SALT-NTD

Study/research: Spine bifida and Anencephaly in Ethiopia, folate for prevention

PI/PIS: Dr. Lola Madrid/ Professor Nega Assefa

Lead Institution: Haramaya University, London School of Hygiene and Tropical Medicine, and Ethiopian Public Health

Implementation Year: 2022-2024

Status of the project: In Progress

Funder: Bill and Melinda Gates foundations  

Project Summary

SALT-NTD aims to achieve the following important goals:

1. To implement triple surveillance to assess the prevalence of folate deficiency, the prevalence of NTD at population level and the outcome of live-born babies born with NTDs that are followed in a hospital.
2. Understand community perception on causes of NTDs and assess acceptability of salt fortification programs.
3. To examine the effect of routine consumption of fortified salt with folic acid in blood folate concentration of women of reproductive age through a pre and post-intervention study.
4. To develop capacity building on epidemiology of NTD and laboratory procedures.
5. To evaluate the feasibility of the pre and post folic acid fortified salt intervention study in the CHAMPS-sites in Eastern Ethiopia, to inform program progress toward impact.

This proposal aims to collaborate with other stakeholders to reduce the NTDs prevalence in Ethiopia to <1/1000 births by increasing the blood folate concentrations in at least 90% of women of reproductive age by conducting a project in the CHAMPS-sites in Eastern Ethiopia. The estimated mortality risk in the study area through these CHAMPS findings and mortality data from the DSS, the NTDs prevalence in the three CHAMPS-Ethiopian sites in Eastern Ethiopia was 7.5 per 1000 births. Mortality surveillance identified that NTDs are common among stillbirths in Eastern Ethiopia, a region with high prevalence of folate deficiency among reproductive‐aged women. Population data are needed to understand the real size of the problem. Due to the lethality and disability of NTDs, the role of folic acid fortification as public health intervention to prevent NTDs in Ethiopia urgently needs to be explored.