Birth prevalence of ano-rectal malformations for the Western Cape Province, South Africa

Master Thesis


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University of Cape Town

Background: Anorectal malformations (ARMs) are a major birth anomaly worldwide. South Africa has ethnically and geologically diverse populations. A recent publication indicated an increased birth prevalence of ARMs in the Witwatersrand referral area between 2005 and 2010. The purpose of this study was to determine the birth prevalence of ARM and its various sub - types in the Western Cape referral district over an 8 year period Methods: For an eight year period from 01 January 2005 to 31 December 2012; retrospective data was collected from the Paediatric Surgical Departments of Red Cross War Memorial Children's Hospital, Tygerberg Children's Hospital as well as the private sector health registries. The number of live births per year for a specific municipal district was obtained from the National Department of Health. The Chi square for trend test was used to determine statistical significance. Results: The birth prevalence for ARM in the Western Cape Province in 2012 was shown to be 1:5572 live births (1.79/10 000 live births). The West Coast Municipality district had the highest average birth prevalence rate of 1:3063 (3 .26/10 000) live births for years studied. There was a male predominance (1.6:1), the most common ARM was the vestibular fistula (19.2%) and in 26% of the patients there was an initial delay in the diagnosis. Conclusion: This study has provided some recent data for ARMs for the Western Cape Province. There was no statistical significant change in the prevalence of ARMs over the eight year period for the Western Cape Province as well as in any of the individual six municipal health districts. ( χ2 for trend p=0.52) . The number of delayed diagnosis of ARM is of concern.