Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Jun 21:2023:9635827.
doi: 10.1155/2023/9635827. eCollection 2023.

Burden of Neural Tube Defects and Their Associated Factors in Africa: A Systematic Review and Meta-Analysis

Reta Wakoya  1   2 , Mekbeb Afework  2
Affiliations
Review

Burden of Neural Tube Defects and Their Associated Factors in Africa: A Systematic Review and Meta-Analysis

Reta Wakoya et al. Int J Pediatr. .

Abstract

Background: Neural tube defects are a type of congenital anomaly caused by an abnormality in the development of the brain and spinal cord during embryogenesis. They cause high rates of mortality, morbidity, and lifelong disability. There are several studies carried out worldwide reporting different findings on the burden and associated factors. The aim of this study is to carry out a systematic review and meta-analysis of the burden of neural tube defects and their associated factors in Africa.

Methods: A total of 58 eligible articles were identified systematically using databases such as PubMed, Embase, African Journal Online Library, ProQuest, Cochrane, Google Scopus, Google Scholar, and Grey literature. Extracted data were analyzed using STATA 16.0 statistical software. The heterogeneity of studies was determined using the Cochrane Q test statistic and I2 test statistics with forest plots. A random effects model was used to examine the pooled burden of neural tube defects, subgroups of the region, subtypes of NTDs, sensitivity analysis, and publication bias. The association between NTDs and associated factors was studied using a fixed-effect model.

Results: Fifty-eight studies with a total of 7,150,654 participants in 16 African countries revealed that the pooled burden of neural tube defects was 32.95 per 10,000 births (95% CI: 29.77-36.13). The Eastern African region had the highest burden in the subgroup analysis, with 111.13 per 10,000 births (95% CI: 91.85-130.42). South African countries had the lowest burden, at 11.43 per 10,000 births (95% CI: 7.51-15.34). In subtype analysis, spina bifida had the highest pooled burden at 17.01 per 10,000 births (95 percent CI: 15.00-19.00), while encephalocele had the lowest at 1.66 per 10,000 births (95% CI: 1.12-2.20). Maternal folic acid supplementation (AOR: 0.38; 95% CI: 0.16-0.94), alcohol consumption (AOR: 2.54; 95% CI: 1.08-5.96), maternal age (AOR: 3.54; 95% CI: 1.67-7.47), pesticide exposure (AOR: 2.69; 95% CI: 1.62-4.46), X-ray radiation (AOR: 2.67; 95% CI: 1.05-6.78), and history of stillbirth (AOR: 3.18; 95% CI: 1.11-9.12) were significantly associated with NTDs.

Conclusion: The pooled burden of NTDs in Africa was found to be high. Maternal age, alcohol consumption, pesticide and X-ray radiation exposure, history of stillbirth, and folic acid supplementation were significantly associated with NTDs.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram depicting the selection process of studies for the systematic review and meta-analysis on the burden and associated factors of neural tube defects in Africa, 2022.
Figure 2
Figure 2
A forest plot depicting the burden of neural tube defects per 10,000 births in Africa, 2022.
Figure 3
Figure 3
The funnel graph depicts the distribution of studies included in the burden of neural tube defects in Africa, 2022.
Figure 4
Figure 4
Results of sensitivity analysis of 45 studies after removing the three studies [15, 24, 48] in Africa, 2022.
Figure 5
Figure 5
Forest plot of subgroup analysis by the regions of showing the burden of neural tube defects per 10,000 births in Africa, 2022.
Figure 6
Figure 6
Forest plot showing the burden of spina bifida per 10,000 in Africa, 2022.
Figure 7
Figure 7
Forest plot depicting the burden of anencephaly per 10,000 in Africa, 2022.
Figure 8
Figure 8
Forest plot showing the burden of encephalocele per 10,000 in Africa, 2022.
Figure 9
Figure 9
Forest plot showing the burden of spina bifida by subregion per 10,000 in Africa, 2022.
Figure 10
Figure 10
Forest plot depicting the pooled burden of anencephaly by subregion per 10,000 in Africa, 2022.
Figure 11
Figure 11
Forest plot showing the pooled burden of encephalocele by subregion per 10,000 in Africa, 2022.
Figure 12
Figure 12
Forest plot showing the association between maternal age and the neural tube defects in Africa, 2022.
Figure 13
Figure 13
Forest plot depicting the association between maternal alcohol consumption and neural tube defects in Africa, 2022.
Figure 14
Figure 14
Forest plot illustrating the associations between maternal folic acid supplementation and the burden of neural tube defects in Africa, 2022.
Figure 15
Figure 15
Forest plot showing the linkage between the maternal exposure to pesticide and neural tube defects in Africa, 2022.
Figure 16
Figure 16
Forest plot showing the linkage between the maternal exposure to X-ray radiation and neural tube defects in Africa, 2022.
Figure 17
Figure 17
Forest plot depicting the association between the parental consanguineous marriage and neural tube defects in Africa, 2022.
Figure 18
Figure 18
Forest plot illustrating the association of the sex of newborn infant and neural tube defects in Africa, 2022.
Figure 19
Figure 19
Forest plot showing the association of maternal medical illness and neural tube defects in Africa, 2022.
Figure 20
Figure 20
Forest plot depicting the association of the maternal history of stillbirth and neural tube defects in Africa, 2022.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Mitchell L. E. Epidemiology of neural tube defects. American Journal of Medical Genetics Part C: Seminars in Medical Genetics . 2005;135C(1):p. 88. doi: 10.1002/ajmg.c.30057. - DOI - PubMed
    1. Blencowe H., Kancherla V., Moorthie S., Darlison M. W., Modell B. Estimates of global and regional prevalence of neural tube defects for 2015: a systematic analysis. Annals of the New York Academy of Sciences . 2018;1414(1):31–46. doi: 10.1111/nyas.13548. - DOI - PubMed
    1. Rampersaud E., Bassuk A. G., Enterline D. S., et al. Whole genomewide linkage screen for neural tube defects reveals regions of interest on chromosomes 7 and 10. Journal of Medical Genetics . 2005;42(12):940–946. doi: 10.1136/jmg.2005.031658. - DOI - PMC - PubMed
    1. MacHenry J. C. R. M., Nevin N. C., Merrett J. D. Comparison of central nervous system malformations in spontaneous abortions in northern Ireland and South-East England. British Medical Journal . 1979;1(6175):1395–1397. doi: 10.1136/bmj.1.6175.1395. - DOI - PMC - PubMed
    1. Al-Mendalawi M. D. Epidemiology of neural tube defects. Saudi Medical Journal . 2015;36(3):373–374. doi: 10.15537/smj.2015.3.11087. - DOI - PMC - PubMed

LinkOut - more resources