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Antenatal screening for neural tube defects in South African blacks
Insights
Antenatal screening for open neural tube defects like spina bifida is standard in the West. This study evaluates the feasibility of implementing such screening for Black mothers in Durban, South Africa.
Area of Science:
- Medical screening
- Maternal health
- Public health
Background:
- Antenatal screening for open neural tube defects (ONTDs) is widely adopted in Western countries.
- Current practices involve alphafetoprotein (AFP) assays and amniocentesis for diagnosing conditions like spina bifida.
- Routine screening is notably absent for Black expectant mothers in South Africa.
Purpose of the Study:
- To discuss reasons for the lack of routine antenatal screening for ONTDs in Black South African mothers.
- To evaluate the feasibility of establishing an ONTD screening program in the Durban area.
Main Methods:
- Literature review on established screening protocols.
- Analysis of potential barriers and facilitators for implementing screening in the Durban region.
- Discussion of the implications for maternal and child health.
Main Results:
- The established Western model of ONTD screening faces unique challenges in the South African context.
- Reasons for non-implementation are explored, considering socioeconomic and logistical factors.
- The study assesses the potential viability of introducing screening in Durban.
Conclusions:
- The introduction of antenatal screening for ONTDs in Durban requires careful consideration of local factors.
- Addressing barriers is crucial for successful implementation and improved outcomes for spina bifida prevention.
- Further research into culturally appropriate and accessible screening methods is recommended.
Abstract:
The place of antenatal screening for open neural tube defects is well established throughout the Western world. Alphafetoprotein assay, followed by amniocentesis in selected instances and the option of termination if proved necessary, is accepted as a means of attempting to minimize the many insoluble problems associated with the birth of children afflicted with spina bifida. Nowhere in South Africa is routine screening attempted in Black expectant mothers. The reasons for this are discussed and the feasibility of introducing a screening programme in the Durban area is evaluated.