HYDROCEPHALUS AND SPINA BIFIDA
Campaign, Surgical Camp and Scientific
Theme: Total fortification for eradication of NTDs in Kenya
Neuro Tube Defects (NTDs) are a group of congenital malformations affecting the nervous system. They include Spina Bifida, Encephaloceles and Anencephaly. An estimated 300 cases of congenital birth defects occurs globally and 40% in Sub- Saharan Africa. In Kenya the national prevalence of NTDs has not been conducted but institutional studies at Kenyatta National Hospital and Kijabe Hospital showed prevalence of 20% and 3.3% respectively. The causative factors are multifactorial and include nutritional, genetic and environmental. Folic acid and B12 nutritional supplements have been found to be associated with 70% reduction in Neuro Tube Defects in countries that have had a successful fortification program of cereals.
The Kenya national health policy for fortification was enacted in 2012, but there has been no surveillance studies to assess the impact of the fortification. Early pregnancies have been associated with a high risk of Neuro Tube Defects and the current crisis of teen pregnancy could be a pointer of an impending surge of Neuro Tube Defects in the coming years.
It costs about Ksh.300, 000 to perform V-P Shunting or repair of Spina Bifida on a single patient. This amount of money tends to be out of reach for many young mothers. This results in delays in seeking the right treatment and management which leads to complications that affect the normal development of the child and can also lead to death.
The health and wellbeing of patients with spina bifida and hydrocephalus have been shown to improve depending on how quickly the condition was diagnosed and treated, and whether the patient had other underlying disorders.
It is with this in mind that the Brain, Spine and Rehabilitation (BSR) Hospital and partners has organized the first annual multisectoral campaign and surgical camp on Hydrocephalus and Spina Bifida to create awareness on prevention, early diagnosis and treatment plus individualized program on long term rehabilitation.
ABOUT THE DISEASE (HYDROCEPHALUS AND SPINA BIFIDA)
Hydrocephalus is a condition where there is an abnormal buildup of Cerebrospinal Fluid (CSF), in the ventricular cavities of the brain. The build-up is often caused by an obstruction that prevents proper fluid drainage as in obstructive hydrocephalus or impaired absorption: communicating hydrocephalus. This build-up of CSF can raise pressure inside the skull, which gradually squashes surrounding brain tissue against the bone resulting in thinned out brain. In some cases, this can cause the head to steadily grow in size, convulsions, and brain damage. Hydrocephalus can be fatal if left untreated. Other symptoms include: headaches, vomiting, blurred vision/blindness, cognitive problems, and walking difficulties.
There are two types of Hydrocephalus; Congenital where it develops before the child is born and Acquired due to birth trauma, meningitis, and tumors.
Spina Bifida is part of a spectrum of Neural Tube Defects (NTDs) that include Encephaloceles and Anencephaly Spina Bifida occurs due to congenital non-closure /fusion of the primitive neuro tube that forms the nervous system. About 20% of Spina Bifida is associated with hydrocephalus. Though the cause is mulfactorial, they are associated with pre-conception folic acid deficiency during the primary neurulation stage. Other causes are environmental and genetic.
The treatment for Hydrocephalus is achieved by diverting the CSF either by placing a tube between the head and any abdominal cavity (V-Shunting) or Endoscopic Third Ventriculostomy E.T.V through an endoscopic camera. Open Spina Bifida requires urgent repair within 24 hours to prevent further neurological damage. However, long term management requires multidisplinary approach depending on the nature of malformations.
HYDROCEPHALUS AND SPINA BIFIDA CAMPAIGN
The campaign aims at creating awareness on prevention and early treatment as well as NeuroRehabilitation hence contributing to Universal Health Coverage (UHC). The campaign will also focus on teen pregnancy prevention since majority of the children with Spina Bifida or NTDs are due to early pregnancies.
The Brain, Spine and Rehabilitation Hospital, seeks your partnership in establishing a sustainable annual campaign on early pregnancy prevention, reduction of NTDs and create awareness on early and long term management of Hydrocephalus and Spina Bifida and lobby for fortification of maize, cereals and the school lunch multivitamin supplementation by the government.
To this end BSR Hospital will be launching the campaign in a Grand Opening ceremony to be held on October 19, 2020, at The Brain Spine and Rehabilitation Hospital ground, from 11:00am. Thereafter, the free surgical procedures are set to begin on October 19 -22, 2020.
A special scientific symposium on NTDs that will bring together, patients, parents and healthcare providers will be held on October 23, 2020 at Kempinsky Hotel as we mark the international day of Spina Bifida and Hydrocephalus.