenu D., Dube L. Prevalence and patterns of birth defects among newborns in southwestern Ethiopia: retrospective study. Pediatrics. 2020 doi: 10.21203/rs.2.17559/v1.
    1. Nnadi D., Singh S. The prevalence of neural tube defects in north-west Nigeria. Saudi Journal for Health Sciences. 2016;5(1):6–10. doi: 10.4103/2278-0521.182858.
    1. Estifanos D., Adgoy E. T., Sereke D., Zekarias B., Marzolf S., Tedla K. The prevalence, trend, and associated demographic factors of neural tube defects at orotta national referral maternity hospital, asmara: retrospective record review study. Science Journal of Public Health. 2017;5(6):p. 452. doi: 10.11648/j.sjph.20170506.17.
    1. Legesse A., Zawidneh D., Gorfu Y. Assessment of prevalence, types and associated risk factors of neural tube defects in pregnant women visiting health centers in Addis Ababa. 2019.
    1. Sadler T. W. Langman’s Medical Embryology: Chapter: Clinical Correlates in Central Nervous System Embryology. 11th. Alphen aan den Rijn, Netherlands: Wolters Kluwer; 1963.
    1. Atta C., Fiest K. M., Frolkis A. D., et al. Global birth prevalence of spina bifida by folic acid fortification status: a systematic review and meta-analysis. American Journal of Public Health. 2016;106(1) doi: 10.2105/ajph.2015.302902a.
    1. Bhide P., Sagoo G. S., Moorthie S., Burton H., Kar A. Systematic review of birth prevalence of neural tube defects in India. Birth Defects Research Part A: Clinical and Molecular Teratology. 2013;97(7):437–443. doi: 10.1002/bdra.23153.
    1. Rosenthal J., Casas J., Taren D., Alverson C. J., Flores A., Frias J. Neural tube defects in latin America and the impact of fortification: a literature review. Public Health Nutrition. 2013;17(3):537–550. doi: 10.1017/s1368980013000256.
    1. Yi Y., Lindemann M., Colligs A., Snowball C. Economic burden of neural tube defects and impact of prevention with folic acid: a literature review. European Journal of Pediatrics. 2011;170(11):1391–1400. doi: 10.1007/s00431-011-1492-8.
    1. Moher D., Liberati A., Tetzlaff J., Altman D. G. The PRISMA group. preferred reporting items for systematic reviews and meta-analyses: the prisma statement. PLoS Medicine. 2009;6(7) doi: 10.1371/journal.pmed.1000097.e1000097
    1. Moola S., Munn Z., Tufanaru C., et al. Chapter 7: systematic reviews of etiology and risk. In: Aromataris E., Munn Z., editors. Joanna Briggs Institute Reviewer’s Manual. Adelaide, Australia: The Joanna Briggs Institute; 2017.
    1. Higgins J. P. T., Thompson S. G., Deeks J. J., Altman D. G. Measuring inconsistency in meta-analyses. BMJ. 2003;327(7414):p. 557. doi: 10.1136/bmj.327.7414.557.
    1. Munn Z., Moola S., Lisy K., Riitano D., Tufanaru C. Methodological guidance for systematic reviews of observational epidemiological studies reporting prevalence and cumulative incidence data. International Journal of Evidence-Based Healthcare. 2015;13(3):147–153. doi: 10.1097/xeb.0000000000000054.
    1. Borenstein M., Hedges L. V., Higgins J. P. T., Rothstein H. R. A basic introduction to fixed-effect and random-effects models for meta-analysis. Research Synthesis Methods. 2010;1(2):97–111. doi: 10.1002/jrsm.12.
    1. Egger M., Smith G. D., Schneider M., Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315(7109):629–634. doi: 10.1136/bmj.315.7109.629.9310563
    1. Begg C. B., Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics. 1994;50(4)778699
    1. Houcher B., Akar N., Begag S., Egin Y. Neural Tube Defects in Algeria. London, UK: Intech Open; 2012.
    1. Ahuka O. L., Toko R. M., Omanga F. U., Tshimpanga B. J. Congenital malformations in the north-eastern democratic republic of Congo during civil war. East African Medical Journal. 2006;8:95–99. doi: 10.4314/eamj.v83i2.9395.
    1. Omer I. M., Abdullah O. M., Mohammed I. N., Abbasher L. A. Research: prevalence of neural tube defects Khartoum, Sudan august 2014-july 2015. BMC Research Notes. 2016;9:p. 495. doi: 10.1186/s13104-016-2298-6.
    1. Alhassan A., Adam A., Nangkuu D. Prevalence of neural tube defect and hydrocephalus in northern Ghana. Journal of Medical and Biomedical Sciences. 2017;6(1):18–23.
    1. Airede K. I. Neural tube defects in the middle belt of Nigeria. Journal of Tropical Pediatrics. 1992;38(27–30) doi: 10.1093/tropej/38.1.27.
    1. Ekanem T. B., Okon D. E., Akpantah A. O., Mesembe O. E., Eluwa M. A., Ekong M. B. Prevalence of congenital malformations in cross river and akwa ibom states of Nigeria from 1980–2003. Congenital Anomalies. 2008;48:167–170. doi: 10.1111/j.1741-4520.2008.00204.x.
    1. Singh R., Al-Sudani O. Major congenital anomalies at birth in benghazi, Libyan arab jamahiriya. Eastern Mediterranean Health Journal. 1995;6(65–75)
    1. Mohammed Y. A., Shawky R. M., Soliman A. A. S., Ahmed M. M. Chromosomal study in newborn infants with congenital anomalies in assiut university hospital: cross-sectional study. Egyptian Journal of Medical Human Genetics. 2011;12(1):79–90. doi: 10.1016/j.ejmhg.2011.02.003.
    1. Njamnshi A. K., Djientcheu V. D. P., Lekoubou A., et al. Neural tube defects are rare among black americans but not in sub-saharan black africans: the case of yaounde-Cameroon. Journal of the Neurological Sciences. 2008;270(13–17) doi: 10.1016/j.jns.2008.01.010.
    1. Sayed A.-R., Bourne D., Pattinson R., Nixon J., Henderson B. Decline in the prevalence of neural tube defects following folic acid fortification and its cost-benefit in South Africa. Birth Defects Research Part A: Clinical and Molecular Teratology. 2008;82(4):211–216. doi: 10.1002/bdra.20442.
    1. Anyebuno M., Amofa G., Peprah S., Affram A. Neural tube defects at korle bu teaching hospital, Accra, Ghana. East African Medical Journal. 1993;70(9):572–574.
    1. Msamati B. C., Igbigbi P. S., Chisi J. E. The incidence of cleft lip, cleft palate, hydrocephalus and spina bifida at queen Elizabeth central hospital, blantyre, Malawi. The Central African Journal of Medicine. 2000;46:292–296. doi: 10.4314/cajm.v46i11.8572.
    1. Venter P. A., Christianson A. L., Hutamo C. M., Makhura M. P., Gericke G. S. Congenital anomalies in rural black south African neonates-a silent epidemic? South African Medical Journal. 1995;85:15–20.7784908
    1. Buccimazza S. S., Molteno C. D., Dunne T. T., Viwoen D. Prevalence of neural tube defects in Cape Town, South Africa. Teratology. 1994;50:50194–50199. doi: 10.1002/tera.1420500304.
    1. Kinasha A. D., Manji K. P. The incidence and pattern of neural tube defects in Dar es Salaam, Tanzania. European Journal of Pediatric Surgery Supplement. 2003;1:S38–S39.
    1. Elsheikh G. E. A., Ibrahim S. A. Neural tube defects in omdurman maternity hospital, Sudan. Khatoum Medical Journal. 2009;2:185–190.
    1. Annie L., Dora P., Simrita S. Estimating the burden of neural tube defects in low- and middle-income countries. Journal of Global Health. 2014;4(1) doi: 10.7189/jogh.04.010402.
    1. Berry R. J., Li Z., Erickson J. D., et al. Prevention of neural-tube defects with folic acid in China. New England Journal of Medicine. 1999;341(20):1485–1490. doi: 10.1056/nejm199911113412001.
    1. MRC Vitamin Study Research Group. Prevention of neural tube defects: results of the medical research council vitamin study. Lancet. 1991;338(8760):131–137.
    1. American Academy of Pediatrics. Folic acid for the prevention of neural tube defects. Pediatrics. 1999;104:p. 325. doi: 10.1542/peds.104.2.325.
    1. Salih M. A., Murshid W. R., Seidahmed M. Z. Epidemiology, prenatal management, and prevention of neural tube defects: review article. Saudi Medical Journal. 2014;35
    1. Jackson J., Malley P., Wei G., Berbano E., Dezee K., Shimeall W. Key for meta-analysis: meta-analysis 101—sgim precourse. 2004.
    1. Egger M., Altman D., Antes G. Systematic reviews in health care, Meta-analysis in context. BMJ. 2001;1 doi: 10.1002/9780470693926.

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