Congenital anomalies in rural black South African neonates--a silent epidemic?
OBJECTIVE
To ascertain the incidence and spectrum of congenital anomalies in neonates born in a rural hospital.


METHODS
This was a prospective, hospital-based study, undertaken on liveborn neonates over the period 12 June 1989 - 31 December 1992.


METHODS
Mankweng Hospital, Sovenga, Northern Transvaal.


RESULTS
Of a total of 10,380 neonates born during this period, 7,617 (73.4%) were examined within the first 24 hours of life. On the basis of published observations, only 26.2% of severe congenital anomalies diagnosable by age 5 years are diagnosable at birth. In this South African study the finding at birth of severe, externally visible congenital anomalies in 14.97 per 1,000 livebirths could mean that by age 5 years the minimum cumulative incidence of severe congenital anomalies may involve 57.14 per 1,000 children. Extrapolating from other Third-World studies, the cumulative incidence of severe congenital anomalies in such communities may affect up to 84.85 per 1,000 children by the age of 5 years. High incidences of neural tube defects (3.55 per 1,000 livebirths) and Down syndrome (2.10 per 1,000 livebirths), both conditions which can be prevented by prenatal screening, were recorded.


CONCLUSIONS
These figures indicate the necessity for inclusion of appropriate prenatal, genetic, family planning and paediatric facilities into the primary health care delivery system of rural areas, to manage such problems and to initiate programmes to reduce the incidence of selected congenital anomalies such as Down syndrome and neural tube defects.
Venter
P A
PA
Department of Health Sciences, University of the North, Sovenga, Northern Transvaal.
Christianson
A L
AL
Hutamo
C M
CM
Makhura
M P
MP
Gericke
G S
GS
D000015:Abnormalities, Multiple / Q000453:epidemiology / Q000208:ethnology; D001741:Black or African American; D044383:Black People; D002490:Central Nervous System / Q000002:abnormalities; D000013:Congenital Abnormalities / Q000453:epidemiology* / Q000208:ethnology; D004065:Digestive System Abnormalities; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D009139:Musculoskeletal Abnormalities; D011446:Prospective Studies; D012424:Rural Population; D013019:South Africa / Q000453:epidemiology / Q000208:ethnology; D014564:Urogenital Abnormalities