Characteristics of the treatment received by children with cleft lip and palate in Argentina

Abstract

Cleft lip and palate (CLP) are congenital abnormalities that affect anatomically and functionally the face and mouth, involving lip (CL), palate (CP), or both (CL/CP).

Objective: to characterize the treatment of children with CLP in public institutions in Argentina.

Patients and Method: Crosssectional study in a random sample of 100 children from the Flap Network. We included children with isolated CL, CP, and CL/CP, of both sexes, with birth weight of 2500 grams or more and gestational age over 36 weeks. The following data were recorded date of birth, hospital of birth, birth weight, gestational age, sex, specific diagnosis of the cleft, and initial surgery data. A telephone survey was conducted with the children’s parents. To characterize the treatment, three indicators were constructed: interdisciplinary, opportunity, and integrality. These indicators were composed of different variables, and according to the sum of the score attributed to each one, the treatment was categorized as high, medium or low based on the treatment guidelines used by the Sumar Program.

Results: 30% of the patients started early treatment, 58% underwent timely surgery, and 29% of the children were in follow-up with basic specialties. The mother’s high educational level was associated with higher probability of having interdisciplinary (OR2.9; 95%CI 1.3-6.8), comprehensive (OR3.7; 95%CI 1.6- 8.7), and timely treatment (OR2.9; 95%CI 1.3-6.7).

Conclusions: There are barriers to accessing care, such as long distances or shift management. Less social vulnerability of families was associated with greater likelihood of receiving treatment close to standards.