Page 430 - HIVMED_v21_i1.indb

Page 3 of 7 Original Research

Methods this study was also obtained from the Free State province
Department of Health. The information of each patient was
This was a retrospective cross-sectional study set at UH, managed with strict confidentiality. The hospital numbers of
Bloemfontein, which is the referral hospital in the FS for the each patient and mother and the date of birth were transcribed
treatment of all NTDs as well as antenatal diagnoses of onto a separate list and a specific research number was allocated
congenital defects. All babies with NTDs (including stillbirths, for each mother and baby (e.g. M1, B1). On the data-sheet
late terminations and live births) from pregnancies reaching and the Excel spread-sheet, only these research numbers were
viability born in UH or referred to UH from 2012 to 2016 were used to ensure confidentiality. These data-sheets were kept in a
included in this study. At UH, viability is defined as later than locked cabinet at the Department of Paediatrics.
28 weeks’ pregnancy duration or more than 800 g birth weight.
Results
The Department of Health Information Systems (DHIS)
defines a delivery later than 28 weeks as a birth, and not a In total, 77 cases of NTDs were captured from 2012 to 2016 at
miscarriage. Early miscarriages or termination of pregnancy UH. The number of cases per year indicated that most were
before 28 weeks’ gestation were excluded to enable born in 2013 and 2014, with 10 in 2012, 19 in 2013, 19 in 2014,
comparison with the Sayed et al. study. Patients referred 15 in 2015 and 14 in 2016. See Figure 1.
10
from outside the FS were also excluded.
Twenty-six (26; 33.8%) of the cases were born in UH, and 51
Measurement in other hospitals. The highest number of referrals was from
the Mangaung area (32.7%). This is displayed in Figure 2.
Neural tube defect cases were identified and data were
collected retrospectively from the following sources: The incidence of NTDs was calculated using the number of
• Surveillance of Birth Defects reporting forms – UH. births in the FS per year as well as the number of NTDs per
• MEDITECH records: the Electronic system for patient year, as shown in Table 1. Thus, over the 5 years, the incidence
data capturing at UH. of NTDs was 0.34/1000 births.
• Hospital records from the Neonatal unit and Obstetric
unit, including admission registers as well as the records- Data for UH and PH were calculated separately from data of
archive of UH. the rest of the FS as both had been sentinel sites for the Sayed
10
• Number of births in the FS for 2012 to 2016 – DHIS. et al. study. There were 27 222 births from 2012 to 2016 and
• The birth data for UH and Pelonomi Hospital (PH) were
collected from the specific maternity wards and calculated 20
separately to that from the rest of the FS.

Once the NTD cases were identified, data from their
10
summaries on MEDITECH as well as hospital files were Number of neural tube defect cases 15 19 19
collected and entered into a data collection sheet. Each case 15 14
was given a unique research number for the information of 5 10
the mother and the baby to maintain the confidentiality of the 0
patients. The data collection sheets were then entered into an 2012 2013 2014 2015 2016
Excel spreadsheet. Year
®
FIGURE 1: Number of neural tube defect (NTD) cases per year at Universitas
The first three cases were used for the pilot study to test the Hospital.
data collection sheet. The data-sheet was adapted to include
the gender and the weight of the baby. These three cases were
included in the study.
FEZILE DABI
22.44%
Analysis of data 488 036
The University analysed the data. The results were LEJWELEPUTSWA THABO MOFUTSANYANA
summarised as frequencies, percentages (categorical 16.32% 26.53%
variables) and medians (numerical variables due to skew 627 626 736 238
distributions). Ninety five per cent confidence intervals
(95% CI) and appropriate hypothesis testing were used for MANGAUNG
32.65%
comparison with other studies. 747 431
XHARIEP
2.04%
Ethical consideration 146 259
Approval to undertake this study was obtained from the
Health Sciences Research Ethics Committee of the University FIGURE 2: Referrals from outside of Universitas Hospital (%) by municipal
of the Free State (HSREC 53/2016) and permission to conduct district and population in 2011. 20
20
http://www.sajhivmed.org.za 422 Open Access