title: Assessing the prevalence of spina bifida and encephalocele in a Kenyan hospital from 2005-2010: implications for a neural tube defects surveillance system.
abstract: BACKGROUND
  Neural tube defects such as anencephaly, spina bifida, and encephalocele are congenital anomalies of the central nervous system. Data on the prevalence of neural tube defects in Kenya are limited. This study characterizes and estimates the prevalence of spina bifida and encephalocele reported in a referral hospital in Kenya from 2005-2010.
  
  
  METHODS
  Cases were defined as a diagnosis of spina bifida or encephalocele. Prevalence was calculated as the number of cases by year and province of residence divided by the total number of live-births per province.
  
  
  RESULTS
  From a total of 6,041 surgical records; 1,184 (93%) had reported diagnosis of spina bifida and 88 (7%) of encephalocele. Estimated prevalence of spina bifida and encephalocele from 2005-2010 was 3.3 [95% Confidence Interval (CI): 3.1-3.5] cases per 10,000 live-births. The highest prevalence of cases were reported in 2007 with 4.4 (95% CI: 3.9-5.0) cases per 10,000 live-births. Rift Valley province had the highest prevalence of spina bifida and encephalocele at 6.9 (95% CI: 6.3-7.5) cases per 10,000 live-births from 2005-2010.
  
  
  CONCLUSIONS
  Prevalence of spina bifida and encephalocele is likely underestimated, as only patients seeking care at the hospital were included. Variations in regional prevalence could be due to referral patterns and healthcare access. Implementation of a neural tube defects surveillance system would provide a more thorough assessment of the burden of neural tube defects in Kenya.
authors.affiliation: Field Epidemiology and Laboratory Training Program (FELTP), Ministry of Health, Nairobi, Kenya.
authors.forename: Jane N
authors.initials: JN
authors.lastname: Githuku
authors.affiliation: National Center on Birth Defects and Developmental Disabilities, Division of Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Azofeifa
authors.affiliation: National Center on Birth Defects and Developmental Disabilities, Division of Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA.
authors.forename: Diana
authors.initials: D
authors.lastname: Valencia
authors.affiliation: Center for Global Health, Division of Global Health Protection, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA.
authors.forename: Trong
authors.initials: T
authors.lastname: Ao
authors.affiliation: National Center on Birth Defects and Developmental Disabilities, Division of Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA.
authors.forename: Heather
authors.initials: H
authors.lastname: Hamner
authors.affiliation: Kenya Ministry of Public Health and Sanitation, Nairobi, Kenya.
authors.forename: Samuel
authors.initials: S
authors.lastname: Amwayi
authors.affiliation: Kenya Ministry of Public Health and Sanitation, Nairobi, Kenya.
authors.forename: Zeinab
authors.initials: Z
authors.lastname: Gura
authors.affiliation: Kenya Ministry of Public Health and Sanitation, Nairobi, Kenya.
authors.forename: Jared
authors.initials: J
authors.lastname: Omolo
authors.affiliation: African Inland Church Kijabe Hospital, Central Province, Kenya.
authors.forename: Leland
authors.initials: L
authors.lastname: Albright
authors.affiliation: National Center on Birth Defects and Developmental Disabilities, Division of Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA.
authors.forename: Jing
authors.initials: J
authors.lastname: Guo
authors.affiliation: Center for Global Health, Division of Global Health Protection, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA.
authors.forename: Wences
authors.initials: W
authors.lastname: Arvelo
mesh_terms: D004677:Encephalocele / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007630:Kenya / Q000453:epidemiology; D008297:Male; D009436:Neural Tube Defects / Q000453:epidemiology*; D011159:Population Surveillance; D015995:Prevalence; D012189:Retrospective Studies; D016135:Spinal Dysraphism / Q000453:epidemiology*
keywords: Kenya; Prevalence; encephalocele; neural tube defects; spina bifida; surveillance