Objectives: The aim of study was to determine the pattern and management of neural
tube defects (NTD). Methodology: It was a hospital based descriptive
cross-sectional retrospective study on patients who consulted and/or were admitted
at the Douala General hospital for neural tube defects from January 2005 to
April 2015. Results: A total of forty-nine (49) patients were enrolled. Males
constituted 59.8% and females 40.2% giving a sex ratio of 1.5 in favour of
males. Most of the parents of the patients (71.5%) had a low socio-economic
status. Myelomeningocele was the most common type (80.4%) followed by 17.4%
cases of meningocele and 2.2% cases of lipomeningocele. Three cases (3) of
encephaloceles were seen during this period. The commonest site of these
defects was the lumbosacral region (47.8%). Other sites included lumbar (19;
41.3%), sacral (3; 6.5%) and thoracolumbar (2; 4.3%) ones. About half of the
patients (24; 48.9%) presented with ruptured lesions. Hydrocephalus was also recorded
in 65.3% of patients. Talipes equinovarus and talipes calcaneovalgus
were the most common associated orthopedic birth defects found. Surgical closure
was done for 44 (89.9%) patients. Ventriculoperitoneal shunting was done in
78.1% of those who presented with hydrocephalus. Post-operative complications
were more frequent in patients with ruptured lesions (P = 0.001). The most common
post-operative complications were wound infections (22; 44.9%) and wound
dehiscence (20; 40.8%). Conclusion: Lumbosacral Myelomeningocele was the
most common type of NTD in our region. Low socio-economic status was a common
risk factor.
References
[1]
Stoll, B.G. (2008) Congenital Anomalies. In: Kliegman, R.M., Jenson, H.B., Behrnan, R.E. and Staton, B.F., Eds., Nelson Textbook of Pediatrics, 18th Edition, WB Sanders Co, 711-713.
[2]
Haslam, R.H.A. (2000) Congenital Anomalies of the Central Nervous System. In: Behrman, R.E., Kliegman, R.M. and Jenso, H.B., Eds., Nelson Textbook of Paediatrics, 16th Edition, Saunders, Philadelphia, 1803-1810.
[3]
Uba, A.F., Isamade, E.S., Chirdan, L.B., Edino, S.T. and Igun, G.O. (2004) Epidemiology of Neural Tube Defects in North Central Nigeria. African Journal of Paediatric Surgery, 1, 16-19.
[4]
Shanta, K., Rajalaxmi, P. and Sadananda, R. (2014) Neurl Tube Defect: Epidemiologic and Demographic Implication. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS), 13, 1-4.
[5]
Oyewole, A., Adeloye, A. and Adeyokunnu, A.A. (1985) Psychosocial and Cultural Factors Associated with the Management of Spina Bifida Cystica in Nigeria. Developmental Medicine & Child Neurology, 27, 498-503.
https://doi.org/10.1111/j.1469-8749.1985.tb04574.x
[6]
Airede, K.I. (1992) Neural Tube Defects in the Middle Belt of Nigeria. Journal of Tropical Pediatrics, 38, 27-30. https://doi.org/10.1093/tropej/38.1.27
[7]
Alatise, O.I., Adeolu, A.A., Komolafe, E.O., Adejuyigbe, O. and Sowande, A. (2006) Pattern and Factors Affecting Management Outcome of Spina Bifida Cystic in Ile-Ife, Nigeria. Pediatric Neurosurgery, 42, 277-283.
https://doi.org/10.1159/000094062
[8]
Ambe, J.P., Nadziga, A.G., Akpede, G.O. and Mava, Y. (2010) Pattern and Outcome of Congenital Abnormality in Newborn Babies in a Nigerian Teaching Hospital. West Africa Medicine, 29, 24-29.
[9]
Djientcheu, V.D.P., Njamnshi, A.K., Wonkam, A., et al. (2008) Management of Neural Tube Defects in a Sub-Saharan African Country: The Situation in Yaoundé-Cameroon. Journal of the Neurological Sciences, 275, 29-32.
https://doi.org/10.1016/j.jns.2008.07.003
[10]
Motah, M., Felix, U., Ndoumbe, A., Moumi, M.G. and Djientcheu, V.D.P. (2014) Tethered Cord Syndrome in Adults: A Case Report in Cameroon. The Pan African Medical Journal, 17, 217. https://doi.org/10.11604/pamj.2014.17.217.3516
[11]
Sanoussi, S., Gamatie, Y., Kelani, A., et al. (2001) Malformations du tube neural au Niger: A propos de 387 cas en 10 ans: Plaidoyer pour un traitement préventif par l'acide folique en période périconceptionnelle. Médecine d’Afrique noire, 48, 509-515.
[12]
Ouattara, O., Dieth, A., Kouame, B., et al. (1997) Les myelomeningoceles en Afrique: Cas de la Cote D’ivoire. Médecined’Afrique Noire, 44.
[13]
Kabre, A., Badiane, S.B., Sakho, V., Ba, M.C. and Gueye, M. (1994) Genetic and Etiologic Aspects of Spina Bifida in Senegal: Apropos of Zil Cases Collected at the Neurosurgical Clinic UHC of Fann. Dakar Medical, 39, 113-119.
[14]
Antony, A.C. (2003) Vegetarianism and Vitamin B12 (Cobalamin) Deficiency (Editorial). The American Journal of Clinical Nutrition, 78, 3-6.
[15]
Elwood, J.M., Little, J. and Elwood, J.H. (1992) Epidemiology and Control of Neural Tube Defects. Oxford University Press, New York.
[16]
Castillo-Lancelloti, C., Tur, J.A. and Uau, Y.R. (2013) Impact of Folic Acid Fortification of Flour on Neural Tube Defects. Public Health Nutrition, 16, 901-911.
[17]
Yerby, M.S. (2003) Management Issues for Women with Epilepsy: Neural Tube Defects and Folic Acid Supplementation. Neurology, 61, S23-S26.
https://doi.org/10.1212/WNL.61.6_suppl_2.S23
[18]
Fieggen, K. and Stewart, C. (2014) Aetiology and Antenatal Diagnosis of Spina Bifida. South African Medical Journal, 104, 218.
[19]
Chen, C.P. (2008) Syndromes, Disorders and Risk Factors Associated with Neural Tube Defects (VII). Taiwanese Journal of Obstetrics & Gynecology, 47, 276-282.
https://doi.org/10.1016/s1028-4559(08)60124-2
[20]
Shehu, B.B., Ameh, E.A. and Ismail, N.J. (2000) Spina Bifida Cystica: Selective Management in Zaria, Nigeria. Annals of Tropical Paediatrics, 20, 239-242.
https://doi.org/10.1080/02724936.2000.11748142
[21]
Mabogunje, O.A. (1990) Spina Bifida Cystica in Northern Nigeria. Child NervSyst, 6, 103-106. https://doi.org/10.1007/BF00307931
[22]
Kumar, R. and Singh, S.N. (2003) Spinal Dysraphism: Trends in Northern India. Pediatric Neurosurgery, 33, 133-145. https://doi.org/10.1159/000068819
[23]
Asindi, A. and Al-Shehri, A. (2001) Neural Tube Defects in the Asir Region of Saudi Arabia. Annals of Saudi Medicine, 21, 26-29.
https://doi.org/10.5144/0256-4947.2001.26
[24]
Najat, F., Baradaran, N. and El Khahab, M. (2011) Large Myelomeningocele Repair. Indian Journal of Plastic Surgery, 44, 87-90.
[25]
Fong, D. (2006) Spinal Dysraphism. The Hong Kong Medical Diary, 11, 7-11.
[26]
Danzer, E. and Flake, A.W. (2006) Inutero Repair of Myelomeningocele. Neuroembryology and Aging, 4, 165-174. https://doi.org/10.1159/000118926
[27]
Salih, M.A., Murshid, W.R. and Seidahmed, M.Z. (2014) Epidemiology, Prenatal Management, and Prevention of Neural Tube Defects. Saudi Medical Journal, 35, S15-S28.
