Seasonal variations in frontoethmoidal meningoencephalocele births in Cambodia

Clinical article

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Object

Frontoethmoidal meningoencephalocele (fMEC) is relatively common in many Southeast Asian countries, with devastating aesthetic and social consequences for affected children. No cause has been detected to date. Among other factors, the authors of this paper attempt to identify a statistically significant difference in the spread of fMEC births throughout the year compared with other births. This seasonal variation in the incidence of fMEC births may provide clues to the causes of this condition.

Methods

From a group of 175 children with fMEC who underwent surgery at the authors' humanitarian institution (Children's Surgical Centre) in Phnom Penh between 2004 and 2008, 86 children were studied. These children were born at full term and had an accurately recorded date of birth. The birth dates of this fMEC group were compared with a group of > 15,000 other live births at one of the main maternity units in Phnom Penh in 2005 and 2006.

Results

Seasonal variation in incidence of fMEC by month of birth was highly statistically significant (p < 0.001), with the peak of births occurring in the dry season (between March and May). This is in contrast to the control group, in which there was an equal distribution of births throughout the year. More than 85% of the parents of children with fMEC who the authors treated were farmers, but this figure reflects the composition of the Cambodian population.

Conclusions

Uneven spread in the incidence of fMEC births throughout the year suggests that a seasonal factor during the wet season may be suspected in the pathogenesis of fMEC in Cambodia.

Abbreviation used in this paper: fMEC = frontoethmoidal meningoencephalocele.

Article Information

Address correspondence to: Franck-Emmanuel Roux, M.D., Ph.D., INSERM 825 et Service de Neurochirurgie, Hôpital Purpan, F-31059 Toulouse, France. email: franck_emmanuel.roux@yahoo.fr.

© AANS, except where prohibited by US copyright law.

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Figures

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    Data of the birth dates from 86 children born with fMEC and from a control group of > 15,000 children born in the main maternity unit in Phnom Penh between 2005 and 2006. A: Photographs of 2 children suffering from fMEC. B: Graph showing the birth dates of the children affected with fMEC. A large group of children with fMEC were born during the dry season in Cambodia (March–May). C: Graph showing the birth dates of > 15,000 children (2005 and 2006 data) born in the main maternity unit of Phnom Penh. The number of births per month is almost stable with no seasonal variations.

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