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Trop Med Int Health. 2017 Mar;22(3):269-285. doi: 10.1111/tmi.12833. Epub 2017 Jan 22.

Birth prevalence of congenital talipes equinovarus in low- and middle-income countries: a systematic review and meta-analysis.

Author information

1
International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK.
2
London School of Hygiene & Tropical Medicine, London, UK.
3
Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Science, University of Oxford, Oxford, UK.

Abstract

OBJECTIVE:

Congenital talipes equinovarus (CTEV), or clubfoot, is a structural malformation that develops early in gestation. Birth prevalence of clubfoot is reported to vary both between and within low- and middle-income countries (LMICs), and this information is needed to plan treatment services. This systematic review aimed to understand the birth prevalence of clubfoot in LMIC settings.

METHODS:

Six databases were searched for studies that reported birth prevalence of clubfoot in LMICs. Results were screened and assessed for eligibility using pre-defined criteria. Data on birth prevalence were extracted and weighted pooled estimates were calculated for different regions. Wilcoxon rank-sum test was used to examine changes in birth prevalence over time. Included studies were appraised for their methodological quality, and a narrative synthesis of findings was conducted.

RESULTS:

Forty-eight studies provided data from 13 962 989 children in 20 countries over 55 years (1960-2015). The pooled estimate for clubfoot birth prevalence in LMICs within the Africa region is 1.11 (0.96, 1.26); in the Americas 1.74 (1.69, 1.80); in South-East Asia (excluding India) 1.21 (0.73, 1.68); in India 1.19 (0.96, 1.42); in Turkey (Europe region) 2.03 (1.54, 2.53); in Eastern Mediterranean region 1.19 (0.98, 1.40); in West Pacific (excluding China) 0.94 (0.64, 1.24); and in China 0.51 (0.50, 0.53).

CONCLUSION:

Birth prevalence of clubfoot varies between 0.51 and 2.03/1000 live births in LMICs. A standardised approach to the study of the epidemiology of clubfoot is required to better understand the variations of clubfoot birth prevalence and identify possible risk factors.

KEYWORDS:

birth prevalence; clubfoot; congenital talipes equinovarus; developing country; incidence; low income

PMID:
28000394
DOI:
10.1111/tmi.12833
[Indexed for MEDLINE]
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