Demography and management outcome of neural tube defects in a Nigerian tertiary health institution

Authors

  • Usman Babagana Department of Surgery, Neurosurgery Unit, University of Maiduguri and University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria

DOI:

https://doi.org/10.18203/2320-6012.ijrms20214407

Keywords:

Demography, Management, Outcome, NTD

Abstract

Background: Neural tube defects (NTD) are a group of congenital anomalies of the central nervous system (CNS). Its management is very challenging. A recognised leading cause is a folic acid deficiency, therefore prevented by taking a preconception folic acid. This study looked at the demographic features and management outcome of neural tube defect, a fairly common preventable condition with the need to raise awareness on its preventive measures.

Methods: The study was conducted on 82 patients with NTD that were managed in federal medical centre Yola, in North-Eastern Nigeria. It was a retrospective study over a 4-year period, from January 2016 to December 2019.

Results: Ages at presentations ranged from 1 to 93 days with a mode of 3 days. There were 29 males and 53 females with a male to female ratio of 1:1.8. Spina bifida constituted 74.4%, encephalocele (20%), Anencephaly (5%). Types of spina bifida managed were myelomeningocele (63.5%), meningocele (33.3%), and lipo-myelomeningocele (3.2%). Two had a 2-level meningocele. Syndromic associations of myelomeningocele were with hydrocephalus (78.1%), foot deformity (22.2%), cardiac (2.5%), and anorectal malformation (2.5%). Ninety-five-point one had various surgeries with 30.8% developing postoperative complications. commonest was post excision of myelomeningocele and encephalocele hydrocephalus (29.1%) in 7 patients. Post-operative Mortality was reported in 2 patients (8.3%).

Conclusions: Myelomeningocele was the commonest NTD, and its syndromic association with hydrocephalus was common. A large number of patients had surgical interventions with a good outcome. Post-op mortality was minimal.

 

References

Abdullah NL, Gunasekaran R, Mohd-Zin SW, Lim BH, P, Mohd-Salleh AS. Cranial neural tube defect after trimethoprim exposure. BMC Res Notes. 2018;11:475.

Hoyt AT, Canfield MA, Romitti PA, Botto LD, Anderka MT, Krikov SV et al. Associations between maternal periconceptional exposure to second hand tobacco smoke and major birth defects. Am J Obstet Gynecol. 2016;215(1):613.

Bhuiyan P, Rajgopal L, Shyamkishore K. Indsserbir Singh’s textbook of human neuroanatomy (fundamental and clinical), Jaypee brothers’ medical publishers ltd. 10th ed. 2018;14.

Greene ND, Stanier P, Copp AJ. Genetics of human neural tube defects. Hum Mol Genet. 2009;18(R2):R113-29.

Meskelu M. Effects of maternal folic acid supplementation on the development of neural tube and cardiovascular system of the off springs in human and animal models. AAU Inst Repository; 2014. SDG Sustaniable Development Goal. 2017. Available at: http://www.un.org/sustainabledevelopment. Accessed 25 July 2021.

Fonseca EB, Raskin S, Zugaib M. Folic acid for the prevention of neural tube defects. Rev Bras Ginecol Obstet. 2013;35:287-9.

Wallingford JB, Niswander LA, Shaw GM, Finnell RH. The continuing challenge of understanding, preventing, and treating neural tube defects. Science. 2013;339(6123):1222002.

Hamamy H. Epidemiological profile of neural tube defects in Arab countries. Middle East J Med Genet. 2014;3:1-10.

Airede KI. Neural tube defects in the middle belt of Nigeria. J Trop Pediatr. 1992;38(1):27-30.

Ugwu RO, Eneh AU, Oruamabo RS. Neural tube defects in a university teaching hospital in southern Nigeria: trends and outcome. Niger J Med. 2007;16(4):368-71.

Berry RJ, Bailey L, Mulinare J, Bower C. Folic Acid Working G: Fortification of flour with folic acid. Food Nutr Bull. 2010;31(1):S22-35.

Cortes F, Mellado C, Pardo RA, Villarroel LA, Hertrampf E. Wheat flour fortification with folic acid: changes in neural tube defects rates in Chile. Am J Med Genet A. 2012;158A(8):1885-90.

Botto LD, Moore CA, Khoury MJ, Erickson JD. Neural-tube defects. N Engl J Med. 1999;341(20):09-19.

Van't Veer T, Meester H, Poenaru D, Kogei A, Augenstein K, Bransford R. Quality of life for families with spina bifida in Kenya. Trop Doct. 2008;38(3):160-2.

Seidahmed MZ, Abdelbasit OB, Shaheed MM, Alhussein KA, Miqdad AM, Khalil MI et al. Epidemiology of neural tube defects. Saudi med j. 2014;35(1):S29-35.

Dolk H. What is the “primary” prevention of congenital anomalies? Lancet. 2009;374(9687):378.

Bankole OB, Arigbabu SO, Kanu OO. Spinal neural tube defects in Lagos University Teaching Hospital, Nigeria. Nig Q J Hosp Med. 2012;22(1):22-4.

Alatise OI, Adeolu AA, Komolafe EO, Adejuyigbe O, Sowande OA. Pattern and Factors Affecting Management Outcome of Spina Bifida Cystica in Ile-Ife, Nigeria. Pediatr Neurosurg. 2006;42:277-83.

Hashim AM, Ahmed S, Jooma R. Management of myelomeningocele. J Surg Pakistan. 2008;13(1):7-11.

Salih MA, Murshid WR, Seidahmed MZ. Epidemiology, prenatal management, and prevention of neural tube defects. Saudi Med J. 2014;35(1):S15-28.

Shin M, Besser LM, Siffel C, Kucik JE, Shaw GM, Lu C et al. Congenital Anomaly Multistate Prevalence and Survival Collaborative. Prevalence of spina bifida among children and adolescents in 10 regions in the United States. Pediatrics. 2010;126(2):274-9.

Ajah LO, Amah CC, Ezeome IV, Ozumba BC, Anozie OB, Asogwa SU. A 10 Year Review of Neural Tube Defects in South-East Nigeria. Int J Med Health Dev. 2017;22(2):125-9.

Turhan AH, Isik S. Neural tube defects: A retrospective study of 69 cases. Asian J Neurosurg. 2019;14:506-9.

Abiodun IO, Olabisi TA, Augustine AA, Olakunle FB, Ayobami OO, Richard AA et al. Epidemiology of anencephaly in a suburban Nigerian agrarian community in the rain forest: An 11-year retrospective study of a single hospital experience. Interdisciplinary Neurosurg. 2020;21:100719.

Xu LW, Vaca SD, He JQ, Nalwanga J, Muhumuza C, Kiryabwire J et al. Neural tube defects in Uganda: follow-up outcomes from a national referral hospital. Neurosurg Focus. 2018;45(4):E9.

Salim D, Elzain A, Mohammed D, Mohamed AA. Spina bifida in Sudan. J neurol neurosci. 2014;5(2:1):1-8.

Rai SK, Singh R, Pandey S, Singh K, Shinde N, Rai S et al. High incidence of neural tube defects in Northern part of India. Asian J Neurosurg. 2016;11(4):352-5.

Githuku JN, Azofeifa A, Valencia D, Trong A, Hamner H, Amwayi S et al Assessing the prevalence of spina bifida and encephalocele in a Kenyan hospital from 2005-2010: implications for a neural tube defects surveillance system. Pan Afr Med J. 2014;18:60.

Anyanwu LC, Danborno B, Hamman WO. The prevalence of neural tube defects in live born neonates in Kano, North-Western Nigeria. Sub-Saharan Afr J Med. 2015;2:105-9.

Toma BO, Shilong DJ, Shwe DD, Bot GM, Diala UM, Ofakunrin AO et al. The prevalence and pattern of central nervous system anomalies in a neonatal unit in a tertiary hospital in Jos, north-central Nigeria. J Med Trop. 2018;20:63-7.

Uba AF, Isamade ES, Chirdan LB, Edino ST, Ogbe ME, Igun GO. Epidemiology of Neural Tube Defects in North Central Nigeria. Afri J Paediatr Surg. 2004;1(1):16-9.

Ismail NJ, Lasseini A, Koko AM, Shehu BB. Clinical profile of spina bifida cystica: six-year review from a regional centre, in Nigeria. Int J Res Review. 2017;4(5):100-4.

Bot GM, Ismail NJ, Mahmud MR, Hassan I, Lasseini A, Shilong DJ et al. Giant Encephalocele in Sokoto, Nigeria: A 5-year review of operated cases. World Neurosurg. 2020;1016.

Kural C, Solmaz I, Tehli O, Temiz C, Kutlay M, Daneyemez MK et al. Evaluation and Management of Lumbosacral Myelomeningoceles in Children. Eurasian J Med. 2015;47(3):174-8.

Lanigan MW. Surgical repair of myelomeningocele. Ann Plast Surg. 1993;31(6):514-21.

Flynn JM, Herrera-Soto JA, Ramirez NF, Fernandez-Feliberti R, Vilella F, Guzman J. Clubfoot release in myelodysplasia. J Pediatr Orthop B. 2004;13:259-62.

Westcott MA, Dynes MC, Remer EM, Donaldson JS, Dias LS. Congenital and acquired orthopedic abnormalities in patients with myelomeningocele. Radiographics. 1992;12(6):1155-73.

Akbar M, Bresch B, Seyler TM, Wenz W, Bruckner T, Abel R, et al. Management of orthopaedic sequelae of congenital spinal disorders. J Bone Joint Surg Am. 2009;91(6):87-100.

Khan F, Rehman A, Shamim MS, Bari ME. Factors affecting ventriculoperitoneal shunt survival in adult patients. Surg Neurol Int. 2015;13(6):25.

Reddy GK, Bollam P, Caldito G. Long-term outcomes of ventriculoperitoneal shunt surgery in patients with hydrocephalus. World Neurosurg. 2014;81(2):404-10.

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Published

2021-10-28

How to Cite

Babagana, U. (2021). Demography and management outcome of neural tube defects in a Nigerian tertiary health institution. International Journal of Research in Medical Sciences, 9(11), 3263–3268. https://doi.org/10.18203/2320-6012.ijrms20214407

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Original Research Articles