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Clinical profile of neural tube defects in Sudanese children: Is malaria a risk factor?
Basma Sadik1, Haydar E Babikir2,3, Mohammed A R Arbab4
1Ministry of Health, Sudan.
Insights
Neural tube defects (NTDs) are common birth defects impacting Sudanese children under five. Spina bifida was the most frequent NTD, often associated with young mothers and consanguineous parents, highlighting potential public health concerns.
Area of Science:
- Pediatrics
- Neurology
- Public Health
Background:
- Neural tube defects (NTDs) represent a significant global public health challenge, causing severe structural malformations in infants.
- Understanding the epidemiological profile of NTDs is crucial for developing targeted prevention and intervention strategies.
Purpose of the Study:
- To investigate the epidemiological characteristics and patterns of neural tube defects in Sudanese children under five years of age.
- To identify risk factors and associated anomalies in pediatric NTD cases.
Main Methods:
- A prospective cross-sectional study was conducted at the National Centre of Neurological Sciences (NCNS) in Khartoum, Sudan.
- Data were collected from 71 children under five diagnosed with NTDs using a structured questionnaire.
- Statistical analysis was performed using SPSS to determine demographic and clinical patterns.
Main Results:
- The majority of NTD cases (57.7%) were infants under six months, with a female-to-male ratio of 1.2:1.
- Spinal defects, particularly spina bifida (73.2%), were more prevalent than cranial defects (encephaloceles at 26.8%).
- Commonly associated conditions included hydrocephalus, with NTDs noted in offspring of young mothers and consanguineous parents.
Conclusions:
- Spina bifida is the predominant NTD in young Sudanese children, frequently linked to maternal age and parental consanguinity.
- While folic acid intake was reported by many mothers, irregular usage was common. Malaria infection during pregnancy and the use of anti-malarial drugs like Sulfadoxine/Pyremethamine (Fansidar®) may contribute to NTD etiology.
Abstract:
Neural tube defects (NTDs) are one of the most common structural malformations in human kind. It is a public health problem with great impact on the child, parents and the community at large. The aim is to study the epidemiological profile and patterns of NTDs in under five-year of age Sudanese children who attended the neurosurgical clinic at the National Centre of Neurological Sciences (NCNS), Khartoum during the period from March 2014 to December 2014. This was a prospective cross-sectional study conducted at the neurosurgery clinic in NCNS, Khartoum. A pre-set structured questionnaire was the research tool. All children under five-year of age with NTDs, who attended the Neurosurgery clinic in NCNS during the period of the study, were recruited. The data were analyzed using statistical package of social sciences (SPSS). The sample size was 71. The majority of cases were less than 6 months of age (57.7%). The female to male ratio was (1.2:1). Spinal defects were noticed to be more common than cranial defects. The spina bifida was the commonest anomaly accounting for (73.2%), whereas, encephaloceles accounted for (26.8%). The lumbo-sacral region was the commonest site (34.6%). Hydrocephalus was the most commonly associated anomaly. NTDs were common in the young mother age group and consanguine parents. Although folic acid was taken by (69.0%) of the mothers, it was not on regular bases in the majority. Infection, particularly, malaria, during pregnancy was reported in 25.4%. Anti-malaria Sulfadoxine/Pyremethamine (Fansidar®) used by most in our cohort is an anti-folate drug and could be implicated in the etiology.
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