The Bangladesh Clubfoot Project

Ford-Powell, V.; Barker, Simon; Khan, Shariful I.; Evans, Angela; Deitz, Fredrick R.

doi:10.1097/bpo.0b013e318279c61d

Cited by 28 publications

(29 citation statements)

References 8 publications

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“…As previously reported [1, 3, 17, 32], we found that children beginning treatment at a younger age, had better outcomes overall, and were less likely to require additional treatment following the standard Ponseti treatment course. Parents were understandably displeased with any further treatment requirements, and less functional outcomes for their children (as occurred in 14 cases reviewed after 4 years).…”

Section: Discussionsupporting

confidence: 87%

Walk for life ‐ the National Clubfoot Project of Bangladesh: the four‐year outcomes of 150 congenital clubfoot cases following Ponseti method

Evans

Chowdhury

Kabir

et al. 2016

Journal of Foot and Ankle Research

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BackgroundCongenital clubfoot deformity can cause significant disability, and if left untreated, may further impoverish those in developing countries, like Bangladesh. The Ponseti method has been strategically introduced in Bangladesh by a non-government organisation, Walk For Life (WFL). WFL has provided free treatment for over 17,500 Bangladeshi children with clubfeet since 2009, sustained by local ownership, and international support. This study assesses the 4-year results in children for whom treatment began before the age of 3 years.MethodsA centrally located WFL clinic at Mymensingh Medical College Hospital (MMCH), representative of the larger WFL clinics, which treats >100 cases annually, was reviewed. In 2015, 99 of the 147 eligible subjects who had begun treatment in 2011 were available for follow up. Specific assessment tools enabled evaluation of parent satisfaction, gait function, and relapse cases.ResultsResults for 99/147 cases were returned after four years: 72 males, 27 females. Typical clubfeet comprised 98/99 of cases, and 55/99 were bilateral. The tenotomy rate was 80 %. Brace use after 3 months was 90 %, at 12 months was 65 %, and at 4 years post treatment was 40 %. Functionally, 98/99 of children could walk and run (99 %). Relapsing deformity was found in 13 %. Relapse severity varied: eight were flexible and partial, five were rigid. Half of the children lost to follow were due to changed phone numbers. While parents were very happy with their child’s feet (97 %), a materials cost of 3000 Taka ($US40) was deemed unaffordable by 60 %.ConclusionsThe 4-year outcomes after Ponseti treatment for clubfoot deformity, showed that 99 % of children available for follow up, were walking independently. The relapse rate was low. Parent satisfaction was high, but those whose children required further treatment were less satisfied.

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Section: Discussionsupporting

confidence: 87%

Walk for life ‐ the National Clubfoot Project of Bangladesh: the four‐year outcomes of 150 congenital clubfoot cases following Ponseti method

Evans

Chowdhury

Kabir

et al. 2016

Journal of Foot and Ankle Research

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“…There are several examples of successful and sustainable implementations of clubfoot programs in low-and middle income programs [5,8,22]. This could be a great solution in Indonesia, because at present there is no national program giving access to clubfoot care for the whole population in need.…”

Section: Discussionmentioning

confidence: 99%

“…This correlation was found in Cape Town and Bali and Sumatra and confirms similar findings in Asia [18,20], Africa [15] and the Americas [14,21], where physical accessibility is described as a barrier for the Ponseti treatment as well. Specialized clubfoot clinics in rural areas are previously proven as a solution for overcoming this barrier [8,22].…”

Section: Discussionmentioning

confidence: 99%

Feasibility and barriers of treating clubfeet in four countries

Wijck

Oomen²,

Heide

2015

International Orthopaedics (SICOT)

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Purpose The purpose of this study was to elucidate why neglected clubfeet still exists despite the availability of a highly (cost)-effective treatment-the Ponseti treatment. Methods A qualitative and partly quantitative study with semi-structured interviews was conducted in four countries: the Netherlands, South Africa, Argentina and Indonesia with both caregivers, mostly parents, of children with clubfoot and practitioners treating clubfoot. The topics discussed with the caregivers (n=51) were the conceptions of the cause of clubfeet, received information, accessibility, financial aspects, and social stigma. With the practitioners (n=11) the focus of the interviews was the treatment protocol and finance. Results Several barriers towards the start of the treatment were highlighted. At all places treatment was financed by the government, insurance or charity. Nevertheless, the cost of transport and missed working days formed a barrier, although there is a large difference between and within countries. Poverty, long travel duration, and beliefs of supernatural causes for the clubfoot result in delay in the start of treatment. Conclusion These are problems we need to address when making effective treatment available for every child to diminish the burden of neglected clubfoot; especially accessible clinics in rural areas can be a good alternative to highly specialized hospitals in large cities. We as a community should try to find and overcome the barriers to treat these patients, because we have a relatively easy and highly costeffective treatment option which can be given by trained nonphysicians supervised by an interested medical doctor.

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“…Methods have been developed for extending the treatment to developing regions, which often have few surgical resources. The first 5000 feet treated as part of a Ponseti program in Bangladesh were recently reported 10 . Each site was required to keep details regarding clubfoot severity, procedures, results, and complications.…”

Section: Foot and Anklementioning

confidence: 99%