Prevention of myelomeningocele: African perspectives
Taopheeq Bamidele Rabiu1, Amos Olufemi Adeleye
1Division of Neurological Surgery, Department of Surgery, LAUTECH Teaching Hospital, Osogbo, Nigeria. eshohealth@gmail.com
Insights
Neural tube defects (NTDs) like myelomeningocele cause severe disabilities. Folate supplementation significantly reduces NTDs, offering a key prevention strategy, especially in Africa where awareness and policies are lacking.
Area of Science:
- Public Health
- Neurology
- Obstetrics
Background:
- Neural tube defects (NTDs), particularly myelomeningocele, represent a significant global public health concern due to severe disabilities and life-threatening outcomes.
- Awareness and preventive efforts for NTDs are notably low in many African countries, hindering progress in global prevention strategies.
Purpose of the Study:
- To review the societal burden of myelomeningocele and assess current prevention strategies, with a specific focus on the African context.
- To highlight the potential of folate supplementation (up to 85% reduction in NTDs) and secondary prevention through prenatal detection and termination as global NTD reduction opportunities.
- To draw attention to the inadequate understanding and policy implementation for NTD prevention in Africa.
Main Methods:
- Literature review of global studies on NTD prevention.
- Analysis of folate supplementation efficacy and secondary prevention methods.
- Assessment of the policy landscape and awareness levels in Africa regarding NTDs.
Main Results:
- Folate deficiency is a significant contributor to NTD causation.
- Effective folate supplementation and secondary prevention strategies can substantially reduce NTD incidence.
- Africa faces significant challenges in NTD awareness and policy implementation for prevention.
Conclusions:
- Understanding folate's role in NTDs has led to some preventive measures globally.
- Urgent promotion of policies for universal folic acid fortification of staple foods is crucial for African governments and the international community.
Background:
The prevention of neural tube defects (NTDs) is now an issue of major public health concern. Myelomeningocele, the most common NTD, often results in severe disabilities and may be life threatening. In Africa, there is little awareness of the NTDs, and most African countries lag behind in the global efforts at preventing them.
Purpose:
Following a review of global literature, we discuss the burden of myelomeningocele on the society and the current state of its prevention with an emphasis on Africa within the global context. The realization that folate supplementation reduces the occurrence of NTDs by as much as 85 % offers an opportunity to promote global reduction in the incidence of NTDs through (1) effective folate supplementation strategies combined with (2) secondary prevention using prenatal detection and termination of NTD pregnancies within respective national legal frameworks. We call attention to the poor state of understanding of NTDs in Africa and the alarming rarity of policies to prevent the condition in the continent.
Conclusions:
The understanding of the contributions of folate deficiency to the causation of NTDs has enabled appropriate, though still inadequate, preventive measures to be taken in several countries. We call on African governments and the international community to rapidly promote policies aimed at making fortification of wheat (and or other substitute staple foods) with folic acid universally available.
