Global Report Identifies Birth Defects Problem

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By Wezi Tjaronda WINDHOEK About 53 out of every 1 000 babies born in Namibia have birth defects, a newly released global report says. Among SADC countries, Namibia is ranked number 11, as the country with the highest number of children born with birth defects. The Democratic Republic of the Congo, which has 71.7 birth defects per 1 000, is the highest in the region, followed by Angola, Zambia and Tanzania. The March of Dimes Global Report on Birth Defects is the first to provide global estimates of birth prevalence for serious birth defects of genetic or partially genetic origin. The report defines defects as abnormalities of structure or function, including metabolism, which are present from birth. Serious birth defects are life threatening or have the potential to result in disability (physical, intellectual, visual or hearing impairment or epilepsy). To date, over 7 000 birth defects have been identified. While some birth defects are clinically obvious at birth, others may only be diagnosed later in life, says the report. The estimates in the March of Dimes report were derived from extrapolation of pooled data from a variety of sources, including birth prevalence rates of selected birth defects in populations of northern European origin from two birth defects registries, global data on carrier rates for common recessive data on national prevalence rates of pregnant women of advanced maternal age and national rates of consanguineous marriage, for instance marriage between close relatives, usually cousin to cousin but including uncle to niece as well as from national demographic profiles. According to the data in the report, five common serious birth defects of genetic or partially genetic origin in 2001 were: congenital heart defects (1 040 835 births); neural tube defects (323 904 births); the hemoglobin disorders, thalassemia (a hereditary form of anaemia), and sickle cell disease (307 897 births); Downs syndrome (trisomy 21) (217 293 births); and glucose-6-phosphate dehydrogenase (G6PD) deficiency (177 032 births). All the five conditions combined account for about 25 percent of all of birth defects of genetic or partially genetic origin. In Namibia, birth defects according to the Under-secretary: Health and Social Welfare Policy, Dr Norbert Forster, are a rare occurrence. He told New Era that the most common defects that babies are born with are clubbed feet, cleft lips, brain defects and another condition which results in a baby being born with a big head. Dr Forster said the causes were infections during pregnancy, alcohol abuse by mother, drinking medicine that a pregnant woman is not supposed to take and also genetically related reasons. He said once an expecting mother has German measles, chances of the baby being born with a defect exist, while mothers who have alcohol problems sometimes gave birth to babies with fetal alcohol syndrome. “It is related to alcohol intake,” Forster said. In addition to this, when an expecting mother takes medication that has an impact on the child, it causes defects in the baby. Other defects are related to genetics, especially when there is in breeding among family members, he added. Every year, an estimated 7.9 million children, who make up six percent of total births worldwide, are born with a serious birth defect of genetic or partially genetic origin. Additional hundreds of thousands more are born with serious birth defects of post-conception origin, including maternal exposure to environmental agents such as alcohol, rubella, syphilis and iodine deficiency that can harm a developing fetus. “This report identifies for the first time the severe and previously hidden toll of birth defects, highlighting the extent of this serious and vastly unappreciated public health problem,” it says. The report adds that serious birth defects can be lethal and for those who survive, these disorders can cause lifelong mental, physical, auditory or visual disability. The data presented in the report show that at least 3.3 million children under five years of age die from birth defects each year and an estimated 3.2 million of those who survive may be disabled for life. Birth defects are a global problem, but their impact is particularly severe in middle- and low-income countries where more than 94 percent of the births with serious birth defects and 95 percent of the deaths of these children occur. The proportions of births with defects to the absolute number of births are much higher in middle- and low-income countries than in high-income countries because of sharp differences in maternal health and other significant risk factors, including poverty, a high percentage of older mothers, a greater frequency of consanguineous marriages and the survival advantage against malaria for carriers of sickle cell, thalassemia, and glucose-6-phosphate dehydrogenase. The birth defects combined range from a high of 82 to a low of 39.7 per 1 000 live births worldwide, with many of the highest birth prevalence rates found among the world’s poorest countries, while many of the lowest rates are found among the world’s wealthier countries, with the exception of countries where common recessive disorders and marriages between first cousins and other close relatives are common.