Epidemiology of Neural Tube Defects in North Central Nigeria

Abstract

Background: Neural tube defects (NTDs) are associated with high childhood morbidity worldwide. We wanted to know the pattern and the possible aetiological factors responsible for this anomaly in northcentral Nigeria. Patients and Methods: The clinical records of all children with NTD admitted at JUTH between 1986 and 2003 were reviewed and the data analyzed for age, gender and antenatal care, incidence, type and location of lesion. Results: There were 284 patients (144 males and 140 females). The incidence of NTD was 0.5/1000 live births and 1.9% of all admissions. The Hausa / Fulani ethnic group constituted the highest proportion. In 165 (58%) patients, the mothers had received antenatal care; however, the antenatal care generally started late in pregnancy. Spina bifida constituted 97% of the total NTDs, 79.6% of which were meningomyeloceles. The sites mostly affected were the lumbosacral and the thoracolumbar regions in 55.8% and 31.9% of cases, respectively. Hydrocephalus was the most common complication occurring in 194 (68.3%) patients. Among those patients presenting with myelomeningocele, 95 (42%) had ruptured sacs, while in 62 (27.4%) the sacs were ulcerated and locally infected; 15 (6.6%) patients had meningitis while 16 (7.1%) had septicemia. Conclusion: The most common type of NTD in this study was lumbosacral myelomeningocele, the majority of which were complicated at presentation. Consanguinity marriage and delayed or absence of antenatal care appear to be important aetiological factors.