"Elevated Prevalence of NTD in Ukraine Highest in a Chornobyl Impacted Region (Polissya)"
Yevtushok, L., Zymak-Zakutnya, N., Polishchuk, S., Yuskiv, N., Lapchenko, S., Oakley, G. P., and Wertelecki, W.
OMNI-Net Ukrainian Birth Defects Program, Rivne, Ukraine;
Department of Medical Genetics, University of South Alabama, Mobile, Alabama, U.S.A.;
Rollins School of Public Health, Emory University, Atlanta, Georgia, U.S.A.
Elevated prevalence rates (PR) of NTDs in Ukraine are persistent. During 2000-2002 and in 2005 the PR were 21 and 22 per 10,000 live births, respectively. The highest PR (28) was in Chornobyl impacted areas (northern counties of Rivne and Volyn oblasts, collectively known as Polissia). The PR in Rivne and Volyn counties not impacted by Chornobyl was lower (20 per 10,000 live births) and virtually the same in the non-Chornobyl impacted Khmelnytsky oblast (south of Rivne and Volyn oblasts).
Ongoing birth defects population surveillance also detected a cluster of conjoined twins in the Rivne oblast (~ 14,000 live births yearly); twice during 2000, and once during, 2002, 2003 (1 twin had spina bifida), 2004 and 2006. No conjoined twins were detected in five other oblasts except for Kherson, which is remote from Rivne (one instance in 2005 between 2003-2006).
The persisting elevated NTD rates prompted the Ukrainian Academy of Medical Sciences in partnership with UNICEF-Kyiv to recommend prompt implementation of a national folic acid flour fortification program. Experts estimated that ~ 500 infant deaths each year from acquired NTDs related to maternal folate deficiency. Also, a "Polissia Initiative" emerged to facilitate national and international partnerships to further investigate the role, if any, of folic acid deficiency, chronic low dose radiation or other factors inducing conjoined twins in Polissia.
Date of report: May 3, 2007