1
|
Leke AZ, Malherbe H, Kalk E, Mehta U, Kisa P, Botto LD, Ayede I, Fairlie L, Maboh NM, Orioli I, Zash R, Kusolo R, Mumpe-Mwanja D, Serujogi R, Bongomin B, Osoro C, Dah C, Sentumbwe–Mugisha O, Shabani HK, Musoke P, Dolk H, Barlow-Mosha L. The burden, prevention and care of infants and children with congenital anomalies in sub-Saharan Africa: A scoping review. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001850. [PMID: 37379291 PMCID: PMC10306220 DOI: 10.1371/journal.pgph.0001850] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 03/17/2023] [Indexed: 06/30/2023]
Abstract
The aim of this scoping review was to determine the scope, objectives and methodology of contemporary published research on congenital anomalies (CAs) in sub-Saharan Africa (SSA), to inform activities of the newly established sub-Saharan African Congenital Anomaly Network (sSCAN). MEDLINE was searched for CA-related articles published between January 2016 and June 2021. Articles were classified into four main areas (public health burden, surveillance, prevention, care) and their objectives and methodologies summarized. Of the 532 articles identified, 255 were included. The articles originated from 22 of the 49 SSA countries, with four countries contributing 60% of the articles: Nigeria (22.0%), Ethiopia (14.1%), Uganda (11.7%) and South Africa (11.7%). Only 5.5% of studies involved multiple countries within the region. Most articles included CA as their primary focus (85%), investigated a single CA (88%), focused on CA burden (56.9%) and care (54.1%), with less coverage of surveillance (3.5%) and prevention (13.3%). The most common study designs were case studies/case series (26.6%), followed by cross-sectional surveys (17.6%), retrospective record reviews (17.3%), and cohort studies (17.2%). Studies were mainly derived from single hospitals (60.4%), with only 9% being population-based studies. Most data were obtained from retrospective review of clinical records (56.1%) or via caregiver interviews (34.9%). Few papers included stillbirths (7.5%), prenatally diagnosed CAs (3.5%) or terminations of pregnancy for CA (2.4%).This first-of-a-kind-scoping review on CA in SSA demonstrated an increasing level of awareness and recognition among researchers in SSA of the contribution of CAs to under-5 mortality and morbidity in the region. The review also highlighted the need to address diagnosis, prevention, surveillance and care to meet Sustainable Development Goals 3.2 and 3.8. The SSA sub-region faces unique challenges, including fragmentation of efforts that we hope to surmount through sSCAN via a multidisciplinary and multi-stakeholder approach.
Collapse
Affiliation(s)
- Aminkeng Zawuo Leke
- Institute for Nursing and Health Research, Centre for Maternal, Fetal and Infant Research, Ulster University, Newtownabbey, United Kingdom
- Centre for Infant and Maternal Health Research, Health Research Foundation, Buea, Cameroon
| | - Helen Malherbe
- Research & Epidemiology, Rare Diseases South Africa NPC, Bryanston, Sandton, South Africa
| | - Emma Kalk
- Centre for Infectious Disease Epidemiology & Research, School of Public Health, University of Cape Town, Cape Town, South Africa
| | - Ushma Mehta
- Centre for Infectious Disease Epidemiology & Research, School of Public Health, University of Cape Town, Cape Town, South Africa
| | - Phylis Kisa
- Makerere University College of Health Sciences, Kampala, Uganda
| | - Lorenzo D. Botto
- Division of Medical Genetics, University of Utah, Salt Lake City, Utah, United States of America
- International Center on Birth Defects, University of Utah, Salt Lake City, Utah, United States of America
| | - Idowu Ayede
- Department of Paediatrics, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria
| | - Lee Fairlie
- Faculty of Health Sciences, Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa
| | - Nkwati Michel Maboh
- Centre for Infant and Maternal Health Research, Health Research Foundation, Buea, Cameroon
| | - Ieda Orioli
- Genetics Department, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- ReLAMC: Latin American Network for Congenital Malformation Surveillance, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rebecca Zash
- The Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana and Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States of America
| | - Ronald Kusolo
- Makerere University-Johns Hopkins University Research Collaboration, Kampala, Uganda
| | - Daniel Mumpe-Mwanja
- Makerere University-Johns Hopkins University Research Collaboration, Kampala, Uganda
| | - Robert Serujogi
- Makerere University-Johns Hopkins University Research Collaboration, Kampala, Uganda
| | - Bodo Bongomin
- Gulu University Faculty of Medicine: Gulu, Gulu, UG/ World Health Organization, Kampala, Uganda
| | - Caroline Osoro
- Kenya Medical Research Institute, Centre for Global Health Research, Nairobi, Kenya
| | - Clarisse Dah
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | | | | | - Philippa Musoke
- Makerere University-Johns Hopkins University Research Collaboration, Kampala, Uganda
| | - Helen Dolk
- Institute for Nursing and Health Research, Centre for Maternal, Fetal and Infant Research, Ulster University, Newtownabbey, United Kingdom
| | - Linda Barlow-Mosha
- Makerere University-Johns Hopkins University Research Collaboration, Kampala, Uganda
| |
Collapse
|
2
|
Impacts of High Environmental Temperatures on Congenital Anomalies: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094910. [PMID: 34063033 PMCID: PMC8124753 DOI: 10.3390/ijerph18094910] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/16/2021] [Accepted: 04/21/2021] [Indexed: 12/16/2022]
Abstract
Links between heat exposure and congenital anomalies have not been explored in detail despite animal data and other strands of evidence that indicate such links are likely. We reviewed articles on heat and congenital anomalies from PubMed and Web of Science, screening 14,880 titles and abstracts in duplicate for articles on environmental heat exposure during pregnancy and congenital anomalies. Thirteen studies were included. Most studies were in North America (8) or the Middle East (3). Methodological diversity was considerable, including in temperature measurement, gestational windows of exposure, and range of defects studied. Associations were detected between heat exposure and congenital cardiac anomalies in three of six studies, with point estimates highest for atrial septal defects. Two studies with null findings used self-reported temperature exposures. Hypospadias, congenital cataracts, renal agenesis/hypoplasia, spina bifida, and craniofacial defects were also linked with heat exposure. Effects generally increased with duration and intensity of heat exposure. However, some neural tube defects, gastroschisis, anopthalmia/microphthalmia and congenital hypothyroidism were less frequent at higher temperatures. While findings are heterogenous, the evidence raises important concerns about heat exposure and birth defects. Some heterogeneity may be explained by biases in reproductive epidemiology. Pooled analyses of heat impacts using registers of congenital anomalies are a high priority.
Collapse
|