• Andreas Leidinger, Jose Piquer, Eliana E Kim, Hadia Nahonda, Mahmood M Qureshi, and Paul H Young.
• Neurosurgery Education and Development (NED) Foundation, Valencia, Spain; Neurosurgery Education and Development (NED) Institute, Mnazi Mmoja Hospital, Stonetown, Tanzania. Electronic address: andreas_leidinger@hotmail.com.
• World Neurosurg. 2019 Jan 1; 121: e493-e499.

BackgroundNeural tube defects are a large health burden for East African countries. Health strategies in the prevention of this disease include nutritional prophylaxis, prenatal diagnosis, and availability of early neonatal neurosurgery. The main objective of this study is to describe our experience in the early surgical management of neural tube defects in the Zanzibar archipelago.MethodsFrom December 2016 to December 2017, we prospectively collected data on all patients admitted with the diagnosis of myelomeningocele. We collected variables regarding demographics, maternal health, preoperative imaging, surgical procedures, and complications at follow-up.ResultsWe collected data on 19 patients. Mean age was 9.8 ± 18.7 days. Of these patients, 52.6% were male and 47.3% were female; 47.3% patients were from Unguja, 42.0% from Pemba, and 5.2% from mainland Tanzania; 68.4% of all mothers were found to have undergone prenatal ultrasonography and 89.5% of all patients received surgery. Surgical wound infection was present in 29.4% of all surgical patients and 52.9% developed secondary hydrocephalus.ConclusionsNeural tube defects are a prevailing condition in East Africa. We believe that more health initiatives should address its prevention, mainly through maternal nutrition. On the basis of our findings, we consider early neonatal neurosurgery as the most important factor in reducing immediate morbidity and mortality.Copyright © 2018 Elsevier Inc. All rights reserved.

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