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Model estimates high rates of unrepaired cleft lips, palates in poor states of India

Researchers estimated more than 72,000 cases of unrepaired cleft lip and/or palate in India, with exceptionally high rates in poorer states with less health care infrastructure, according to study results recently published in JAMA Facial Plastic Surgery.

The researchers used data from patients receiving care from 12 Operation Smile programs in 12 low- and middle-income countries in Latin America, Africa, the Middle East and Asia and India between June 1, 2013, and May 31 2014.

“The resulting model describes the prevalent unmet need for cleft surgery in India by state and includes patients older than the surgery target data of 1 and 2 years for cleft lip and/or cleft palate repair, respectively,” the researchers wrote.

State-level economic and health system indicators were used to estimate the total number of unrepaired cleft lip and/or palate (CL/P) cases in each state.

There were an estimated 72,637 cases of unrepaired CL/P (uncertainty interval, 58,644-97,870 cases) detected in 28 states with available data.

The percentage of individuals by state with unrepaired CL/P who were older than the respective target ages ranged from 37% in Goa to 65.8% in Bihar, with a median of 57.9%.

The median rate of unrepaired CL/Ps was 5.9 per 100,000 population. The rates ranged from less than 3.5 per 100,000 in Kerala and Goa to 10.0 per 100,000 in Bihar.

“Although the most populated states had the largest number of unrepaired CL/Ps (eg, Uttar Pradesh), poor states with less health care infrastructure have exceptionally high rates (eg, Bihar, Nagaland),” the researchers concluded. “To address this burden, local and international CL/P care programs could use these estimates of the number and the rate of unrepaired cases in their area to inform their goals … and strategy.” – by Bruce Thiel

Disclosure: The researchers report working for or otherwise being affiliated with Operation Smile International.