Cleft-Related Infanticide and Abandonment: A Systematic Review of the Academic and Lay Literature.

Objective: We aimed to describe the scope of cleft-related infanticide and identify issues that might inform prevention strategies.

Design: Systematic reviews of both academic (eg, PubMed, EBSCOhost) and lay literature (eg, LexisNexis Academic, Google) databases were performed to identify all primary reports of cleft-related infanticide. All languages were included.

Patient Barriers to Accessing Surgical Cleft Care in Vietnam: A Multi-site, Cross-Sectional Outcomes Study.

Background: Most people who lack adequate access to surgical care reside in low- and lower-middle-income countries. Few studies have analyzed the barriers that determine the ability to access surgical treatment. We seek to determine which barriers prevent access to cleft care in a resource-limited country to potentially enable barrier mitigation and improve surgical program design.

Barriers to Reconstructive Surgery in Low- and Middle-Income Countries: A Cross-Sectional Study of 453 Cleft Lip and Cleft Palate Patients in Vietnam.

Background: Despite health system advances, residents of low- and middle-income countries continue to experience substantial barriers in accessing health care, particularly for specialized care such as plastic and reconstructive surgery.

Methods: A cross-sectional household survey of patients seeking surgical care for cleft lip and/or cleft palate was completed at five Operation Smile International mission sites throughout Vietnam (Hanoi, Nghe An, Hue, Ho Chi Minh City, An Giang, and Bac Lieu) in November of 2014.

Results: Four hundred fifty-three households were surveyed.

A Model of the Unmet Need for Cleft Lip and Palate Surgery in Low- and Middle-Income Countries.

Background: There is a significant unmet need for the cleft lip and/or palate (CL/P) care in low- and middle-income countries (LMICs) ; however, country-level estimates that can be used to inform local and international cleft care program strategies are lacking.

Methods: Using data from Operation Smile surgical programs in twelve LMICs and country-level indicators from the World Health Organization and World Bank, we developed a model to estimate the proportion of individuals with CL/Ps older than respective surgery age targets for cleft lip and cleft palate surgery (1 and 2 years, respectively). After extrapolating this model to other LMICs with available indicator data, we combined these findings with estimates of CL/P prevalence among live births to estimate the total number of unrepaired CL/P cases in LMICs worldwide.

Estimate of Unmet Need for Cleft Lip and/or Palate Surgery in India.

Importance: The unmet need for cleft lip and/or palate (CL/P) care in India is significant. However, estimates required for CL/P care program planning are lacking.

Objective: To estimate the unmet need for CL/P surgery in India at the state level.

Inequitable Access to Timely Cleft Palate Surgery in Low- and Middle-Income Countries.

Background: Delayed cleft palate repair has significant implications for physical, mental, and social well-being and has been suggested to lead to an increased risk of infant and under-five mortality in low- and middle-income countries (LMICs).

Methods: Using medical records from Operation Smile international programs taking place in eleven different LMICs between March and May 2014, we performed a logistic regression assessing the relationship between delayed surgery access, defined as primary palatoplasty presentation after 24 months of age, and GDP per capita across 11 countries.

Results: Median age of presentation ranged from 13 to 24 months in upper-middle-income countries, 17 to 35 months in lower-middle-income countries, and 14 to 66 months in low-income countries.

A Health Systems Perspective on the Mission Model for Cleft Lip and Palate Surgery: A Matter of Sustainability or Responsibility?

One in 700 children around the world are born with cleft lip and/or palate (CL/P). Although reconstructive surgery is widely available in high-income settings, over 2 billion people in low- and middle-income countries lack access to essential surgical care. The mission model has been demonstrated to be highly effective in responding to the global surgical workforce crisis, but has been questioned in regard to its sustainability, value, and overall impact.

Providing more than health care: the dynamics of humanitarian surgery efforts on the local microeconomy.

Humanitarian cleft surgery has long been provided by teams from resource-rich countries traveling for short-term missions to resource-poor countries. After identifying an area of durable unmet need through surgical missions, Operation Smile constructed a permanent center for cleft care in Northeast India. The Operation Smile Guwahati Comprehensive Cleft Care Center (GCCCC) uses a high-volume subspecialized institution to provide safe, quality, comprehensive, and cost-effective cleft care to a highly vulnerable patient population in Assam, India.

Surgical education through video broadcasting.

Surgical training is facing new obstacles. As advancements in medicine are made, surgeons are expected to know more and to be able to perform more procedures. In the western world, increasing restrictions on residency work hours are adding a new hurdle to surgical training.

Seat belt and child seat use in Lipetskaya Oblast, Russia: frequencies, attitudes, and perceptions.

Objective: Despite the importance of understanding seat belt use patterns among drivers and passengers for the purpose of direct interventions or monitoring improvements, no study has described wearing rates for all seat positions in Russia. This study describes observed seat belt use and knowledge, attitudes, and perceptions of seat belt use in Lipetskaya Oblast, Russia.

Methods: An observational study on the use of seat belts and child restraints in the Lipetskaya region conducted during October 2010 collected data in 6 districts and on 3 different road types.

Assessing prion infectivity of human urine in sporadic Creutzfeldt-Jakob disease.

Prion diseases are neurodegenerative conditions associated with a misfolded and infectious protein, scrapie prion protein (PrP(Sc)). PrP(Sc) propagate prion diseases within and between species and thus pose risks to public health. Prion infectivity or PrP(Sc) presence has been demonstrated in urine of experimentally infected animals, but there are no recent studies of urine from patients with Creutzfeldt-Jakob disease (CJD).

Elevated infant mortality rates among oral cleft and isolated oral cleft cases: a meta-analysis of studies from 1943 to 2010.

Objective : To review available published literature in order to obtain a more comprehensive assessment of the association between infant mortality and oral clefts, overall and isolated. Design : A wide-ranging search of published studies relating infant mortality rates to oral clefts and congenital malformations was conducted, yielding applicable data sets. Settings of the included studies varied to a limited extent, although all were conducted within high-income countries with superior health indicators.

Cleft lip and palate as a cost-effective health care treatment in the developing world.

Background: The considerable number of surgical procedures performed each year, as well as the significant burden of surgical disease globally, have brought surgery into the arena of public health concerns. Several articles have shown the cost-effectiveness of surgical interventions in the developing world. The authors suggest that surgery has an important role in global public health, specifically through international volunteer surgical missions as a vehicle for delivery.