Prevalence of neural tube defects and uptake of the folic acid program in antenatal clinics in Tanzania: A systematic review

Abstract

Abstract: Neural tube defects are birth deformities of the brain, spine, or spinal cord which occurs when the neural tube does not close properly. Significant link between dietary folic acid deficiency during pregnancy and the development of neural tube defects has been found, hence emphasis of nutritional supplements for women in reproductive age for almost half a century.
Google scholar, PubMed, PubMed Central were systematically searched for relevant community- based and hospital-based studies up to 30th April 2023. Search terms used were “neural tube defects”, “folic acid program”, “Tanzania”, “antenatal care”. The literature search yielded eight eligible studies and three surveys done in few regions of Tanzania. A prevalence estimate ranging from 9.9 to 30.2 per 10 000 was demonstrated. In the studies included, the largest sample size was
28 217 participants, and lowest 445 participants. With the folic acid program, 0.7% of women of reproductive age were aware that folic acid intake during pregnancy can prevent NTDs. About28.5% of women 15- 49 years of age with children under five years of age took an ironfolic acid supplementation during 90 days or longer during pregnancy for past birth, which was
much lower in Zanzibar (12.8%). Limited available data on NTD inform the need for additional primary, wide scope research that
would expose the true burden of the defects and facilitate preventive policies on preventive factors. Efforts to increase intake of folic acid supplements and fortified flour among women of reproductive age and the general community are needed to reduce occurrence of NTDs.