|LETTER TO EDITOR
|Year : 2016 | Volume
| Issue : 2 | Page : 101-102
The prevalence of neural tube defects in North-West Nigeria
Mahmood Dhahir Al-Mendalawi
Department of Paediatrics, Al Kindy College of Medicine, Baghdad University, Baghdad, Iraq
|Date of Web Publication||25-Oct-2016|
Mahmood Dhahir Al-Mendalawi
Department of Paediatrics, Al Kindy College of Medicine, Baghdad University, P.O. Box: 55302, Baghdad Post Office, Baghdad
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Al-Mendalawi MD. The prevalence of neural tube defects in North-West Nigeria. Saudi J Health Sci 2016;5:101-2
I read with interest the study by Nnadi and Singh entitled, "The prevalence of neural tube defects (NTDs) in North-West Nigeria."  I would like to throw light on the expanding health problem of NTDs in Iraq and compare it with that reported in Nigeria. 
First, Nnadi and Singh mentioned that the prevalence of NTDs among their studied population was 2.2/1000 deliveries.  I presume that the actual NTDs prevalence was underestimated. This could be attributed to the following two points. (1) The aforementioned prevalence was extracted from hospital-based data rather than community-based data. (2) In Nigeria, the rate of home delivery is still substantial (60.5%).  Therefore, a significant number of babies with NTDs born at home are expected not to be medically registered.
Second, Nnadi and Singh  did well in comparing their reported NTDs prevalence (2.2/1000 deliveries) with those reported locally and internationally. Unexpectedly, they did not compare their reported NTDs prevalence with that recorded in Iraq. Iraq is currently considered among the countries with the highest reported NTDs prevalence in the world, with a mean prevalence of 24.2/1000 live births.  Nnadi and Singh  attributed two risk factors contributing to the development of NTDs, namely a maternal febrile illness in all the trimesters of pregnancy and low-socioeconomic class, even though there was no statistical significance. However, the etiology behind the reported surge in NTDs prevalence in Iraq is quite different. It was attributed to the cumulative effects of exposure to toxicants, including depleted uranium, maternal malnutrition, gestational folate deficiency, absent national program on dietary folate fortification, and marked psychosocial stress secondary to decades of conflicts Iraq has engaged. 
Third, a call has been recently sent to the health authorities in Iraq to take into consideration implementing a national program to halt further rise in the NTDs prevalence. This program ought to comprise various epidemiologic, statistical, diagnostic, therapeutic, and preventive measures tailored by related personnel.  Although the prevalence of NTDs (2.2/1000 deliveries) reported by Nnadi and Singh  is in consistence with literature, the implementation of a similar program in Nigeria is still solicited to prevent further staggering in NTDs prevalence.
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Conflicts of interest
There are no conflicts of interest.
| References|| |
Nnadi DC, Singh S. The prevalence of neural tube defects in North-West Nigeria. Saudi J Health Sci 2016;5:6-10.
Ashimi AO, Amole TG. Prevalence, reasons and predictors for home births among pregnant women attending antenatal care in Birnin Kudu, North-West Nigeria. Sex Reprod Healthc 2015;6:119-25.
Al-Mendalawi MD. Towards a national program to combat neural tube defects in Iraq. Congenit Anom (Kyoto) 2014;54:123.
Al-Mendalawi MD. Neural tube defects: Is it a growing health problem in Iraq? J Arab Board Health Specializations 2012;13:24-8.