Observed birth prevalence of structural congenital disorders among live births at a regional facility in South Africa.

Abstract

Congenital disorders (CDs) are a global health issue and an important contributor to childhood mortality and morbidity. In South Africa (SA), the size and nature of the problem is unknown because reporting of CDs has been unreliable. Inaccurate assessment and under-reporting have led to an underestimate of the contribution of CDs to the burden of disease. As SA undergoes a positive epidemiological transition, the CD burden will be expected to increase. This study aimed to fill the void in empiric CD data in the country. The objectives were to measure the birth prevalence of CDs of live births and describe the pattern of CDs at a regional hospital in KwaZulu Natal Province in 2018 using the Birth Defects Notification Tool (BDNT) developed by the National Department of Health. The collected data was then compared with existing published data in SA and country-specific modelled estimates. A retrospective, observational, descriptive review of CDs diagnosed within the neonatal service at Edendale Hospital (EDH) was conducted in 2018. All in-house live births diagnosed with CDs were included in the study. Stillbirths and neonates with identified CDs born elsewhere and referred to EDH after birth were excluded from the study. Data were obtained from the birth registry, neonatal admission register, and the individual BDNT. A total of 117 neonates were diagnosed and notified with a CD from the 7516 live births examined at EDH. The total birth prevalence for the study period was 15.57 per l000 live births, which equates to 1 in every 64 live births affected by a CD at EDH in 2018. The most affected systems were the musculoskeletal (31.6%) and circulatory systems (18.8%). Birth prevalence rates of key CDs were comparable to previously published SA data and are in line with current modelled estimates. This study responds to the paucity of birth prevalence data on CDs in SA and serves as a starting point for comparison locally and with other national and international data. It offers additional evidence on the health burden represented by CDs in SA and the need to address the surveillance, care and prevention of these conditions as a healthcare priority.