Archive | 2021
Prevalence of malnutrition among children at primary cleft surgery: A cross-sectional analysis of a global database
Abstract
Background: Orofacial clefts are common birth defects requiring prompt feeding support and timely surgery. Little information exists about the impact of inadequate care provision in poor-resource settings. We aimed to estimate the burden of malnutrition in children from 101 low- and middle-income countries (LMICs) using cleft surgery records collected by one cleft NGO. Methods: We conducted a cross-sectional study using anonymised records of children [≤]5 years who underwent cleft surgery between 2008 and 2018. The data included birth date, gender, weight at surgery, ethnicity, country of origin, and date of primary surgery and was analysed using descriptive statistics. The prevalence of malnutrition was derived from the generation of weight-for-age z scores and described in relation to cleft type, gender, and ethnicity/geography. For purpose of comparison, the most recent prevalence estimates for underweight in children under-5 were extracted from publicly available national surveys. Findings: The analysis included 602,568 children. The overall prevalence of underweight at the time of primary cleft surgery was 28.6%; a figure well above the global underweight prevalence in under-5 children without cleft estimated at about 13.5%. The prevalence of underweight varied with the age at primary surgery and the type of cleft, as well as with gender, ethnicity, and region of origin, and was positively correlated with country-specific estimates of underweight prevalence in children without cleft. Interpretation: Our findings support the need for advancing universal health coverage with special efforts to increase timely nutrition care and access to surgery for the most disadvantaged children. Funding: None.