ArticleBirth defects research2021
Projected impact of mandatory food fortification with folic acid on neurosurgical capacity needed for treating spina bifida in Ethiopia.
Article in Birth defects research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 3 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 3 syntheses or guidelines pooled it, 27 citations in OpenAlex.
- Prevalence of neural tube defects and their associated factors in Sub-Saharan Africa: a systematic review.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2025Pooled it
- Birth prevalence and risk factors of neural tube defects in Ethiopia: a systematic review and meta-analysis.BMJ open · 2023Pooled it
- Dietary Recommendations for Ethiopians on the Basis of Priority Diet-Related Diseases and Causes of Death in Ethiopia: An Umbrella Review.Advances in nutrition (Bethesda, Md.) · 2023Pooled it
- Timeliness of surgical repair among infants with myelomeningocele in a tertiary care hospital in Addis Ababa, Ethiopia.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2025Observational
- The safety of a dolutegravir (DTG)-based antiretroviral treatment (ART) regimen for pregnancy and birth outcomes in Ethiopia: evidence from multicenter cohort study.BMC infectious diseases · 2024Article
- Augmented Reality (AR) in Surgery in Low- and Middle-Income Countries (LMICs): A Scoping Review.Cureus · 2024Article
- Surgically Correctable Congenital Anomalies: Reducing Morbidity and Mortality in the First 8000 Days of Life.World journal of surgery · 2023Review
- Spina bifida management in low- and middle-income countries - a comprehensive policy approach.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2023Review
- A case study of ReachAnother Foundation as a change champion for developing spina bifida neurosurgical care and advocating for primary prevention in Ethiopia.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2023Review
- The role of neurosurgery in advancing pediatric CNS tumor care worldwide.Brain & spine · 2023Review
- Clinical spine care partnerships between high-income countries and low-and-middle-income countries: A scoping review.PloS one · 2023Article
- Folate, Vitamin B12, and Homocysteine Levels in Women With Neural Tube Defect-Affected Pregnancy in Addis Ababa, Ethiopia.Frontiers in nutrition · 2022Article
- Consumption of dietary folate estimates and its implication for reproductive outcome among women of reproductive age in Kersa: cross-sectional survey.BMC nutrition · 2021Article
- Projected impact of mandatory food fortification with folic acid on neurosurgical capacity needed for treating spina bifida in Ethiopia.Birth defects research · 2021Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Spina bifida, also known as meningomyelocele, is a major birth defect mostly associated with folate deficiency in the mother early in pregnancy. The prevalence of spina bifida is disproportionately high in Ethiopia compared to the global average; about 10,500 liveborn are affected annually. Many affected infants do not receive timely repair surgery. There are a high number of stillbirths, and neonatal, infant, and under-five deaths. Mandatory fortification of staple foods such as wheat and maize flour with folic acid, a B vitamin, is an effective primary prevention strategy for spina bifida. Survival in those with spina bifida increases if neurosurgical intervention is available soon after birth, along with continuous surgical and clinical aftercare throughout the lifespan. Currently, Ethiopia does not have mandatory food fortification for primary prevention or adequate neurosurgical capacity to meet the need to prevent adverse outcomes associated with spina bifida. We present in this paper two concurrent and complementary policy and practice solutions occurring in Ethiopia through global partnerships: (1) capacity-building of neurosurgery care through training programs; and (2) promoting national mandatory folic acid fortification of staples for primary prevention of spina bifida. These two policy and practice interventions ensure all affected infants can receive timely pediatric neurosurgery and sustained surgical aftercare through required neurosurgeon availability, and ensure primary prevention of spina bifida. Primary prevention of spina bifida frees up significant neurosurgical capacity in resource-poor settings that can then be directed to other critical neurosurgical needs thus lowering child mortality and morbidity.
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