Demographic profiles and care management of children with spina bifida in Zambia

Abstract

Background: Spina bifida (SB), a major neural tube defect (NTD), is a leading cause of childhood disability in sub-Saharan Africa, with rising incidence in Zambia. It poses complex medical challenges requiring multidisciplinary care; yet, there is limited demographic and prevalence data on the same, particularly in Zambia.

Aim: To examine the demographic profiles, clinical features, management practices, key trends and care delivery gaps in SB care from 2010 to 2014.

Setting: The study was conducted at two Lusaka hospitals.

Methods: A retrospective study reviewed records with complete data on age, diagnosis, lesion location, residence and treatment. Descriptive statistical analysis was conducted using Statistical Package for Social Sciences (SPSS) version 23.0.

Results: Among 180 cases, 69.4% involved myelomeningocele with hydrocephalus, and 53.3% had lumbar lesions. Females constituted 55.6% of cases. Primary interventions included meningoplasty (61.7%) and Ventriculoperitoneal (VP) shunting (41.7%). Lusaka province accounted for 31.1% of cases, while Muchinga and Luapula had minimal referrals, exposing geographical disparities in access to specialised care. Rehabilitation services were severely underutilised, with only 4.0% receiving post-surgical physiotherapy and limited follow-up care.

Conclusion: The rising prevalence of SB highlights critical gaps in care delivery, particularly in underserved provinces and rehabilitation services. Despite early hospital admissions and surgical interventions, rehabilitation remains severely under-resourced.

Contribution: This study identifies key disparities and underutilised rehabilitation services in SB care in Zambia, offering recommendations to improve referral systems, decentralise specialist care and strengthen multidisciplinary frameworks for equitable healthcare access and better outcomes.