Publication:

Demography and management outcome of neural tube defects in a Nigerian tertiary health institution

Background Neural tube defects (NTD) are a group of congenital anomalies of the central nervous system (CNS). Its management is very challenging. A recognised leading cause is a folic acid deficiency, therefore prevented by taking a preconception folic acid. This study looked at the demographic features and management outcome of neural tube defect, a fairly common preventable condition with the need to raise awareness on its preventive measures.

Methods The study was conducted on 82 patients with NTD that were managed in federal medical centre Yola, in North-Eastern Nigeria. It was a retrospective study over a 4-year period, from January 2016 to December 2019.

Results Ages at presentations ranged from 1 to 93 days with a mode of 3 days. There were 29 males and 53 females with a male to female ratio of 1:1.8. Spina bifida constituted 74.4%, encephalocele (20%), Anencephaly (5%). Types of spina bifida managed were myelomeningocele (63.5%), meningocele (33.3%), and lipo-myelomeningocele (3.2%). Two had a 2-level meningocele. Syndromic associations of myelomeningocele were with hydrocephalus (78.1%), foot deformity (22.2%), cardiac (2.5%), and anorectal malformation (2.5%). Ninety-five-point one had various surgeries with 30.8% developing postoperative complications. commonest was post excision of myelomeningocele and encephalocele hydrocephalus (29.1%) in 7 patients. Post-operative Mortality was reported in 2 patients (8.3%).

Conclusions Myelomeningocele was the commonest NTD, and its syndromic association with hydrocephalus was common. A large number of patients had surgical interventions with a good outcome. Post-op mortality was minimal.