Unmet Burden of Cleft Lip and Palate in Rural Gujarat, India: A Population‐Based Study

Abstract

The incidence of CL with or without palate was found to be 0.7 per 1,000 live births. The large number of unoperated cases (backlog) of cleft deformities suggests a big burden of unmet need in rural India.

Anatomical patterns of cleft lip and palate deformities among neonates in Mekelle, Tigray, Ethiopia; implication of environmental impact

“…Other studies conducted in South Indian population showed similar results, indicating CL/P being the most frequently occurring cleft anomaly, thus corroborating our result [19][20][21]. A contrasting view has been promulgated by Khajanchi et al who asserted in their work that occurrence of CL was the most common cleft abnormality followed by CL/P [22]. Environmental factors have been associated with increased risk of CL/P including: consanguinity, smoking, alcohol ingestion, use of anticonvulsants during pregnancy as well as insufficient folic acid intake in the pregestational period and first trimester of pregnancy [23].…”

Team Care Protocols for Individuals with Cleft Lip and Palate and Modified Protocols for Developing Countries

“…The lack of knowledge and resources leads to unacceptable delays in treatment, and many infants with orofacial clefts die of malnutrition. [5,16] Lack of treatment may have many causes: ignorance, child neglect, lack of affordability, lack of transportation, and gender bias. In some rural parts of India, sociocultural beliefs also lead to denial of medical care as a child born with a cleft is deemed as a preternatural blessing.…”

Estimate of Unmet Need for Cleft Lip and/or Palate Surgery in India

“…2,3 Infants born with CL/P in LMICs face significant barriers to treatment, which often lead to prolonged disfigurement, social stigma, speech impairment, and feeding difficulty that may result in malnutrition and even death. [4][5][6] Although CL/P is a complex condition that benefits from comprehensive care, the provision of safe, timely, and effective surgery helps to achieve a successful outcome. 5,6 Like other LMICs, India lacks reliable documentation of birth anomalies 7 ; thus, accurate estimates of the burden of CL/P in India are few.…”

“…5,6 Like other LMICs, India lacks reliable documentation of birth anomalies 7 ; thus, accurate estimates of the burden of CL/P in India are few. 4 A multicenter hospital-based study of 94 610 births 8 reported that the incidence of CL/P was 9.3 per 10 000 births and the incidence of cleft palate was 1.7 per 10 000 births. Khajanchi et al 4 performed a populationbased assessment of the unmet need for CL/P treatment in a single district.…”

“…Hospital-based studies do not capture individuals with CL/P who died, were killed, did not seek care, or could not reach care. 9 Although population-based studies are superior, the one aforementioned study 4 was conducted in only 1 district and did not use random sampling. Given the mosaic of socioeconomic disparities and health service capabilities between and within states in India, an estimate from a single district cannot be extrapolated to the entire country.…”