@article{3a595a6dbc2f4f0c8f45de2c136a68a0,
title = "Historical perspective on folic acid and challenges in estimating global prevalence of neural tube defects",
abstract = "Neural tube defects (NTD) are major congenital malformations affecting births worldwide. NTD are associated with life-long disability, significant medical care costs, and child mortality. Their prevalence varies worldwide. We conducted a review of published literature and surveillance systems to examine challenges in estimating an overall global prevalence estimate for NTD. Our review showed that most low- and middle-income countries do not track NTD and indicate a high prevalence of these malformations where data are available. Challenges in global NTD prevalence estimation include (1) quality of surveillance methods, (2) existing risk factors (including geographic or socioeconomic factors, availability and use of folic acid, and racial–ethnic and genetic factors), and (3) limitations in education and access to care. We recommend population-based surveillance systems tracking all pregnancy outcomes and major risk factors. Countries should invest in sustainable, multisource surveillance systems, in parallel to folic acid interventions, for gaining a more accurate knowledge of global prevalence of NTD than we currently have. Such efforts will assist in both global prevention of NTD and periodic evaluation of folic acid interventions for NTD reduction. Global NTD prevalence data can drive political will and accelerate the implementation and evaluation of NTD prevention programs.",
keywords = "anencephaly, neural tube defects, prevalence, spina bifida, surveillance",
author = "Vijaya Kancherla and Black, {Robert E.}",
note = "Funding Information: This paper was developed in support of the technical consultation Folate Status in Women and Neural Tube Defect Prevention, convened by the Micronutrient Forum and supported through Nutrition International by a grant provided by the Bill & Melinda Gates Foundation. An earlier version of this manuscript was presented to members of the technical consultation on April 12–13, 2017, held at the Nutrition International headquarters in Ottawa, Ontario, Canada. This paper is being published individually, but will be consolidated with other manuscripts as a special issue of Annals of the New York Academy of Sciences, under the coordination of Homero Martinez and Aliki P. Weakland. The special issue is the responsibility of the editorial staff of Annals of the New York Academy of Sciences, who delegated to the coordinators preliminary supervision of both technical conformity to the publishing requirements of Annals of the New York Academy of Sciences and general oversight of the scientific merit of each article. The authors alone are responsible for the views expressed in this paper; they do not necessarily represent the views, decisions, or policies of the institutions with which they are affiliated or the decisions, policies, or views of the Micronutrient Forum. The opinions expressed in this publication are those of the authors and are not attributable to the sponsors, publisher, or editorial staff of Annals of the New York Academy of Sciences. Publisher Copyright: {\textcopyright} 2018 The Authors. Annals of the New York Academy of Sciences published by Wiley Periodicals, Inc. on behalf of New York Academy of Sciences.",
year = "2018",
doi = "10.1111/nyas.13601",
language = "English (US)",
volume = "1414",
pages = "20--30",
journal = "Annals of the New York Academy of Sciences",
issn = "0077-8923",
publisher = "Wiley-Blackwell",
number = "1",
}