The Global Burden of Neural Tube Defects and Disparities in Neurosurgical Care.

Structured Abstract Background Despite the success of folic acid fortification programs, neural tube defects (NTDs) such as spina bifida, encephalocele, and anencephaly remain among the most substantial causes of childhood morbidity and mortality worldwide. Although these are complicated conditions that require an interdisciplinary approach to care, definitive treatment of survivable NTDs is often neurosurgical. Methods Using Global Burden of Disease (GBD) data, we examined the global burden of NTDs as related to a nation's wealth, healthcare quality, and access to neurosurgical care. We abstracted data for death by cause, years lived with disability (YLD), GDP, UN geoscheme, Food Fortification Initiative (FFI) participation, and Healthcare Access and Quality (HAQ) index. We compared means using one-way ANOVA and proportions using Fisher exact tests, with statistical significance as alpha=0.05. Results 17/20 (85%) nations with the most deaths due to NTDs (p Conclusions Despite the success of folic acid fortification programs, greater global public health efforts should be placed on improving access to neurosurgical care in low and middle-income nations through sustainable initiatives such as surgeon exchange programs and the establishment of neurosurgery residency training programs.