Dataset Information

Mobile Surgical Scouts Increase Surgical Access for Patients with Cleft Lip and Palate in Nepal.

ABSTRACT: Background: In Nepal's remote regions, challenging topography prevents patients with cleft lip and palate (CLP) from seeking care. Objective: To measure the effect of a mobile surgical scout program on CLP surgical care in remote regions of Nepal. Methods: Forty-four lay people were trained as mobile surgical scouts and over 5 months traversed remote districts of Nepal on foot to detect and refer CLP patients for surgical care. Surgical patients from remote districts were compared with matched time periods in the year before intervention. Diagnostic accuracy of the surgical scouts was assessed. Findings: Mobile surgical scouts accurately diagnosed (90%) and referred (82%) patients for cleft surgery. Before the intervention, CLP surgeries from remote districts represented 3.5% of cleft surgeries performed. With mobile surgical scouting, patients from remote districts comprised 8.2% of all cleft surgeries (p = 0.007). When transportation and accompaniment was provided in addition to mobile surgical scouts, patients from remote districts represented 13.5% (p ≤ 0.001) of all cleft surgeries. Conclusion: Task-shifting the surgical screening process to trained scouts resulted in accurate diagnoses, referrals, and increased access to cleft surgery in remote districts of Nepal.

SUBMITTER: Shaye DA

PROVIDER: S-EPMC9700372 | biostudies-literature | 2022 Nov-Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Mobile Surgical Scouts Increase Surgical Access for Patients with Cleft Lip and Palate in Nepal.

Shaye David A DA Nakarmi Kiran Kishor KK Shakya Pramila P Pradhan Leeza L Bhattarai Kabita K Rayamajhi Badri B Joshi Hemanta Dhoj HD Yuen Courtney M CM Shrestha Kailash Khaki KK Rai Shankar Man SM

Facial plastic surgery & aesthetic medicine 20210913 6

Background: In Nepal's remote regions, challenging topography prevents patients with cleft lip and palate (CLP) from seeking care. Objective: To measure the effect of a mobile surgical scout program on CLP surgical care in remote regions of Nepal. Methods: Forty-four lay people were trained as mobile surgical scouts and over 5 months traversed remote districts of Nepal on foot to detect and refer CLP patients for surgical care. Surgical patients from remote districts were co ...[more]

PMID: 34516932

Similar Datasets

Project description:BackgroundCleft lip/palate (CLP) is a congenital orofacial anomaly appearing in approximately one in 700 births worldwide. While in high-income countries CLP is normally addressed surgically during infancy, in developing countries CLP is often left unoperated, potentially impacting multiple dimensions of life quality. Previous research has frequently compared CLP outcomes to those of the general population. But because local environmental and genetic factors contribute to the risk of CLP and also may influence life outcomes, such studies may downwardly bias estimates of both CLP status and correction.ObjectivesThis research represents the first study to use causal econometric methods to estimate the effects of both CLP status and CLP correction on the physical, social, and mental well-being of children.MethodsData were collected first-hand from 1,118 Indian children, where we obtained first-hand data on height, weight, grip strength, cognitive ability, reading, and math ability. A professional speech therapist reviewed digital recordings of speech taken at the interview to obtain four measures of speech quality. Using this data, the household fixed-effects model we employ jointly estimates effects of CLP status and CLP surgical intervention.FindingsOur results indicate that adolescents with median-level CLP severity show statistically significant losses in indices of speech quality (-1.59σ), physical well-being (0.32σ), academic and cognitive ability (-0.37σ), and social integration (-0.32σ). We find strong evidence that CLP surgery significantly restores speech if performed before five years of age. The first surgeries performed on less-severe CLP cases significantly restore social integration, psychological well-being, academic/cognitive ability, and a general index of human flourishing.ConclusionsChildren born with CLP in India face statistically significant losses in speech, physical health, mental health, and social inclusion. CLP surgical intervention significantly restores speech quality if carried out at an early age. Surgeries with the most significant impact on life outcomes are the first surgeries performed on less-severe CLP cases.

Dataset Information

Mobile Surgical Scouts Increase Surgical Access for Patients with Cleft Lip and Palate in Nepal.

Publications

Mobile Surgical Scouts Increase Surgical Access for Patients with Cleft Lip and Palate in Nepal.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets