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The global birth prevalence of clubfoot: a systematic review and meta-analysis

Tracey Smythe1,2, Sara Rotenberg3, Chris Lavy4

  • 1International Centre for Evidence in Disability, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, WC1E 7HT, UK.

Eclinicalmedicine
|September 8, 2023
PubMed

Insights

Globally, approximately 176,476 children are born with clubfoot annually. This systematic review provides the first global birth prevalence estimate, highlighting disparities in low- and middle-income countries.

Area of Science:

  • Orthopedics
  • Public Health
  • Epidemiology

Background:

  • Clubfoot (congenital talipes equinovarus) is a common birth defect.
  • Estimates of clubfoot birth prevalence in low- and middle-income countries (LMICs) range from 0.5 to 2 per 1000 births.
  • A global estimate of clubfoot birth prevalence was previously lacking.

Purpose of the Study:

  • To conduct a systematic review to estimate the global birth prevalence of clubfoot.
  • To identify regional variations in clubfoot prevalence worldwide.
  • To inform public health strategies and resource allocation for clubfoot management.

Main Methods:

  • Systematic review of studies published between January 1st, 2012, and February 9th, 2023.
  • Searched multiple databases including EMBASE, CINAHL, Global Health, LILACS, and Medline.
  • Calculated pooled prevalence using inverse variance and random effects models; quality assessed using a modified Newcastle-Ottawa Scale.

Main Results:

  • Included 35 studies from 36 countries across five WHO regions, analyzing data from over 44 million births.
  • The global pooled prevalence of clubfoot was estimated at 1.18 per 1000 births (95% CI: 1.00-1.36).
  • Higher prevalence rates were found in LMICs, specifically the South-East Asia Region (1.80) and Africa Region (1.31); an estimated 176,476 children are born with clubfoot globally each year.

Conclusions:

  • This study provides the first comprehensive global estimate of clubfoot birth prevalence.
  • A significant burden of clubfoot exists globally, with higher rates in LMICs.
  • Findings emphasize the need for improved access to effective treatment and prevention strategies in resource-limited settings.
Abstract

Keywords:
Birth defectsBirth prevalenceClubfootCongenital anomaliesCongenital talipes equinovarusGlobalMeta-analysisSystematic review

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