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Global Burden of Orofacial Clefts and the World Surgical Workforce Publisher Pubmed



Massenburg BB1, 2, 3, 4, 5, 6, 7, 8, 9 ; Hopper RA1, 2, 3, 4, 5, 6, 7, 8, 9 ; Crowe CS1, 2, 3, 4, 5, 6, 7, 8, 9 ; Morrison SD1, 2, 3, 4, 5, 6, 7, 8, 10 ; Alonso N1, 2, 3, 4, 5, 6, 7, 8 ; Calis M1, 2, 3, 4, 5, 6, 7, 8 ; Donkor P1, 2, 3, 4, 5, 6, 7, 8 ; Kreshanti P1, 2, 3, 4, 5, 6, 7, 8 ; Yuan J1, 2, 3, 4, 5, 6, 7, 8 ; Nguyen TH11 ; Stein C12 ; Tovanipalone MR13 ; Tran BX14 ; Kassebaum NJ15 Show All Authors
Authors
  1. Massenburg BB1, 2, 3, 4, 5, 6, 7, 8, 9
  2. Hopper RA1, 2, 3, 4, 5, 6, 7, 8, 9
  3. Crowe CS1, 2, 3, 4, 5, 6, 7, 8, 9
  4. Morrison SD1, 2, 3, 4, 5, 6, 7, 8, 10
  5. Alonso N1, 2, 3, 4, 5, 6, 7, 8
  6. Calis M1, 2, 3, 4, 5, 6, 7, 8
  7. Donkor P1, 2, 3, 4, 5, 6, 7, 8
  8. Kreshanti P1, 2, 3, 4, 5, 6, 7, 8
  9. Yuan J1, 2, 3, 4, 5, 6, 7, 8
  10. Nguyen TH11
  11. Stein C12
  12. Tovanipalone MR13
  13. Tran BX14
  14. Kassebaum NJ15
  15. Abdollahi M16
  16. Alipour V17
  17. Alsharif U18
  18. Arabloo J17
  19. Bernabe E19
  20. Bolla SR20
  21. Cho DY1, 9
  22. Chung MT21
  23. Dai X22
  24. Do HT23
  25. Hwang BF24
  26. Lasrado S25
  27. Mokdad AH26
  28. Negoi RI27
  29. Nguyen HLT28
  30. Roberts NLS22
  31. Travillian RS22
  32. Wilner LB22

Source: Plastic and Reconstructive Surgery Published:2021


Abstract

Background: Orofacial clefts are one of the most common congenital anomalies, but this disease burden is unevenly distributed worldwide. The authors hypothesize that this burden falls disproportionately on the countries with the smallest surgical workforce or lowest Socio-Demographic Index, rather than those with the highest prevalence of disease. Methods: The authors estimated the prevalence and disease burden of orofacial clefting from 1990 to 2017 in 195 countries using the Global Burden of Disease methodology. Prevalence and disability-adjusted life-years were compared geographically, temporally, and against the size of the national surgical workforce, Socio-Demographic Index, and income status. Linear and logarithmic regressions were performed. Results: In 2017, the prevalence of orofacial clefting was estimated to be 10.8 million people, representing a disease burden of 652,084 disability-adjusted life-years, with most of this disease burden experienced by low-and middle-income countries (94.1%). From 1990 to 2017, there was a decrease in disease burden (-70.2%) and prevalence (-4.9%). There was negative logarithmic association between surgical workforce size and disease burden, with a surgical workforce of greater than six providers per 100,000 population (3.6 disability-adjusted life-years versus 22.4 disability-adjusted life-years per 100,000 population; p < 0.0001). Conclusions: Burden of orofacial clefting has a strong negative association with the size of the surgical workforce, suggesting that strengthening the surgical workforce will help alleviate this burden. Epidemiologic data on countries and regions with inadequate surgical workforces and high disease burden should guide future research efforts and allocation of resources, and guide the treatment and educational goals of international charitable organizations. © 2021 Lippincott Williams and Wilkins. All rights reserved.
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