The aim of this scoping review was to determine the scope, objectives and methodology of
contemporary published research on congenital anomalies (CAs) in sub-Saharan Africa
(SSA), to inform activities of the newly established sub-Saharan African Congenital Anomaly
Network (sSCAN). MEDLINE was searched for CA-related articles published between
January 2016 and June 2021. Articles were classified into four main areas (public health
burden, surveillance, prevention, care) and their objectives and methodologies summarized.
Of the 532 articles identified, 255 were included. The articles originated from 22 of the 49
SSA countries, with four countries contributing 60% of the articles: Nigeria (22.0%), Ethiopia
(14.1%), Uganda (11.7%) and South Africa (11.7%). Only 5.5% of studies involved multiple
countries within the region. Most articles included CA as their primary focus (85%), investigated
a single CA (88%), focused on CA burden (56.9%) and care (54.1%), with less coverage
of surveillance (3.5%) and prevention (13.3%). The most common study designs were
case studies/case series (26.6%), followed by cross-sectional surveys (17.6%),

retrospective record reviews (17.3%), and cohort studies (17.2%). Studies were mainly
derived from single hospitals (60.4%), with only 9% being population-based studies. Most
data were obtained from retrospective review of clinical records (56.1%) or via caregiver
interviews (34.9%). Few papers included stillbirths (7.5%), prenatally diagnosed CAs (3.5%)
or terminations of pregnancy for CA (2.4%).This first-of-a-kind-scoping review on CA in SSA
demonstrated an increasing level of awareness and recognition among researchers in SSA
of the contribution of CAs to under-5 mortality and morbidity in the region. The review also
highlighted the need to address diagnosis, prevention, surveillance and care to meet Sustainable
Development Goals 3.2 and 3.8. The SSA sub-region faces unique challenges,
including fragmentation of efforts that we hope to surmount through sSCAN via a multidisciplinary
and multi-stakeholder approach.


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