Birth Prevalence of Anorectal Malformation in the Referral Area for the University of the Witwatersrand Tertiary Hospitals, South Africa

BackgroundAnorectal malformations (ARMs) are a major congenital anomaly in neonates. There is significant geographical variation in the birth prevalence varying from 1:1,500 to 1:5,000 live births. There is no published literature on the birth prevalence of ARM occurring within the referral area for The University of Witwatersrand tertiary hospitals in South Africa. MethodsRetrospective data were collected from the Pediatric Surgical Department, University of the Witwatersrand. Patient records for a 6-year period from January 2005 to December 2010 were obtained from Chris Hani Baragwanath Academic Hospital and Charlotte Maxeke Johannesburg Academic Hospital. The number of live births per year for a specific municipal district was obtained from the National Department of Health. The (2) test for trend test was used to determine statistically significance. ResultsThe birth prevalence for ARM in 2010 was shown to be 1:3,989 live births (2.5/10,000 live births) for the University of Witwatersrand tertiary hospital referral area. A statistically significant overall increase in the birth prevalence of ARM from January 2005 till December 2010 was demonstrated (p<0.0001). The municipal districts of Johannesburg (p=0.0015) and Ekurhuleni (p=0.0066) revealed the greatest increase in birth prevalence. ConclusionThis study has provided current statistics on the birth prevalence of ARM in the University of Witwatersrand tertiary hospital referral area, as well as demonstrating a positive incremental trend in the occurrence of this condition over a 6-year period. Future studies will examine the birth prevalence in several other provinces of South Africa. Results from the collective data will then be used to form conclusions regarding any regional or national changes in the birth prevalence of ARM as well as to identify any epidemiological trends.