Nutritional status among women whose pregnancy outcome was afflicted with neural tube defects in Tigray region of Ethiopia.

BACKGROUND: Nutritional deficiency in pregnant women is a confirmed cause of neural tube defects (NTDs). Alongside to this background, We sought to determine the nutritional status and level of awareness on the issue of the NTDs as well as folic acid (FA) utilization among women who born infants with NTDs in Tigray region of Ethiopia. METHOD: A standard interviewer and a food frequency questionnaire was used to obtain information from mothers of cases with neural tube defects (n = 205) and their controls (n = 412). Demographic information, weekly food frequency consumption, information on awareness on the issue of the NTDs as well as folic acid (FA) use was collected. RESULT: The mean age of the mothers of the cases and controls was 26.5 years (range 17-43 years) and 26.05 years (range 18-40 years), respectively. Approximately 92.2% (189/205) of the cases and 90.5% (373/412) control mothers do not know the term folic acid (FA). Notably, all participant mothers (100%) did not understand that NTDs are a serious health problem associated with inadequate intake of FA and none of them used FA prior to conception. Food frequency analysis revealed that except for cereals (p = 0.12) and milk products (p = 0.8), the proportion of the consumed food type within seven days recalls period showed a statistically significant difference (p < 0.05) as compared with controls. The dietary diversity score assessment showed those attained low and high dietary diversity score were a statistically significant difference (p = 0.0003) and (p = 0.0002) respectively) as compared with controls, but the medium dietary diversity score no significant variation was found (p = 0.35). CONCLUSION: This study has shown none of the study participants do understand that NTDs are a serious health problem associated with inadequate intake of FA. Dietary diversity score was significantly associated with incidence of NTDs. This Ethiopian study also highlighted the need of considering the basic food in future programs of food fortification with folic acid, preconceptional folic acid supplementation and adequate dietary intake counseling. Advance research is required to find out the gene-nutrient and gene environment interactions, as well as particular causative factors associated with NTDs in Ethiopia.

Maternal risk factors associated with neural tube defects in Tigray regional state of Ethiopia.

INTRODUCTION: Unlike developing countries, including Ethiopia the identification of the risk factors in decreasing the burden of neural tube defects (NTDs) is well established in the developed world. Hence, we sought to determine the factors associated with NTDs in Tigray - Ethiopia. METHODS: We undergo a case-control analysis where all NTDs cases were compared to a group of controls derived randomly from the same hospitals where cases were recruited from. The NTDs survey tool which contains a standard questionnaire was prepared. Parental socio-demographic and clinical information such, maternal age, obstetric history, illnesses, drug intake, radiation, occupation, education, history of congenital anomalies, residence, exposure to pollutants such as smoking, chemicals, paternal history, and folic acid utilization was collected and analyzed using SPSS version 20. RESULT: This study has shown the maternal age, and residency, birth order 3 and 4, unplanned pregnancy, history of breastfeeding above 2 years, history of stillbirths, history of male gender predominance were found to have a strong association with an occurrence of NTDs (p = 0.0001). Though the binary logistic regression analysis showed no significant association in some of the risk factors such as maternal health and drug history, the frequency analysis showed they may have an impact on the incidence of NTDs. CONCLUSION: This study has shown the majority of the maternal risk factors and other lifestyle patterns had a significant impact on the occurrence of NTDs. Therefore, efficient monitoring of NTDs in Ethiopia is vital, so our study could be groundwork information in Ethiopia for future programs.

High burden of neural tube defects in Tigray, Northern Ethiopia: Hospital-based study.

INTRODUCTION: Neural tube defects are the major causes of fetal loss and considerable disabilities in infants. Currently, there is no significant research on the incidence of Neural tube defects in the Tigray region of Ethiopia. OBJECTIVE: To determine the incidence and clinical pattern of the Neural Tube Defects. METHODS: A hospital-based cross-sectional study was conducted from October 2016 to June 2017. All pregnancy outcomes were examined for any externally visible birth defects and neurological integrity by trained midwives under the supervision of senior obstetrics and gynecology and a neurosurgeon. Data were collected using a survey tool to collect maternal and newborn demographic data and a checklist developed to capture newborns with Neural Tube Defects. Data were analyzed using SPSS version 20. The prevalence of NTDs was calculated per 10,000 births. RESULT: Out of the 14,903 births during the study period, a total of 195 infants were born afflicted with Neural Tube Defects. The burden of infants with anencephaly and spina bifida was 66.4 and 64.4 per 10, 000 births, respectively. The overall incidence rate of NTDs in this study was 131 per 10, 000 births of which 23% were liveborn and 77% were stillborn. The highest burden of Neural Tube Defects was observed in Adigrat Hospital from Eastern Zone of Tigray (174 per 10,000 births) and Lemlem Karl Hospital from Southern Zone of Tigray (304 per 10,000 births) compared to Kahsay Abera Hospital from Western Zone (72.8 per 10,000 births) and Sihul Hospital from North Western Zone of Tigray (69.8 per 10,000 births). CONCLUSION AND RECOMMENDATION: Assuming that the non folic acid preventable rate should be 5 per 10,000 births, our prevalence rate is 131 per 10,000 births, and then we have a rate or an epidemic that is 26 times what it should be. This just emphasizes the urgency to implement effective programs to get all women of reproductive age to have adequate folic acid to prevent all of folic acid-preventable spina bifida and anencephaly, which would prevent 96% (125/130) of spina bifida and anencephaly in the Tigray Provence.

Patterns and Causes of Amputation in Ayder Referral Hospital, Mekelle, Ethiopia: A Three-Year Experience.

BACKGROUND: Amputation is a surgical procedure for the removal of a limb which is indicated when limb recovery is impossible. There are different types of amputation, and their causes can vary from one area to the other. Therefor, the aim of this study is to find out the patterns and causes of amputations in patients presented to Ayder Referral Hospital, Mekelle, Ethiopia. METHODS: the record of 87 patients who had amputation at different sites after admission to Ayder referral hospital, Mekelle, Ethiopia in three years period were reviewed retrospectively. RESULT: A total of 87 patients had amputation of which 78.2% were males. The age range was from 3 to 95 years, and the mean age was 40.6 in years. The most common indications were trauma (37.7%), tumor (24.1%), and peripheral arterial disease (PAD) (20.7%). The commonest type of amputation was major lower limb amputation (58.6%) which includes above knee amputation (35.6%)and below knee amputation (23%) followed by digital amputation (17.2%). There was 11.4% major upper limb amputation of which there was one patient who had re-amputation. CONCLUSION: Most of the indications for amputations in our setup are potentially preventable by increasing awareness in the society on safety measures both at home and at work and early presentation to health facilities.