Introduction: Neural tube defects (NTDs), particularly spina bifida, are significant contributors to childhood mortality and disability globally, with high prevalence in Africa. Limited healthcare resources and differing treatment approaches across regions lead to disparities in patient outcomes. This study examines spina bifida incidence, management, and outcomes across African regions, highlighting regional differences in treatment efficacy and improvement rates.
Methods: A systematic review following PRISMA guidelines was conducted using PubMed, Google Scholar, Cochrane, and Scopus databases. Studies reporting on spina bifida incidence, improvement rates, and mortality across African regions were included, encompassing both retrospective studies and case reports.
Results: Thirty-seven studies, including 4 case reports and 33 retrospective studies, covering 5,153 patients, were identified. The mean patient age was 20.76 years (95% CI: [-15.28; 56.81]). Myelomeningocele was the most common subtype, affecting 60.87% of cases (95% CI: [45.80%; 75.95%]), while spina bifida aperta (14.82%, 95% CI: [0%; 32.04%]) and meningocele (9.76%, 95% CI: [2.00%; 17.52%]) were less common. Spina bifida occulta was rare (0.27%, 95% CI: [0.04%; 0.50%]). Clinical improvement rates were highest in West Africa (51%, 95% CI: [31%; 71%]) and slightly lower in East Africa (47%, 95% CI: [28%; 65%]). Myelomeningocele carried the highest mortality risk (28%, 95% CI: [5%; 52%]), whereas spina bifida aperta had a lower mortality rate (6%, 95% CI: [0%; 12%]). Mortality varied by region, with West Africa reporting the highest rate (38%), East Africa the lowest (11%), and South Africa intermediate (28%).
Conclusion : This review highlights regional differences in the incidence and outcomes of spina bifida across Africa. Myelomeningocele poses a higher mortality risk, and West Africa, in particular, exhibits elevated mortality rates alongside modest improvement rates. Attention to public health policies related to folate deficiency and supplementation are crucial to mitigate NTD impact in Africa and globally.
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