To estimate the number of new cases of cleft lip and cleft palate in the department (state) of Alta Verapaz, Guatemala, in 2012.
Design
Cross-sectional survey of midwives from communities identified through a two-stage cluster-sampling process. Midwives were asked how many babies they had delivered in the past year and how many of those newborns had various types of birth defects, as illustrated in pictures.
Setting
Indigenous Mayan communities in rural north-central Guatemala.
Participants
Midwives (n = 129) who had delivered babies in the previous year.
Main Outcome Measure
Reports of babies born with cleft lip and cleft palate.
Results
A 1-year prevalence rate of 18.9 per 10,000 for cleft lip and 4.7 per 10,000 for cleft palate was estimated for Alta Verapaz. None of the cases of cleft lip also had cleft palate.
Conclusion
The indigenous communities in north-central Guatemala might have a relatively high cleft lip prevalence rate compared with the global average.
CampañaH., PawlukM.S., López CameloJS, Grupo de Estudio delECLAMC. Prevalencia al nacimiento de 27 anomalías congénitas seleccionadas, en 7 regiones geográficas de la Argentina.Arch Argent Pediatr.2010; 108: 409–417.
2.
ClopperC.J., PearsonE.S.The use of confidence or fiducial limits illustrated in the case of the binomial.Biometrika.1934; 26: 404–413.
HuntO., BurdenD., HepperP., JohnstonC.The psychosocial effects of cleft lip and palate: a systematic review.Eur J Orthod.2005; 27: 274–285.
5.
Instituto Nacional de Estadístico (INE).Censo de población y habitación: 2002.Guatemala City: INE;2002.
6.
Instituto Nacional de Estadístico (INE).Pobreza y desarrollo: Un enfoque departamental. Encuesta nacional de condiciones de vida: 2011.Guatemala City: INE;2011.
7.
International Perinatal Database of Typical Oral Clefts (IPDTOC) Working Group.Prevalence at birth of cleft lip with or without cleft palate: Data from the International Perinatal Database of Typical Oral Clefts (IPDTOC).Cleft Palate Craniofac J.2011; 48: 66–81.
8.
JacobsenK.H., BankoskiA.J.Predictors of compliance with scheduled surgery in rural Guatemala.Int Health.2010; 2: 206–211.
9.
JohnA., SellD., SweeneyT., Harding-BellA., WilliamsA.The cleft audit protocol for speech–augmented: a validated and reliable measure for auditing cleft speech.Cleft Palate Craniofac J.2006; 43: 272–288.
10.
MarasasW.F., RileyR.T., HendricksK.A., StevensV.L., SadlerT.W., Gelineau-van WaesJ., MissmerS.A., CabreraJ., TorresO., GelderblomW.C.. Fumonisins disrupt sphingolipid metabolism, folate transport, and neural tube development in embryo culture and in vivo: a potential risk factor for human neural tube defects among populations consuming fumonisin-contaminated maize.J Nutr.2004; 134: 711–716.
11.
McLeodN.M., UrisoteM.L.A., SaeedN.R.Birth prevalence of cleft lip and palate in Sucre, Bolivia.Cleft Palate Craniofac J.2004; 41: 195–198.
12.
Ministerio de Salud Pública y Asistencia Social (MSPAS). Nacimientos por año de ocurrencia, según departamento de residencia de la madre, período 2003–2012.Guatemala City: Gobierno de Guatemala; 2013.
13.
NazerJ., HubnerM.E., CatalánJ., CifuentesL.Incidencia de labio leporino y paladar hendido en la Maternidad del Hospital Clínico de la Universidad de Chile y en las maternidades chilenas participantes en el Estudio Colaborativo Latino Americano de Malformaciones Congénitas (ECLAMC) período 1991–1999.Rev Med Chil.2001; 129: 285–293.
14.
OwenK.K., ObregónE.J., JacobsenK.H.A geographic analysis of access to health services in rural Guatemala.Int Health.2010; 2: 143–149.
15.
Pan American Health Organization (PAHO).Salud en las Americas 2007. Volume II-Países.Washington, DC: PAHO;2007: 392–411.
16.
ParkerS.E., MaiC.T., CanfieldM.A., RickardR., WangY., MeyerR.E., AndersonP., MasonC.A., CollinsJ.S., KirbyR.S.. Updated national birth prevalence estimates for selected birth defects in the United States, 2004–2006.Birth Defects Res A Clin Mol Teratol.2010; 88: 1008–1016.
17.
Secretaría de Planificación y Programación de la Presidencia (SEGEPLAN).Infraestructura de Datos Espaciales de Guatemala (IDEG), 2009. Available at http://ide.segeplan.gob.gt. Accessed November 10, 2013.
18.
StevensV.L., TangJ.Fumonisin B1-induced sphingolipid depletion inhibits vitamin uptake via the glycosylphosphatidylinositol-anchored folate receptor.J Biol Chem.1997; 272: 18020–18025.
19.
TanakaS.A., MahabirR.C., JupiterD.C., MenezesJ.M.Updating the epidemiology of cleft lip with or without cleft palate.Plast Reconstr Surg.2012; 129: 511e–518e.
20.
TorresO.A., PalenciaE., Lopez de PratdesabaL., GrajedaR., FuentesM., SpeerM.C., MerrillAHJr., O'DonnellK., BaconC.W., GlennA.E., RileyR.T.Estimated fumonisin exposure in Guatemala is greatest in consumers of lowland maize.J Nutr.2007; 137: 2723–2729.
21.
United Nations Development Programme (UNDP).Diversidad étnico-cultural y desarrollo humano: la ciudadanía en un Estado plural. Informe nacional de desarrollo humano: Guatemala.Guatemala City: UNDP;2005. Report No. P964.
22.
VanderasA.P.Incidence of cleft lip, cleft palate, and cleft lip and palate among races: a review.Cleft Palate J.1987; 24: 216–225.
23.
VieiraA.R., KarrasJ.C., OrioliI.M., CastillaE.E., MurrayJ.C.Genetic origins in a South American clefting population.Clin Genet.2002; 62: 458–463.
24.
WehbyG.L., MurrayJ.C.Folic acid and orofacial clefts: a review of the evidence.Oral Dis.2010; 16: 11–19.
