Prevalence and characteristics of congenital talipes equinovarus (clubfoot) in Northern Ghana: a two year retrospective descriptive study
Objective: This study aimed to determine the prevalence and phenotypic characteristics of clubfoot in the Northern Region, one of the most deprived regions of Ghana.
Method: Parameters of interest included sex distribution, laterality, types of clubfoot, annual trends and prevalence rate. Data was collected in the sole clubfoot clinic for the region from January 2015 to December 2016. A descriptive statistical analysis of the data was conducted using SPSS version 16.
Result: A total of 112 cases were recorded, resulting in a prevalence rate of 0.9 per 1000 live births. The highest number of cases for both years was recorded in January. Twice the number of males were affected as females and bilateral clubfoot formed 65.5% of case presentations while idiopathic clubfoot made up 67.9% of total clubfoot types. Almost same numbers of left (n=19) feet were affected as right (n=20) in unilateral clubfoot.
Conclusions: The phenotypic characteristics were similar to findings in other parts of Ghana, Africa and the world although the prevalence rate was lower than expected. Future investigations into associated risk factors and the influencers of the phenotypic and annual trends are therefore warranted.
- Malagelada F, Mayet S, Firth G, Ramachandran M. The impact of the Ponseti treatment method on parents and caregivers of children with clubfoot: a comparison of two urban populations in Europe and Africa. J Child Orthop. 2016;10(2):101-7.
- Smythe T, Kuper H, Macleod D, Foster A, Lavy C. Birth prevalence of Congenital Talipes Equinovarus in Low and Middle Income Countries: A Systematic Review and Meta‐analysis. Trop Med Int Health. 2016; doi:10.1111/tmi.12833.
- Werler MM, Yazdy MM, Mitchell AA, Meyer RE, Druschel CM, Anderka M, et al. Descriptive epidemiology of idiopathic clubfoot. Am J Med Genet A. 2013; doi:10.1002/ajmg.a.35955.
- Nguyen MC, Nhi HM, Nam VQD, Van Thanh D, Romitti P, Morcuende JA. Descriptive epidemiology of clubfoot in Vietnam: a clinic-based study. Iowa Orthop J. 2012;32:120.
- Palma M, Cook T, Segura J, Pecho A, Morcuende JA. Descriptive epidemiology of clubfoot in Peru: a clinic-based study. Iowa Orthop J. 2013;33:167.
- Cure Clubfoot Worldwide. The Ponseti method for treating congenital clubfot in infants: a manual for medical and parmedical professionals working to eradicate neglected clubfoot in the developing world. In: Cure Clubfoot Worldwide, St John of God Hospital, editor. 2014.
- Parker SE, Mai CT, Strickland MJ, Olney RS, Rickard R, Marengo L, et al. Multistate study of the epidemiology of clubfoot. Birth Defects Res A Clin Mol Teratol. 2009;85(11):897-904.
- Childers-Buschle K WR, Owen R. Global Clubfoot report, 2013. Global clubfoot initiative; 2013. http://globalclubfoot.com/wp-content/uploads/downloads/2015/07/Global-data-report-2013-WEBSITE-DOWNLOAD.pdf. Accessed 7th November 2017.
- Ghana Statistical Service. Ghana poverty mapping report. In: Service GS, editor. Accra: Ghana Statistical Service; 2015. http://www.statsghana.gov.gh/docfiles/publications/POVERTY%20MAP%20FOR%20GHANA-05102015.pdf. Accessed 8th November 2017.
- Adegbehingbe O, Oginni L, Ogundele O, Ariyibi A, Abiola P, Ojo O. Ponseti clubfoot management: changing surgical trends in Nigeria. Iowa Orthop J. 2010;30:7.
- Adegbehingbe OO, Adetiloye AJ, Adewole L, Ajodo DU, Bello N, Esan O, et al. Ponseti method treatment of neglected idiopathic clubfoot: Preliminary results of a multi-center study in Nigeria. World J Orthop. 2017; doi:10.5312/wjo.v8.i8.624.
- Ayana B, Klungsøyr PJ. Good results after Ponseti treatment for neglected congenital clubfoot in Ethiopia: A prospective study of 22 children (32 feet) from 2 to 10 years of age. Acta Orthop. 2014; doi:10.3109/17453674.2014.957085 .
- Boakye H, Afiriyie N, Abebrese T, Ajediran I, editors. Treatment outcome of Ponseti method in the management of clubfoot at Komfo Anokye Teaching Hospital, Ghana: A retrospective study. ACRI. 2016; doi:10.9734/ACRI/2016/23832
- Abebrese T. Occurrences of Idiopathic Congenital Talipes Equinovarus at the Komfo Anokye Teaching Hospital. 2016. http://imsear.hellis.org/handle/123456789/183405. Accessed 7th November 2017.
- Alderman BW, Takahashi ER, LeMier MK. Risk indicators for talipes equinovarus in Washington State, 1987-1989. Epidemiology. 1991:289-92.
- Dickinson KC, Meyer RE, Kotch J. Maternal smoking and the risk for clubfoot in infants. Birth Defects Res A Clin Mol Teratol. 2008; doi:10.1002/bdra.20417.
- Moorthi RN, Hashmi SS, Langois P, Canfield M, Waller DK, Hecht JT. Idiopathic talipes equinovarus (ITEV)(clubfeet) in Texas. Am J Med Genet A. 2005; doi: 10.1002/ajmg.a.30505.
- Pirani S, Naddumba E, Mathias R, Konde-Lule J, Penny JN, Beyeza T, et al. Towards effective Ponseti clubfoot care: the Uganda sustainable clubfoot care project. Clin Orthop Relat Res. 2009. https://link.springer.com/article/10.1007%2Fs11999-009-0759-0?LI=true.
- Accessed 6th November 2017.
- Ukoha U, Egwu O, Okafor I, Ogugua P, Udemezue O, Olisah R, et al. Incidence of congenital talipes equinovarus among children in southeast Nigeria. Int J Biol Med Res. 2011;2(3):712-5.
- Mkandawire N, Kaunda E. Incidence and patterns of congenital talipes equinovarus (clubfoot) deformity at Queen Elizabeth Central Hospital, Banter, Malawi. East Cent Afr J Surg. 2004;9(2):28-31.
- Biruk W. Management of Club-Foot at Tikur Anbessa Hospital; Addis Ababa, Ethiopia. East Cent Afr J Surg. 2007;12(1):24-9.
- Rademacher-Schulz C, Schraven B, Mahama ES. Time matters: shifting seasonal migration in Northern Ghana in response to rainfall variability and food insecurity. Clim Dev. 2014;6(1):46-52.
- Bacino CA, Hecht JT. Etiopathogenesis of equinovarus foot malformations. Eur J Med Genet. 2014; https://doi.org/10.1016/j.ejmg.2014.06.001.
- Zionts LE, Jew MH, Ebramzadeh E, Sangiorgio SN. The influence of sex and laterality on clubfoot severity. J Pediatr Orthop. 2017; doi: 10.1097/BPO.0000000000000603.
- Lavy C, Mannion S, Mkandawire N, Tindall A, Steinlechner C, Chimangeni S, et al. Club foot treatment in Malawi–a public health approach. Disabil Rehabil. 2007; https://doi.org/10.1080/09638280701240169
- Lisi A, Botto LD, Rittler M, Castilla E, Bianchi F, Botting B, et al. Sex and congenital malformations: an international perspective. Am J Med Genet A. 2005; doi: 10.1002/ajmg.a.30514.
- Navara KJ. Programming of offspring sex ratios by maternal stress in humans: assessment of physiological mechanisms using a comparative approach. J Comp Physiol [B]. 2010;180(6):785-96.
- Kruse LM, Dobbs MB, Gurnett CA. Polygenic threshold model with sex dimorphism in clubfoot inheritance: the Carter effect. J Bone Joint Surg Am. 2008;90(12):2688.