A rural cleft project in Uganda

Hodges, Andrew; Hodges, Sarah

doi:10.1054/bjps.1999.3238

Cited by 34 publications

(26 citation statements)

References 2 publications

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“…However, in resource-poor countries, early synchronous lip and palatal closure can be a lifesaving procedure. Moreover, as mentioned in the literature [3,45] and as seen in this study, generally no anesthetic morbidity and mortality are present.…”

Section: Discussionsupporting

confidence: 81%

Impact of Early Synchronous Lip and Palatal Repair on Speech

Luyten

Bettens

D’haeseleer

et al. 2013

Folia Phoniatr Logop

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Aims: The purpose of this study was to describe articulation and resonance characteristics of Ugandan English-speaking children with cleft lip and palate (CLP) after synchronous lip and palatal closure (Sommerlad technique) prior to the age of 6 months in comparison with an age- and gender-matched control group. Methods: Eleven Ugandan patients with CLP (mean age 4;9 years), repaired during a synchronous lip and (soft and hard) palatal closure at a mean age of 3.4 months, were included as well as a control group (n = 22) consisting of 2 Ugandan age- and gender-matched noncleft children for each patient (mean age 4;10 years). Objective and perceptual speech assessment techniques were applied. Results: Consonant inventories were significantly smaller in the CLP group. Moreover, phonetic disorders and phonological processes occurred in 91 and 100% of the CLP group, respectively. Perceptual consensus evaluation revealed absence of hyponasality and cul-de-sac resonance in all patients. Hypernasality and nasal emission/turbulence occurred in 18 and 27% of the patients, respectively. No significant group differences were observed regarding the mean nasalance values of oral speech samples. Conclusion: Various deviations from normal speech development seem to occur in patients with CLP following synchronous lip and palatal closure before 6 months of age.

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Section: Discussionsupporting

confidence: 81%

Impact of Early Synchronous Lip and Palatal Repair on Speech

Luyten

Bettens

D’haeseleer

et al. 2013

Folia Phoniatr Logop

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“…These missions, also called safaris [39] or blitzes [40], frequently carry their own equipment with them [38, 41], often return to the same region in subsequent years [24, 42–44], and strive toward close partnership with local hospitals and ministries of health [45, 46]. …”

Section: Resultsmentioning

confidence: 99%

Charitable Platforms in Global Surgery: A Systematic Review of their Effectiveness, Cost‐Effectiveness, Sustainability, and Role Training

2014

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ObjectiveThis study was designed to propose a classification scheme for platforms of surgical delivery in low- and middle-income countries (LMICs) and to review the literature documenting their effectiveness, cost-effectiveness, sustainability, and role in training. Approximately 28 % of the global burden of disease is surgical. In LMICs, much of this burden is borne by a rapidly growing international charitable sector, in fragmented platforms ranging from short-term trips to specialized hospitals. Systematic reviews of these platforms, across regions and across disease conditions, have not been performed.MethodsA systematic review of MEDLINE and EMBASE databases was performed from 1960 to 2013. Inclusion and exclusion criteria were defined a priori. Bibliographies of retrieved studies were searched by hand. Of the 8,854 publications retrieved, 104 were included.ResultsSurgery by international charitable organizations is delivered under two, specialized hospitals and temporary platforms. Among the latter, short-term surgical missions were the most common and appeared beneficial when no other option was available. Compared to other platforms, however, worse results and a lack of cost-effectiveness curtailed their role. Self-contained temporary platforms that did not rely on local infrastructure showed promise, based on very few studies. Specialized hospitals provided effective treatment and appeared sustainable; cost-effectiveness evidence was limited.ConclusionsBecause the charitable sector delivers surgery in vastly divergent ways, systematic review of these platforms has been difficult. This paper provides a framework from which to study these platforms for surgery in LMICs. Given the available evidence, self-contained temporary platforms and specialized surgical centers appear to provide more effective and cost-effective care than short-term surgical mission trips, except when no other delivery platform exists.

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“…In 2006, Eipe et al 14 reported their experience with 20 patients who had cleft lip repair under infraorbital nerve block. Hodges and Hodges 15 reviewed 336 cleft lip repairs in Uganda in 2000. Those who became anxious were given a small dose of ketamine.…”

Section: Discussionmentioning

confidence: 99%