Working together to help strengthen Kenya’s capacity for birth defects prevention: A great collaborative startPosted on by
Alejandro Azofeifa and Diana Valencia work to expand birth defects surveillance worldwide through Birth Defects COUNT, a CDC global initiative.
A Call for Assistance
In early 2012, Dr. Leland Albright, a pediatric neurosurgeon at Kijabe Hospital in Kijabe, Kenya, alerted CDC to what appeared to be a rising number of patients with some serious birth defects of the brain and spine called neural tube defects. He asked CDC to help pinpoint whether the prevalence was actually increasing or if there was simply an increased number of referrals to the hospital from throughout Kenya. Dr. Albright also questioned whether genetic, nutritional or social factors could be causing the increase.
When word of Kenya’s situation came to us at CDC’s National Center on Birth Defects and Developmental Disabilities, we were immediately intrigued. As public health professionals committed to preventing birth defects and ensuring that women around the world can have healthier pregnancies and healthier babies, we sprang into action.
After speaking with Dr. Albright, it was clear that assessing the prevalence of neural tube defects in Kijabe Hospital was a critical first step toward addressing some of Dr. Albright’s questions. Additional conversations with Dr. Albright and other Kenyan health officials resulted in developing a Field Epidemiology Laboratory Training Program (FELTP) project to determine the prevalence of neural tube defects among babies born at Kijabe Hospital. FELTP is a program offered by CDC to help countries develop, establish and refine public health strategies for addressing health issues.
Taking this first step was crucial. Kenya did not have a systematic way to estimate the prevalence of neural tube defects, making it difficult to compare the numbers of babies with neural tube defects seen at Kijabe Hospital with those at other hospitals in Kenya.
However, the hospital had maintained an administrative database for several years with information on birth defects for patients seen by Dr. Albright. This information was a starting point for FELTP staff working to determine the number of babies with neural tube defects that presented in Kijabe Hospital. In September 2012, we had the opportunity to work with FELTP staff on a report documenting the prevalence of babies born with neural tube defects in Kijabe Hospital, which was presented to country health officials.
Kenyan officials were surprised by the findings and expressed concern. Several noted the importance of this information for Kenya and described it as “eye-opening.” A problem that once was essentially unrecognized was called by some Kenyan public health officials “a critical public health matter.”
It underscored yet again how valid, comprehensive and rigorously collected information, like the data collected at Kijabe Hospital, is a crucial pillar of successful public health policies. In this case the information, along with systematic surveillance and a comprehensive birth defects surveillance system can help health officials in Kenya monitor and respond to babies born with neural tube defects.
Looking Toward the Future
Kenya recently mandated the fortification of food staples with several micronutrients including folic acid, providing an opportunity for country health officials to compare rates of neural tube defects (or the frequency with which they occur) before and after fortification. We are excited about the opportunities for birth defects prevention in Kenya. We continue to collaborate with country health officials in their efforts to implement birth defects surveillance through local hospitals. We also maintain a close connection with FELTP and will support a FELTP fellow who will help implement birth defects surveillance in Kenya.
Reflecting on this experience, we appreciate the opportunity to work with our public health colleagues in Kenya on such an important project. It was a pleasure to work alongside FELTP and other public health staff in Kenya, and with dedicated doctors like Dr. Albright. Their combined efforts on this project left a positive impression on country health officials, CDC staff, and the people they serve.