Our findings add to a growing body of knowledge of environmental risk factors for oral clefts from low- and middle-income countries. Our findings on liver are contradictory to prior results. Large multisite studies are needed to identify environmental and genetic risk factors for oral clefts. Birth Defects Research (Part A) 106:624-632, 2016. © 2016 Wiley Periodicals, Inc.
Introduction: The objectives of this study were to obtain the birth prevalence of cleft lips and/or cleft palates (CL±P) and to identify potential associated risk factors in the population of the Northeast (NE) region of Thailand. Methods: The data were collected from October 1, 2012, to September 30, 2013, for infant deliveries with nonsyndromic CL±P in all hospitals of 4 provinces in the region. Workshops were conducted to establish diagnostic criteria, treatment guidelines, referral systems, data collection, and data reporting. All patients included in this study, including a case (the child born with cleft lip and palate [CLP]) and 2 control cases (2 following children born without CLP in the same hospital), completed a questionnaire regarding demographics, cleft characteristics, and factors of interest such as alcohol intake, smoking, vitamin use, and medication. Unadjusted and adjusted odds ratio were presented for the magnitude of associations between proposed risk factors and CL±P along with 95% CIs. Results: The overall birth prevalence of CL±P was 1.93 per 1000 live births. There was a significant difference in percentages of infants with low birth weights ( P = .03), family history of CL±P ( P = .01) in cases than controls. Mothers who took self-medication or a menstrual regulation supplement were more likely to have the child with CL±P ( P = .01 adjusted). Conclusions: The prevalence of CL±P in the NE Thailand was high. Low infant birth weight, family history of CL±P, and the use of self-medication or menstrual regulation herbal supplement was significant factors.
The Northeast region has the highest rate of cleft lip-palate (CLP) deformities in Thailand. This born handicapped condition leads to complicated problems in many ways. The best treatment is managing the system to have good coordination by an interdisciplinary team that rehabilitate patients' physical and mental conditions so they can recover as well as possible. This study aimed to determine the (1) knowledge of taking care of patients and (2) service satisfaction of caregivers resulting from the development of Tawanchai Cleft Center's nursing care system as a 1-stop coordinating service in 2010. The study included 106 caregivers. We used a questionnaire to assess the knowledge level and the service satisfaction. Most of the patients had left unilateral complete cleft lip and palate (41%). The mother was the caregiver most of them time (68%); 43% had completed primary education, and 40% worked in agriculture. The average knowledge level among caregivers for the specialized care of patients with CLP was a good level ((Equation is included in full-text article.)= 3.71, SD = 0.81). The average knowledge level concerning the cause, the treatment guideline, and treatment by a multidisciplinary team of patients with CLP was a moderate level ((Equation is included in full-text article.)= 3.28, SD = 0.85). The satisfaction of caregivers regarding service at the In- and Out-patient Surgery Department was very good for all items ((Equation is included in full-text article.)= 3.54, SD = 0.54). The one-stop coordination service developed for caregivers neatly fit the needs of CLP patients and resulted in a moderate to good level of knowledge and a very good level of satisfaction regarding the specialized care needed.
Background: Cleft Lip and Palate (CLP) negatively affect the quality of life (QoL) and nasolabial appearance, especially in preteen patients who start to be interested in their own appearance and society. Objective: The objective of this study is to evaluate the cost-effectiveness of plastic surgery for Thai preteen CLP patients through their satisfaction with their QoL and nasolabial appearance. Methods: A cross-sectional study covered purposively selected 30 samples aged between 8 and 12 years old.Their satisfaction with their QoL and appearance was reflected through an interview and a questionnaire with the cooperation of their parents as their caregivers including satisfaction with their nasolabial appearance evaluated by five experts. They compared the photos of patients’nasolabial appearance with those of normal faces of children of the same age using 5-rating scales. Results: General findings showed 53.3% of samples were male patients with mostly (63.3%) UCLP whose parents were mainly (73.3%) poor, so they relied on government financial supports for the treatment. Only some (15%) earned up to 5,001 to 10,000 baht per month because of their low education with just high school level. Specific findings indicated the overall satisfaction with QoL through five dimensions at average level (3.26±1.39). This was based on the satisfaction with the center services, the overall treatments, the medical additional costs, parental satisfaction with psychosocial effects including concerns about the impacts of CLP on the family ranged from high to low i.e. 4.30±0.98, 3.72±1.15, 3.70±1.14, 3.33±1.08 and 2.81±1.46 respectively. Moreover, five experts trended to be highly satisfied with patients’ nasolabial appearance by rating it from Good (53.3%) to Fair (43.43%) with only Poor (3.3%). Conclusion: The good cost-effectiveness of the surgery was represented through the average and high satisfaction of CLP patients with their QoL and their appearance respectively indicating the absence of disability weights for these treated CLP patients.
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