title: The burden of selected congenital anomalies amenable to surgery in low and middle-income regions: cleft lip and palate, congenital heart anomalies and neural tube defects.
abstract: OBJECTIVE
  To quantify the burden of selected congenital anomalies in low and middle-income countries (LMICs) that could be reduced should surgical programmes cover the entire population with access to quality care.
  
  
  METHODS
  Burden of disease and epidemiological modelling.
  
  
  METHODS
  LMICs from all global regions.
  
  
  METHODS
  All prevalent cases of selected congenital anomalies at birth in 2010.
  
  
  METHODS
  Disability-adjusted life years (DALYs).
  
  
  METHODS
  Surgical programmes for three congenital conditions were analysed: clefts (lip and palate); congenital heart anomalies; and neural tube defects. Data from the Global Burden of Disease 2010 Study were used to estimate the combination of fatal burden that could be addressed by surgical care and the additional long-term non-fatal burden associated with increased survival.
  
  
  RESULTS
  Of the estimated 21.6 million DALYs caused by these three conditions in LMICs, 12.4 million DALYs (57%) are potentially addressable by surgical care among the population born with such conditions. Neural tube defects have the largest potential with 76% of burden amenable by surgery, followed by clefts (59%) and congenital heart anomalies (49%). Sub-Saharan Africa and South Asia have the greatest proportion of surgically addressable burden for clefts (68%), North Africa and Middle East for congenital heart anomalies (73%), and South Asia for neural tube defects (81%).
  
  
  CONCLUSIONS
  There is an important and neglected role surgical programmes can play in reducing the burden of congenital anomalies in LMICs.
authors.affiliation: Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA School of Population Health, University of Queensland, Brisbane, Queensland, Australia.
authors.forename: Hideki
authors.initials: H
authors.lastname: Higashi
authors.affiliation: School of Population Health, University of Queensland, Brisbane, Queensland, Australia.
authors.forename: Jan J
authors.initials: JJ
authors.lastname: Barendregt
authors.affiliation: Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA Division of Anesthesiology & Pain Medicine, Seattle Children's Hospital, Seattle, Washington, USA.
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Kassebaum
authors.affiliation: Department of Surgery, School of Medicine, Stanford University, Stanford, California, USA.
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Weiser
authors.affiliation: Department of Surgery, School of Medicine, University of California, San Diego, California, USA.
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Bickler
authors.affiliation: Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA School of Population Health, University of Queensland, Brisbane, Queensland, Australia.
authors.forename: Theo
authors.initials: T
authors.lastname: Vos
mesh_terms: D002971:Cleft Lip / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery; D002972:Cleft Palate / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery; D017281:Cost of Illness; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D006330:Heart Defects, Congenital / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery; D006801:Humans; D009436:Neural Tube Defects / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery; D011203:Poverty; D015995:Prevalence; D019057:Quality-Adjusted Life Years
keywords: Congenital Abnorm; Epidemiology; Paediatric Surgery