Congenital disorders and community genetic services in Nigeria: A systematic review

Maclawrence K. Famuyiwa

Abstract

Nigeria has a large number of congenital disorders (CD). For instance, two out of every hundred children born in Nigeria have sickle cell disorders (SCD). Making Nigeria the country with the highest incidence of SCD. This article reviews the prevalence of CD in Nigeria; with emphasis on those having a heavy statistical burden on the country, the availability of community genetics services in Nigeria and the efforts being made to tackle the challenges of CD. A systematic review of birth prevalence of congenital malformations (CM) in Nigeria was done through a literature search, with no time restriction for publication dates. Only studies that included the birth prevalence of CM were included. Eligible studies with incorrect or missing data were excluded. This revealed a dearth of data on CD in Nigeria, as in most Low- and Middle-Income Countries. A predominance of CM of the musculoskeletal and gastrointestinal systems was found in Nigeria. However, the pattern of CM in the South-South region was more of the central nervous system. There is scarcity of resources to address the challenges of CD in Nigeria with feeble government assistance. Meanwhile, 70% of CD can be prevented and adequately managed by well implemented community genetics services. (Afr J Reprod Health 2020; 24[3]: 161-175).

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Ten Kate LP. Al-Gazali I, Anand S, Bittles AH,

Cassiman JJ, Christianson A, Cornel MC, Hamamy H, Kaariainen H, Kristofersson U, Marais D, Penchaszadeh VB, Rhman P and Schimdtice J. Community genetics. Its definition. Journal of Community Genetics [Epub]. 2010; 1:19-22.

WHO. Community genetics services Report of a WHO

Consultation on community genetics in low- and middle-income countries. Geneva, Switzerland, 13–14 September 2010. Geneva, Switzerland: World Health Organization, 2011.

WHO. Congenital anomalies. Geneva, Switzerland:

World Health Organization, 2015.

Christianson A, Howson C and Modell B. March of

Dimes Global report on birth defects the hidden tool of dying children and children with disabilities. New York: March of Dimes Birth Defects Foundation. 2006.

WHO. Management of birth defects and hemoglobin

disorders. World health Organization. Geneva, Switzerland. 2006.

Czeizel A, Intôdy Z and Modell B. What proportion of

congenital abnormalities can be prevented? British Medical Journal. 1993; 306(6876): 499-503. DOI:10.1136/bmj.306.6876.499.

Nelson K and Holmes L. Malformations due to

presumed spontaneous mutations in newborn infants. New England Journal of Medicine. 1989; 320:19-23.

Turnpenny P and Ellard S. (Eds.). Emery’s Elements of

Medical Genetics.12th ed. Livingstone, Edinburgh, United Kingdom: Elsevier Churchill, 2005.

Christianson A and Modell B. Medical genetics in

developing countries. Annual Review of Genomics and Human Genetics. 2004; 5:219-65.

Seashore M and Wappner R. Genetics in Primary Care

& Clinical Medicine. New York: Prentice-Hall International Inc., 1996.

WHO. Resolutions. The World Health Assembly.

Geneva, Switzerland: World Health Organization. 2010.

Darmstadt G, Howson C, Walraven G, Armstrong R,

Blencowe H and Christianson AE. Prevention of congenital disorders and care of affected children: A consensus statement. JAMA Pediatrics. 2016; 170(8): 790-3. DOI:10.1001/jamapediatrics.2016.0388.

World Bank. Data for Lower middle income, Nigeria.

Washington, DC: The World Bank Group.

World Population Review. Nigeria Population 2018.

World Population Review. 2018.

WHO. Nigeria. Abuja, Nigeria: World Health

Organization. 2018.

UNICEF. Maternal and child health. Abuja, Nigeria:

United Nations Children Fund. 2018. Available from: https://www.unicef.org/nigeria/children_1926.html.

WHO. Prevention and control of birth defects in South-

East Asia region: Strategic framework (2013-2017). New Delhi, India: World Health Organization. 2013.

Milewicz D. Classification of genetic disorders. In:

Willerson J, Wellens H, Cohn J and Holmes D, eds. Cardiovascular Medicine. 2007. DOI: https://doi.org/10.1007/978-184628-715-2_123.

Adeyokunnu A. The incidence of Down's syndrome in

Nigeria. Journal of Medical Genetics. 1982; 19(4): 277-9.

Adeyokunnu A. The incidence of Turner's syndrome in

Ibadan, Nigeria. African Journal of Medicine and Medical Sciences. 1982; 11(3): 105-12.

CDC. Sickle Cell Disease. Atlanta, Georgia: Centers for

Disease Control and Prevention. 2012. Available from: https://www.cdc.gov/globalhealth/countries/nigeria/what/scd.htm.

Akinyanju O. The national burden of sickle cell disorder

and the way forward. Lagos: Sickle Cell Foundation Nigeria. 2010. Available from: http://www.sicklecellfoundation.com/wp-content/uploads/2015/05/Nat-Burden-SCD.pdf.

Sickle Cell Foundation Nigeria. What is sickle cell

disorders? Information about sickle cell disorder. Lagos, Nigeria: Sickle Cell Foundation Nigeria 2018. Available from: http://www.sicklecellfoundation.com/sickle-cell/what-is-sicklecell-disorder/.

Molineaux L, Fleming A, Cornille-Brogger R, Kagan I

and Storey J. Abnormal haemoglobins in the Sudan Savannah of Nigeria.III. Malaria, immunoglobulins and antimalarial antibodies in sickle cell disease. Ann Trop Med Parasitology. August 1979; 73(4): 301-10.

Orimolade E, Adepiti A, Ikuomola A and Ige O.

Congenital anomalies in a State Specialist Hospital; A Secondary Level of Healthcare. East and Central African Journal of Surgery. 2014; 19(2). Available from: file:///C:/Users/special%202/Downloads/107739-293997-1-PB.pdf.

Iregbulem L. The incidence of cleft lip and palate in

Nigeria. Cleft Palate Journal. July 1982; 19(3): 201-5.

Butali A, Adeyemo WI, Mossey PA, Olasoji HO, Onah

II, Adebola A, Efunkoya AA, Akintububo A, James O, Adeosun OO, Ogunlewe MO, Ladeinde AJ, Mofikoya BO, Adeyemi MO, Ekhaguere OA, Emeka IC, Awoyale TA, and The Nigeria CRAN collaboration Prevalence of Orofacial Clefts in Nigeria. Thé Cleft Palate Cranio-facial J. May 2014 May; 51(3): 320-5. doi: 10.1597/12-135. Epub 2013 Apr 4. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3706513/.

Abue AD, Nwachukwu, MI, Aniah, JA and Ayang U.

Prevalence of Cleft Lip and Palate in Abuja Nigeria (From December2000 to December 2010), IOSR-JPBS. Jul. – Aug. 2013; 7 (2): 111-113. Available from: www.iosrjournals.org

Omo-Aghoja VW, Omo-Aghoja L O, Ugboko VI,

Obuekwe ON4, Saheeb BDO, FeyiWaboso P, and Onowhakpor A. Antenatal determinants of oro-facial clefts in Southern Nigeria. African Health Sciences. March 2010; 10 (1).

WHO. Non-communicable Diseases. Geneva,

Switzerland: World health Organization. 2018. Available from: http://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases.

Commonwealth Health Online. Non-communicable

diseases in Nigeria. Cambridge: Commonwealth of Nations. 2008. Available from:

http://www.commonwealthhealth.org/africa/nigeria/non_communicable_diseases_in_nigeria/.

WHO. Non-communicable Diseases (NCD) Country

Profiles, 2014-Nigeria. Geneva, Switzerland: World Health Organization. 2014. Available from: http://www.who.int/nmh/countries/nga_en.pdf.

Okunola O, Akintunde A and Akinwusi P. Some

emerging issues in medical admission pattern in the tropics. Nigeria Journal of Clinical Practice. 2012; 15: 51-4.

Kyari F, Tafida A, Sivasubramaniam S, Murthy G, Peto

T, Gilbert C and Group TN. Prevalence and risk factors for diabetes and diabetic retinopathy: results from the Nigeria national blindness and visual impairment survey. BMC Public Health 2014; 14: 1299. DOI: https://doi.org/10.1186/1471-2458-141299.

CancerIndex. Nigeria. Lagos, Nigeria: CancerIndex.

Available from: http://www.cancerindex.org/Nigeria.

Olusanya B, Slusher T and Boppana S. Prevalence of

congenital cytomegalovirus infection in Nigeria: a pilot study. Pediatric Infectious Diseases Journal 2015; 34(3): 3224. DOI:10.1097/INF.0000000000000555.

Yahaya H, Ibrahim A, Ahmad I and Yunusa I. Rubella

Prevalence in Nigeria (1977– 2015): An Update Review on the Impact. Annals of Experimental Biology. 2017; 5(2): 15-21. Available from: http://www.scholarsresearchlibrary.com/articles/rubellaprevalence-in-nigeria-19772015-anupdate-review-on-the-impact.pdf.

Bamgboye A, Afolabi K, Esumeh F and Enweani, I.

Prevalence of rubella antibody in pregnant women in Ibadan, Nigeria. West African Journal of Medicine. Jul-Sep 2000; 23(3): 245-8.

Anorlu R, Odum C and Essien E. Asymptomatic malaria

parasitaemia in pregnant women at booking in a primary health care facility in a peri urban community in Lagos, Nigeria. African Journal of Medicine and Medical Sciences 2001; 30: 39-41.

Mockenhaupt F, Ulmen U, von Gaertner C, Bedu-Addo

G and Bienzle U. Diagnosis of placental malaria. Journal of Clinical Microbiology. 2002; 40(1): 306–8. DOI:10.1128/JCM.40.1.306-308.2002

WHO. Malaria. Brazzaville: World health Organization.

Available from:

http://www.afro.who.int/health-topics/malaria.

National Agency for the Control of AIDS. National

HIV/AIDS Strategic Framework, 2017-2021. Abuja, Nigeria: National Agency for the Control of AIDS. 2017. Available from:

https://www.childrenandaids.org/sites/default/files/2017-11/NATIONAL-HIV-ANDAIDS-STRATEGIC-FRAMEWORK.pdf.

World Population Review. Nigeria Population 2018.

World Population Review. 2018. Available from: http://worldpopulationreview.com/countries/nigeria-population/.

Chigozie JU, Dochka DD and Treasure NU. Effects of

Maternal Plasmodium falciparum Malaria and HIV infection on Birth Weight in Southeastern Nigeria. McGill Journal of Medicine. 16 Nov 2009; 12(2). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2997242/.

Okwa O. The status of malaria among pregnant women:

a study in Lagos, Nigeria. African Journal of Reproductive Health, December, 2003; 7(3): 77-83.

Adefioye O, Adeyeba O, Hassan,l W and Oyeniran O.

Prevalence of malaria parasite infection among pregnant women in Osogbo, southwest, Nigeria. American-Eurasian Journal of Scientific Research. 2007; 2: 43–45.

Agomo C, Oyibo W, Anorlu R and Agama P. Prevalence

of Malaria in Pregnant Women in Lagos, South-West Nigeria. Korean Journal of Parasitology. June 2009; 47(2): 179– 183. doi:10.3347/kjp.2009.47.2.179.

Steketee R, Nahlen B, Parise M and Menendez C. The

burden of malaria in pregnancy in malaria endemic areas. Am J Trop Med Hyg. 2001; 64: 28-35.

Newman R, Hailemariam A, Jimma D, Degifie A,

Kebede D, Rietveld AE, Nahlen BL, Barnwell JW, Steketee RW and Parise ME. Burden of malaria during pregnancy in areas of stable and unstable transmission in Ethiopia during a nonepidemic year. J Infect Dis. 2003; 187: 1765-72.

Desai M, ter Kuile F and Nosten F. Epidemiology and

burden of malaria in pregnancy. Lancet Infect Dis. 2007; 7: 93-104. DOI: 10.1016/S14733099 (07)70021-X, 7:93–104.

Rogerson S and Boeuf P. New approaches to malaria in

pregnancy. Parasitology. 2007; 134: 1883-93.

WHO. Guidelines for the treatment of malaria: 2nd ed.

Geneva, Switzerland: World health Organization. (2010).

WHO. Assessment of the safety of artemisinin

compounds in pregnancy: report of two informal consultations convened in 2006. Geneva, Switzerland: World Health Organization. 2007.

White T and Clark R. Sensitive periods for developmental toxicity of orally administered artesunate in the rat. Birth Defects. Res B Dev Reprod Toxicol. 2008; 407-17. DOI:10.1002/bdrb.20157, 83:407–417.

Adam I, Elhassan E, Omer E, Abdulla M, Mahgoub H

and Adam G. Safety of artemisinins during early pregnancy, assessed in 62 Sudanese women. Ann Trop Med Parasitol. 2009; 103: 205-10. DOI: 10.1179/136485909X398285.

Manyando C, Mkandawire R and Puma L. Safety of

artemether-lumefantrine in pregnant women with malaria: results of a prospective cohort study in Zambia. Malar J. 2010; 9: 249. DOI: 10.1186/1475-2875-9-249.

Mosha D, Mazuguni FM, Sevene E, Abdulla S and

Genton B. Safety of artemetherlumefantrine exposure in first trimester of pregnancy: an observational cohort. Malar J. 2014; 13: 197. doi:10.1186/14752875-13-197.

Taylor G and Low-Beer N. Antiretroviral therapy in

pregnancy: a focus on safety. Drug Saf. 2001; 24(9): 683-702.

Alwan A and Modell B. Community control of genetic

and congenital disorders. Geneva, Switzerland: EMRO, World Health Organization. 1997.

Penchaszadeh V. Preventing congenital anomalies in

developing countries. Community Genetics. 2002; 5(1): 61-9.

Ukah A. The Redeemed Christian Church of God

(RCCG), Nigeria. Local identities and global processes in African pentecoliasm [PhD Dissertation]. Germany: University of Bayreuth. 2003. [Cited 2018 June 20]. Available from: https://epub.unibayreuth.de/968/1/Ukah.pdf.

Udobang W. It’s like millions of ants are biting my

bones' – fighting sickle cell disease in Nigeria. The Guardian Newspapers-Nigeria. Lagos, Nigeria: Guardian News and Media Limited. 2017 July 19. Available from: https://www.theguardian.com/globaldevelopment-professionalsnetwork/2017/jul/19/its-like-millions-of-ants-are-biting-mybones-fighting-sickle-cell-disease-innigeria.

Nigerian National Assembly. A bill for an act to provide

for compulsory haemoglobin -genotype screening test before marriage conducted under the marriage act and before registration of new births under the birth, death, etc. (compulsory registration) act and for matter connected. Abuja, Nigeria: Nigerian National Assembly. 2017. Available from http://www.nassnig.org/document/download/8764.

Oginni F, Oladele A, Adenekan A and Olabanji J. Cleft

Care in Nigeria: Past, Present, and Future. The Cleft Palate-Craniofacial Journal. 2012; 50(3). DOI: 10.1597/12-057.

Adegbehingbe O, Oginni L, Ogundele J, Ariyibi A,

Abiola P and Ojo O. Ponseti clubfoot management: changing surgical trends in Nigeria. The Iowa Orthopaedic Journal. Jan 2010; 30: 7-14. Available from: https://www.researchgate.net/publication/47661854_Ponseti_clubfoot_management_changing_surgical _trends_in_Nigeria.

Ponsetti Clubfoot Foundation. Articles. Nigeria: Ponsetti

Clubfoot Foundation. 2018. [Cited 2018 June 24]. Available from: http://ponseticlubfootfoundation.org/index.php/component/content/article/2uncategorised/52-aboutnigerian-sustainable-clubfoot-programme.

Uba A, Isamade E, Chirdan L, Edino S, Ogbe M and

Igun G. Epidemiology of neural tube defects in North Central Nigeria. African Journal of Paediatric Surgery. 2004; 1(1): 16-9. Available from: http://irepos.unijos.edu.ng/jspui/bitstream/123456789/619/1/AfrJPaediatrSurg111624760 45_065240.pdf.

Smithells R, Sheppard S and Schorah C. Vitamin

deficiencies and neural tube defects. Arch. Dis. Child. 1976; 51: 944–50.

Swanson E and Lagace R. Hausa. Ethnographic Atlas.

Canterbury: Centre for Social Anthropology and Computing, University of Kent. 1967.

Scott-Emuakpori A. The Mutation Load in an African

Population. Am J Hum Genet. 1974; 26(2): 674-82.

Schwimmer B. Kinship and social organization: an

interactive tutorial. Igbo marriage patterns. University of Manitoba. 2003. Available from: https://umanitoba.ca/faculties/arts/anthropology/tutor/case_studies/igbo/igbo_marriage.h tml.

Ekanem TB, Okon DE, Akpantah AO, Mesembe OE,

Eluwa MA and Ekong MB. Prevalence of congenital malformations in Cross River and Akwa Ibom states of Nigeria from 1980–2003. Congenit Anom (Kyoto). 2008; 48(4):167–170.

Ekanem B, Bassey IE, Mesembe OE, Eluwa MA and

Ekong MB. Incidence of congenital malformation in 2 major hospitals in Rivers state of Nigeria from 1990 to 2003. East Mediterr Health J. 2011; 17(9):701–705.

Eluwa MA, Aneosong SA, Akpantah AO, Ekong MB,

Asuquo OR and Ekanem TB. Congenital malformations recorded in four hospitals in central part of Cross River state, Nigeria. Int Journal of Pharmaceut. Sc. Invention. 2013; 2(10), 27-30.

Abbey M, Oloyede O, Bassey G, Kejeh BM, Otaigbe

BE, Opara PI, Eneh AU and Akani CI. Prevalence and pattern of birth defects in a tertiary health facility in the Niger Delta area of Nigeria. Internal Journal of Women's Health, 2017; 9: 115—121. DOI: https://doi.org/10.2147/IJWH.S108905.

Onyiriuka A., Edorh S and Onyiriuka C. Congenital

malformations in newborns as seen in a secondary healthcare institution in Benin City, Nigeria. Achaiki Iatriki, 2016; 35(2), 93-102. Retrieved August 10, 2018, from https://www.researchgate.net/publication/312197920_Congenital_malformations_in_ne wborns_as_seen_in_a_secondary_healthcare_institution_in_Benin_City_Nigeria

Sunday-Adeoye I, Okonta P and Egwuatu V. Congenital

malformation in singleton and twin births in rural Nigeria. Nigeria Postgrad. Medical Journal. 2007; 14(4), 277-80. Retrieved August 10, 2018, from https://www.researchgate.net/publication/5686623_Congenital_malformations_in_single ton_and_twin_births_in_rural_Nigeria.

Onyearugha C and Onyire B. Congenital malformations

as seen in a secondary healthcare institution in Southeast Nigeria. 2014; 9(2), 59-62. doi:10.4103/97831230.139163.

Anyanwu L, Danborno B and Hanmann W. Birth

prevalence of overt congenital anomalies in Kano metropolis: overt congenital anomalies in the Kano. Universal Journal of Public Health. 2015 3(2), 89-96. Retrieved August 8, 2018, from http://www.hrpub.org/download/20150301/UJPH6-17603445.pdf.

Pius S, Yenti M, Wabada S, Ibrahim HA, Bukar MA,

Kullima AA, Dada BJ and Bello, M. Congenital birth defects, its incidence and management challenges in a poor resource health facility: A scenario from North-Eastern Nigeria. . International Journal of Clinical Medicine Research. 2018; 5 (2), 44-49. Retrieved August 9, 2018 from: http://www.aascit.org/journal/archive2?journalid=906&paperld=6629.

Bakare T, Sowande OA, Adejuyigbe OO, Chinda JY and

Usang UE. Epidemiology of external birth defects in neonates in Southwestern Nigeria. Afr J of Paediatr Surg [serial online] 2009 [cited 2020 Feb 21]; 6: 28-30. doi:10.4103/0189-6725.48572. Available from: http://www.afrjpaedsurg.org/test.asp?2009/6/1/28/48572.

Fajolu I, Ezenwa B, Akintan P and Ezeaka V. An 8 year

review of major congenital abnormalities in a tertiary hospital in Lagos, Nigeria. Nigeria. Journal of Paediatrics. 2016; 43(3), 175-79. Retrieved August 10, 2018, from njpaediatics.com/4334.html.

Ndibazza J, Lule S, Nampijja M, Mpairwe H, Oduru G,

Kiggundu M, Akello M, Muhangi L and Elliot AM. A description of congenital anomalies among infants in Entebbe, Uganda. Birth Defects Res A Clin Mol Teratol. 2011; Sep, 91(9): 857-861. doi10.1002/bdra.20838. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3272344/#_ffn_sectitle.

Ocheng J, Kiryowa H, Munabi I and Ibingira CB.

Prevalence, nature and characteristics of external anomalies at Mulago Hospital. East and Central African Journal of Surgery 2011 (Mar/Apr); 16:1 26-30. Accessed on 24 Feb. 2020 from: http://www.bioline.org.br/request?11004

Mashuda F, Zuechner A, Chalya PL, Kidenya BR and

Manyama M. Pattern and factors associated with congenital anomalies among young infants admitted to Bugando medical centre, Mwanza, Tanzania. BMC Res Notes. 2014; 7: 195. doi: 10.1186/1756-0500-7-195. Available from: https://www.nbci.nlm.nih.gov/pmc/articles/PMC3974194/#_ffn_sectitle.

Delport SD, Christianson AL, van den Berg HJ,

Wolmarans L and Gericke GS. Congenital anomalies in black South African live born neonates at an urban academic hospital. S Afr Med J. 1995; 85(1): 11-15.

Obire O and Amusan F. The environmental impact of

oilfield formation water on a freshwater stream in Nigeria. J Appl Sci Environ Manag. 2003; 7(1): 61-6.

Kuratsune M and Yoshimura T E. Epidemiologic study

on Yusho, a poisoning caused by ingestion of rice oil contaminated with a commercial brand of polychlorinated biphenyls. Environ Health Perspect, 1972; 1: 119-28.

Harada M. Congenital Minamata disease: intrauterine

methylmercury poisoning. Teratology. 1978; 18: 285-8.

Rogan W and Gladen BE. Congenital poisoning by

polychlorinated biphenyls and their contaminants in Taiwan. Science. 1988; 241: 334-6.

Clarkson T. The three modern faces of mercury. Environ

Health Perspect. 2002; 110(Suppl 1): 11-23.

Smithells R, Sheppard S and Schorah C. Vitamin

deficiencies and neural tube defects. Arch. Dis. Child. 1976; 51: 944-50.

HSPH. Folate (Folic Acid)-vitamin B9. The nutrition

source. Harvard T.H. Chan School of Public Health. 2020. Available from: https://www.hsph.havard.edu/nutritionsource/folic -acid/.

Arth A, Kancherla V, Pachon H, Zimmerman S, Johnson

Q and Oakley GJ. A 2015 global update on folic acid-preventable spina bifida and anencephaly. Birth Defects Res. A Clin Mol Teratol. 2016; 106(7): 520-9.

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