PMID- 30233830
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220322
IS  - 2059-7908 (Print)
IS  - 2059-7908 (Electronic)
IS  - 2059-7908 (Linking)
VI  - 3
IP  - 4
DP  - 2018
TI  - Clubfoot treatment in 2015: a global perspective.
PG  - e000852
LID - 10.1136/bmjgh-2018-000852 [doi]
LID - e000852
AB  - INTRODUCTION: Clubfoot affects around 174 000 children born annually, with 
      approximately 90% of these in low-income and middle-income countries (LMIC). 
      Untreated clubfoot causes life-long impairment, affecting individuals' ability to 
      walk and participate in society. The minimally invasive Ponseti treatment is 
      highly effective and has grown in acceptance globally. The objective of this 
      cross-sectional study is to quantify the numbers of countries providing services 
      for clubfoot and children accessing these. METHOD: In 2015-2016, expected cases 
      of clubfoot were calculated for all countries, using an incidence rate of 
      1.24/1000 births. Informants were sought from all LMIC, and participants 
      completed a standardised survey about services for clubfoot in their countries in 
      2015. Data collected were analysed using simple numerical analysis, country 
      coverage levels, trends over time and by income group. Qualitative data were 
      analysed thematically. RESULTS: Responses were received from 55 countries, in 
      which 79% of all expected cases of clubfoot were born. More than 24 000 children 
      with clubfoot were enrolled for Ponseti treatment in 2015. Coverage was less than 
      25% in the majority of countries. There were higher levels of response and 
      coverage within the lowest income country group. 31 countries reported a national 
      programme for clubfoot, with the majority provided through public-private 
      partnerships. CONCLUSION: This is the first study to describe global provision 
      of, and access to, treatment services for children with clubfoot. The numbers of 
      children accessing Ponseti treatment for clubfoot in LMIC has risen steadily 
      since 2005. However, coverage remains low, and we estimate that less than 15% of 
      children born with clubfoot in LMIC start treatment. More action to promote the 
      rollout of national clubfoot programmes, build capacity for treatment and enable 
      access and adherence to treatment in order to radically increase coverage and 
      effectiveness is essential and urgent in order to prevent permanent disability 
      caused by clubfoot.
FAU - Owen, Rosalind M
AU  - Owen RM
AD  - Global Clubfoot Initative, London, UK.
FAU - Capper, Beth
AU  - Capper B
AD  - Global Clubfoot Initative, London, UK.
FAU - Lavy, Christopher
AU  - Lavy C
AD  - Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, 
      University of Oxford, Oxford, UK.
LA  - eng
PT  - Journal Article
DEP - 20180903
PL  - England
TA  - BMJ Glob Health
JT  - BMJ global health
JID - 101685275
PMC - PMC6135438
OTO - NOTNLM
OT  - cross-sectional survey
OT  - health systems
OT  - orthopedic surgery
OT  - paediatrics
OT  - public health
COIS- Competing interests: None declared.
EDAT- 2018/09/21 06:00
MHDA- 2018/09/21 06:01
PMCR- 2018/09/03
CRDT- 2018/09/21 06:00
PHST- 2018/03/27 00:00 [received]
PHST- 2018/07/11 00:00 [revised]
PHST- 2018/07/13 00:00 [accepted]
PHST- 2018/09/21 06:00 [entrez]
PHST- 2018/09/21 06:00 [pubmed]
PHST- 2018/09/21 06:01 [medline]
PHST- 2018/09/03 00:00 [pmc-release]
AID - bmjgh-2018-000852 [pii]
AID - 10.1136/bmjgh-2018-000852 [doi]
PST - epublish
SO  - BMJ Glob Health. 2018 Sep 3;3(4):e000852. doi: 10.1136/bmjgh-2018-000852. 
      eCollection 2018.