title: Age of individuals undergoing cleft lip and cleft palate surgeries in Nepal.
abstract: BACKGROUND
  Timely repair of cleft lip and palate maximises the benefits of surgery. Developing countries have large number of adults with unrepaired clefts. The impact of a cleft program can be determined by observing the trends of lower age at surgery. Public Health Concern Trust, Nepal has been providing a comprehensive nationwide cleft service since 1999. This study was conducted to see any change in the age at surgery.
  
  
  METHODS
  A retrospective cross sectional study was conducted to analyse the data of all the individuals' age at primary cleft surgery from July 1999 to June 2010. Mean and median age of individuals as well as the proportion of individuals operated on at the right age in different years were calculated and compared.
  
  
  RESULTS
  The median age for cleft lip surgery decreased from 100 to 24 months. Similarly the median age for cleft palate surgery decreased from 70 to 28 months. Proportion of surgeries carried out in the recommended age also increased. A change in the policy of the program reaching out to more remote areas and removing the age barrier for surgery resulted in older adults receiving surgery and increased median age especially for cleft palate repairs.
  
  
  CONCLUSIONS
  A nationwide cleft program for a decade had a small impact on age at surgery. There are still many individuals who are missing the ideal age for surgery. The program needs to reach more remote areas. This information will be useful for governmental as well as non-governmental organizations working in the area of clefts.
authors.affiliation: Department of Burns, Plastic and Reconstructive Surgery, Kathmandu Model Hospital, Exhibition Road, Kathmandu, Nepal.
authors.forename: Shankar Man
authors.initials: SM
authors.lastname: Rai
authors.affiliation: Department of Burns, Plastic and Reconstructive Surgery, Kathmandu Model Hospital, Exhibition Road, Kathmandu, Nepal.
authors.forename: Kiran
authors.initials: K
authors.lastname: Nakarmi
authors.affiliation: Department of Burns, Plastic and Reconstructive Surgery, Kathmandu Model Hospital, Exhibition Road, Kathmandu, Nepal.
authors.forename: Surendra
authors.initials: S
authors.lastname: Basnet
authors.affiliation: Department of Burns, Plastic and Reconstructive Surgery, Kathmandu Model Hospital, Exhibition Road, Kathmandu, Nepal.
authors.forename: Pramila
authors.initials: P
authors.lastname: Shakya
authors.affiliation: Department of Burns, Plastic and Reconstructive Surgery, Kathmandu Model Hospital, Exhibition Road, Kathmandu, Nepal.
authors.forename: Krishna
authors.initials: K
authors.lastname: Nagarkoti
authors.affiliation: Department of Burns, Plastic and Reconstructive Surgery, Kathmandu Model Hospital, Exhibition Road, Kathmandu, Nepal.
authors.forename: Mangal
authors.initials: M
authors.lastname: Ghartimagar
authors.affiliation: Department of Burns, Plastic and Reconstructive Surgery, Kathmandu Model Hospital, Exhibition Road, Kathmandu, Nepal.
authors.forename: Bishal
authors.initials: B
authors.lastname: Karki
authors.affiliation: Department of Burns, Plastic and Reconstructive Surgery, Kathmandu Model Hospital, Exhibition Road, Kathmandu, Nepal.
authors.forename: Suzita
authors.initials: S
authors.lastname: Hirachan
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002648:Child; D002675:Child, Preschool; D002971:Cleft Lip / Q000453:epidemiology / Q000601:surgery*; D002972:Cleft Palate / Q000453:epidemiology / Q000601:surgery*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008493:Medical Missions; D008875:Middle Aged; D009390:Nepal / Q000453:epidemiology; D055815:Young Adult