Neural Tube Defects in India - Another Epidemic
Anil Cherian and colleagues report in The Lancet (366: 930, 2005) very elevated prevalence of neural tube defects (8.2 per 1,000 live births) in the Ballrampur District, Uttar Pradesh, India. Of the ten cases reported, six were spina bifida. The investigators believe that the data reflects a bias for underreporting and that there are 168 other districts similar to those studied. They also stress the lack of planning for NTD prevention by periconceptional folate supplementation in India and urge India’s Ministry of Health to develop a comprehensive strategy to reduce the instances of NTD without delay.
A companion editorial by V. S. Salvi and K. R. Damania (366: 871, 2005) stressed that folic acid deficiency is a major concern for all developing countries and India is no exception. They also point out a sex bias consisting of an allocation of food to women after the rest of the family. They comment the daily intake of folic acid in rural areas of various Indian states is far lower than the daily 400 micrograms necessary to prevent birth defects.
