title: Unmet burden of cleft lip and palate in rural Gujarat, India: a population-based study.
abstract: BACKGROUND
  The burden of cleft lip and palate (CLP) in the developing world is being tackled by local hospitals and international surgical missions. However, the unmet surgical burden of these conditions is not known, because there are few population-based studies. We conducted this study to find the incidence and prevalence of cleft lip (CL), cleft palate (CP), and CLP and also estimate the unmet burden of these conditions.
  
  
  METHODS
  Four blocks comprising of half a million people in the Patan district of Gujarat were chosen as the study areas. This study was conducted over a period of 3 months in 2009. Patients with CL, CP, and CLP were identified by community health workers using snowball sampling method. Data collected included demographics, type of cleft, operated or not, and place of operation. Disability adjusted life years (DALY) was calculated to measure the unmet burden of this disease.
  
  
  RESULTS
  The most common among the three conditions was CL (69.4 %). Overall, cleft abnormalities were more common in males (61 %). The overall incidence and prevalence of cleft deformity was 0.73 per 1,000 live births and 0.1 per 1,000 people respectively. The unmet burden of surgical disease of these four blocks was 230 to 494 DALYs.
  
  
  CONCLUSIONS
  The incidence of CL with or without palate was found to be 0.7 per 1,000 live births. The large number of unoperated cases (backlog) of cleft deformities suggests a big burden of unmet need in rural India.
authors.affiliation: Seth G.S. Medical College and KEM Hospital, Mumbai, 400012, India, montykhajanchi@kem.edu.
authors.forename: Monty U
authors.initials: MU
authors.lastname: Khajanchi
authors.forename: Hemant
authors.initials: H
authors.lastname: Shah
authors.forename: Purvi
authors.initials: P
authors.lastname: Thakkar
authors.forename: Martin
authors.initials: M
authors.lastname: Gerdin
authors.forename: Nobhojit
authors.initials: N
authors.lastname: Roy
mesh_terms: D002648:Child; D002971:Cleft Lip / Q000453:epidemiology* / Q000601:surgery; D002972:Cleft Palate / Q000453:epidemiology* / Q000601:surgery; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D008297:Male; D020380:Needs Assessment; D015995:Prevalence; D019651:Plastic Surgery Procedures / Q000706:statistics & numerical data; D012107:Research Design; D012423:Rural Health / Q000706:statistics & numerical data