Last summer break, my friends and I got a chance of visiting University Teaching Hospital, Kigali (CHUK) during an event we had organized to support sick children. Later I visited University Teaching Hospital of Butare where I also saw several children suffering from several childhood diseases.

Childhood diseases are illnesses, impairments or abnormal conditions that affect infants and children. That is to say those in the age span that begins with the fetus and extends till adolescence.

Visiting those hospitals inspired me to start doing research related to some childhood diseases that I found there so that I could contribute to children’s welfare. So today I explain one of the diseases called spina bifida.

Spina bifida is a neural tube defect, a type of birth defect of the brain, spine or spinal cord. It occurs when the spinal column of the fetus doesn’t close completely during the first month of pregnancy. Sometimes, the defect causes an opening in the back, which is visible through which the spinal cord and its coverings may push. Other times, there is no opening and the defect remains hidden under the skin.

Spina bifida is divided into three main types: Spina bifida occulta, Spina bifida meningocele and Myelomeningocele. Myelomeningocele is the most severe and the most common form of spina bifida.

Causes

Even though the exact cause of spina bifida is still unknown, these could play a great role. Low levels of the vitamin B (folic acid ) during pregnancy are linked to spina bifida. Folic acid plays a large role in cell growth and development, as well as tissue formation. Not having enough folic acid in the diet before and during early pregnancy can increase the unborn child’s risk of spina bifida and other neural tube defects.

Some evidence suggests that genes may play a role. When one parent has spina bifida, there is a 1 in 25 (4 percent) chance of passing spina bifida to the baby, but research shows that most babies born with spina bifida have no family history of the condition.

A high fever during pregnancy may increase a woman’s chances of having a child with spina bifida. Pregnant women should not use hot tubs or saunas.

Women with epilepsy who have taken the drug valproic acid to control seizures also are at an increased risk of having a child with spina bifida.

Women with diabetes and obesity have a higher risk of having a child with spina bifida.

Problems caused by spina bifida

Learning disabilities: Children with spina bifida sometimes have problems with language, reading, math and paying attention.

Paralysis: Children with spina bifida also might have trouble moving certain muscles. The degree of paralysis depends on where the meningocele is in the spine. The higher the opening is on the back, the more severe the paralysis can be.

Hydrocephalus: Extra fluid can cause the head to swell and put pressure on the brain. Hydrocephalus can cause intellectual and developmental disabilities. These are problems with how the brain works that can cause a person to have trouble or delays in physical development, learning, communicating, taking care of himself or getting along with others. In some cases, a surgeon needs to drain the extra fluid from a baby’s brain.

Chiari II malformation: This condition happens when the lower part of the brain sits in the upper part of the neck. Some babies with this condition have hydrocephalus, weakness in the upper body (like in the arms and hands) and breathing or swallowing problems.

Skin problems: People with spina bifida can develop sores, calluses, blisters and burns on their feet, ankles and hips. But they may not know they have these problems because they may not be able to feel certain parts of their body.

Urinary tract infections (UTIs): The urinary tract is the system of organs (including the kidneys and bladder) that helps your body get rid of waste and extra fluids in the urine. Babies with spina bifida often can’t control when they urinate because the nerves that help a baby’s bladder and bowels work are damaged.

Prevention

Many cases of spina bifida can be prevented if women of child-bearing age take 0.4 milligrams (400 micrograms) of folic acid regularly during early pregnancy and continue to take it throughout the first trimester. Some women may have to take more folic acid, especially if they are taking valproic acid for epilepsy or depression.

Because many women don’t find out that they’re pregnant until 4 to 5 weeks into the pregnancy, it is important to start taking folic acid before becoming pregnant. This provides the best protection for an unborn baby. Good sources of folic acid include egg yolks , orange juice, dried beans, peas, nuts, dark green leafy vegetables and some fruits. Many foods such as some breakfast cereals, enriched breads, flours, pastas, rice, and other grain products are now fortified with folic acid. Many multivitamins also contain the recommended dosage of folic acid as well.

Folic acid is a B vitamin which helps the body make healthy new cells and is important in the development of a healthy fetus. It is therefore highly recommended for pregnant women.

The writer is a medical student at Karadeniz Technical University in Turkey