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High potential for reducing folic acid-preventable spina bifida and anencephaly, and related stillbirth and child mortality, in Ethiopia.
Birth Defects Res. 2019 11 15; 111(19):1513-1519.BD

Abstract

BACKGROUND

Recent surveillance studies in Ethiopia show an epidemic of spina bifida and anencephaly, two major neural tube birth defects that are severe and life-threatening. Our objective was to estimate proportional reductions in current stillbirth and child mortality rates in Ethiopia through folic acid-based interventions to prevent spina bifida and anencephaly.

METHODS

Using secondary data from multiple sources, we estimated percent reductions in stillbirth, neonatal, infant, and under-five child mortality rates that would have occurred in Ethiopia in the year 2016 had all folic acid-preventable spina bifida and anencephaly been prevented; and the contributions of these reductions toward Ethiopia's Year 2030 Every Newborn Action Plan (ENAP) goal on stillbirth, and sustainable development goal (SDG) on child mortality rates. The 2016 prevalence of spina bifida and anencephaly in Ethiopia was assumed as 13 per 1,000 total births, with the prevention goal reaching 0.5 per 1,000 total births.

RESULTS

Folic acid interventions in Ethiopia would have prevented about 41,610 cases of folic acid-preventable spina bifida and anencephaly-affected pregnancies during the year 2016. We estimate that this prevention is associated with reduction of 31,830 stillbirths and 7,335 under-five child deaths annually. The proportional contribution of this prevention toward achieving Ethiopia's ENAP goal is 54% for stillbirth, and toward SDG is 4.5% for neonatal- and 6.8% for under-five mortality.

CONCLUSIONS

Spina bifida and anencephaly contribute to substantial stillbirths and child death in Ethiopia. Large-scale fortification of foods like wheat flour and salt can help achieve Ethiopia's ENAP and SDG targets addressing preventable stillbirth, neonatal, and under-five mortality.

Authors+Show Affiliations

Department of Epidemiology, Emory University, Rollins School of Public Health, Atlanta, Georgia.Department of Epidemiology, Emory University, Rollins School of Public Health, Atlanta, Georgia.Department of Neurosurgery, School of Medicine, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.Department of Nutrition and Dietetics, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.Department of Epidemiology, Emory University, Rollins School of Public Health, Atlanta, Georgia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31424635

Citation

Dixon, Meredith, et al. "High Potential for Reducing Folic Acid-preventable Spina Bifida and Anencephaly, and Related Stillbirth and Child Mortality, in Ethiopia." Birth Defects Research, vol. 111, no. 19, 2019, pp. 1513-1519.
Dixon M, Kancherla V, Magana T, et al. High potential for reducing folic acid-preventable spina bifida and anencephaly, and related stillbirth and child mortality, in Ethiopia. Birth Defects Res. 2019;111(19):1513-1519.
Dixon, M., Kancherla, V., Magana, T., Mulugeta, A., & Oakley, G. P. (2019). High potential for reducing folic acid-preventable spina bifida and anencephaly, and related stillbirth and child mortality, in Ethiopia. Birth Defects Research, 111(19), 1513-1519. https://doi.org/10.1002/bdr2.1584
Dixon M, et al. High Potential for Reducing Folic Acid-preventable Spina Bifida and Anencephaly, and Related Stillbirth and Child Mortality, in Ethiopia. Birth Defects Res. 2019 11 15;111(19):1513-1519. PubMed PMID: 31424635.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High potential for reducing folic acid-preventable spina bifida and anencephaly, and related stillbirth and child mortality, in Ethiopia. AU - Dixon,Meredith, AU - Kancherla,Vijaya, AU - Magana,Tony, AU - Mulugeta,Afework, AU - Oakley,Godfrey P,Jr Y1 - 2019/08/19/ PY - 2019/05/18/received PY - 2019/07/15/revised PY - 2019/08/09/accepted PY - 2019/8/20/pubmed PY - 2020/8/26/medline PY - 2019/8/20/entrez KW - Ethiopia KW - anencephaly KW - child mortality KW - spina bifida KW - sustainable development goals SP - 1513 EP - 1519 JF - Birth defects research JO - Birth Defects Res VL - 111 IS - 19 N2 - BACKGROUND: Recent surveillance studies in Ethiopia show an epidemic of spina bifida and anencephaly, two major neural tube birth defects that are severe and life-threatening. Our objective was to estimate proportional reductions in current stillbirth and child mortality rates in Ethiopia through folic acid-based interventions to prevent spina bifida and anencephaly. METHODS: Using secondary data from multiple sources, we estimated percent reductions in stillbirth, neonatal, infant, and under-five child mortality rates that would have occurred in Ethiopia in the year 2016 had all folic acid-preventable spina bifida and anencephaly been prevented; and the contributions of these reductions toward Ethiopia's Year 2030 Every Newborn Action Plan (ENAP) goal on stillbirth, and sustainable development goal (SDG) on child mortality rates. The 2016 prevalence of spina bifida and anencephaly in Ethiopia was assumed as 13 per 1,000 total births, with the prevention goal reaching 0.5 per 1,000 total births. RESULTS: Folic acid interventions in Ethiopia would have prevented about 41,610 cases of folic acid-preventable spina bifida and anencephaly-affected pregnancies during the year 2016. We estimate that this prevention is associated with reduction of 31,830 stillbirths and 7,335 under-five child deaths annually. The proportional contribution of this prevention toward achieving Ethiopia's ENAP goal is 54% for stillbirth, and toward SDG is 4.5% for neonatal- and 6.8% for under-five mortality. CONCLUSIONS: Spina bifida and anencephaly contribute to substantial stillbirths and child death in Ethiopia. Large-scale fortification of foods like wheat flour and salt can help achieve Ethiopia's ENAP and SDG targets addressing preventable stillbirth, neonatal, and under-five mortality. SN - 2472-1727 UR - https://www.unboundmedicine.com/medline/citation/31424635/High_potential_for_reducing_folic_acid_preventable_spina_bifida_and_anencephaly_and_related_stillbirth_and_child_mortality_in_Ethiopia_ L2 - https://doi.org/10.1002/bdr2.1584 DB - PRIME DP - Unbound Medicine ER -