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Reasons for late presentation of cleft deformity in Nepal
Richard Schwarz1, Sanu Bhai Khadka
1Western Regional Hospital, Pokhara, Nepal. Rschwarz@inf.org.np
Objectives:
To determine the causes of late presentation of patients with cleft lip and palate in Nepal.
Design:
Cross-sectional survey using interviews of patients' parents.
Setting:
The study was carried out between April 1999 and September 1999 in Western Regional Hospital (WRH), Pokhara, Nepal, a secondary care center.
Patients:
All patients with cleft lip and palate coming to WRH outpatient department or coming for surgery were included in the study. Those without parents were excluded. A total of 53 patients were included.
Results:
Forty-two (79%) presented after 3 months. The most common reasons were lack of knowledge of availability of repair (31%), lack of accessibility of care (29%), and lack of finances (24%).
Conclusions:
In Nepal, the majority of patients with cleft present late, mainly because of a lack of awareness of cleft services, the remoteness of available services, or a lack of finances. These obstacles can be largely surmounted through itinerant services.
