{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T04:15:44Z","timestamp":1787890544221,"version":"build-2784847793"},"reference-count":36,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2014,5,27]],"date-time":"2014-05-27T00:00:00Z","timestamp":1401148800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>To evaluate the prevalence and unmet need for cleft lip\u2013cleft palate reconstructive surgery by using incidence. Our hypotheses were that the age of presentation to screening clinics will decrease between 2006 and 2012, and the geospatial distribution of cases will expand to a more rural catchment area.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Longitudinal cross\u2010sectional\/geospatial distribution study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An online, secure database was created from intake forms for children with cleft lip\u2013cleft palate (N\u2009=\u2009604) in Zimbabwe (2006\u20132012). Univariate analysis was completed. A linear regression model was fitted to test the time trend of a child's age at the time of presentation. Unique patient addresses (n\u2009=\u2009411) were matched. Maps presenting cleft diagnosis and presentation year were created with geographic information systems (GIS) software.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median age of presentation was greater for isolated cleft palate (4.2 years, n\u2009=\u2009106) than isolated cleft lip (1.5 years, n\u2009=\u2009251) and cleft lip\u2013cleft palate (2.0 years, n\u2009=\u2009175). Cleft lip cases were mostly left sided with equal gender distribution. The overall age of presentation remained stable (<jats:italic>P<\/jats:italic>\u2009=\u2009.83). The age of children with isolated cleft palate decreased by 0.8 years per surgical trip (<jats:italic>P<\/jats:italic>\u2009=\u2009.01), suggesting the prevalence of unrepaired cleft palate is decreasing due to local and visiting surgeons. The catchment area extended to a less populous area, but clustered around Harare and Bulawayo.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study gives Zimbabwe\u2010specific evidence that supports reports of the persistent burden of disease requiring attention. The GIS software provided data for the primary needs assessment, which will direct communication to healthcare providers and prospective patients outside of the current catchment area.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>3 <jats:italic>Laryngoscope<\/jats:italic>, 125:S1\u2013S14, 2015<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.24747","type":"journal-article","created":{"date-parts":[[2014,5,27]],"date-time":"2014-05-27T17:55:38Z","timestamp":1401213338000},"source":"Crossref","is-referenced-by-count":20,"title":["Cleft lip\u2013cleft palate in Zimbabwe: Estimating the distribution of the surgical burden of disease using geographic information systems"],"prefix":"10.1002","volume":"125","author":[{"given":"Travis T.","family":"Tollefson","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California Davis, Sacramento California U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Shaye","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Minnesota Minneapolis Minnesota U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blythe","family":"Durbin\u2010Johnson","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of California Davis, Sacramento California U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omid","family":"Mehdezadeh","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery New York University\u2013Langone Medical School New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonard","family":"Mahomva","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery University of Zimbabwe College of Health Sciences Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Midion","family":"Chidzonga","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery New York University\u2013Langone Medical School New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,5,27]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-008-9525-9"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.11.088229"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2013.02.020"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsurg.2010.03.002"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-8-121"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e31818a43af"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)60924-1"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-009-0261-6"},{"key":"e_1_2_7_10_1","first-page":"12","article-title":"Surgery in developing countries. Should surgery have a role in population\u2010based health care?","volume":"92","author":"Duda RB","year":"2007","journal-title":"Bull Am Coll Surg"},{"key":"e_1_2_7_11_1","first-page":"495","article-title":"The global burden of disease in 1990: summary results, sensitivity analysis and future directions","volume":"72","author":"Murray CJ","year":"1994","journal-title":"Bull World Health Organ"},{"key":"e_1_2_7_12_1","first-page":"1245","volume-title":"Disease Control Priorities in Developing Countries","author":"Debas HT","year":"2006"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61690-0"},{"key":"e_1_2_7_14_1","unstructured":"World Health Organization Global Health Atlas 2003. Available at:http:\/\/apps.who.int\/globalatlas\/. Accessed November 9 2009."},{"key":"e_1_2_7_15_1","unstructured":"Zimbabwe inflation rockets higher. BBC website. Available at:http:\/\/news.bbc.co.uk\/go\/pr\/fr\/\u2010\/2\/hi\/business\/7569894.stm. Accessed August 11 2009."},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.20508"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-8628(19980113)75:2<126::AID-AJMG2>3.0.CO;2-R"},{"key":"e_1_2_7_18_1","first-page":"216","article-title":"Incidence of cleft lip, cleft palate among races: a review","volume":"24","author":"Vanderas AP","year":"1987","journal-title":"Cleft Palate J"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1597\/1545-1569(1996)033<0406:GONOCR>2.3.CO;2"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.4314\/cajm.v46i11.8572"},{"key":"e_1_2_7_21_1","unstructured":"Africa: Zimbabwe. The World Factbook. US Central Intelligence Agency website. Available at:https:\/\/www.cia.gov\/library\/publications\/the\u2010world\u2010factbook\/geos\/zi.html. Accessed July 28 2010."},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1597\/11-087"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-011-1055-1"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-009-0198-9"},{"key":"e_1_2_7_25_1","first-page":"15","article-title":"Africa has unique and urgent barriers to cleft care: lessons from practitioners at the Pan\u2010African Congress on cleft lip and palate","volume":"12","author":"Adetayo O","year":"2012","journal-title":"Pan Afr Med J"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6831-11-5"},{"key":"e_1_2_7_27_1","unstructured":"Statistics. ICT Facts and Figures 2013. International Telecommunication Union website. Available at:http:\/\/www.itu.int\/en\/ITU\u2010D\/Statistics\/Pages\/stat\/default.aspx. Accessed June 6 2013."},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e318254b2a2"},{"key":"e_1_2_7_29_1","first-page":"892437","article-title":"An opportunity for diagonal development in global surgery: cleft lip and palate care in resource\u2010limited settings","volume":"2012","author":"Patel P","year":"2012","journal-title":"Plast Surg Int"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000200"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-008-9799-y"},{"key":"e_1_2_7_32_1","first-page":"221","volume-title":"Health Systems Performance Assessment","author":"Shengelia B","year":"2003"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e31827a294a"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-009-0256-3"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e318254b2fd"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.158"},{"key":"e_1_2_7_37_1","unstructured":"CampbellCA RestrepoC ShermanR MageeWP. Comprehensive cleft care in the developing world: a reproducible model for excellence and sustainability. Presented at: 12th International Congress on Cleft Lip\/Palate and Related Craniofacial Anomalies; May 5\u201310 2013; Lake Buena Vista FL. Abstract 1153."}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flary.24747","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.24747","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T17:08:09Z","timestamp":1696007289000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.24747"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,5,27]]},"references-count":36,"journal-issue":{"issue":"S1","published-print":{"date-parts":[[2015,2]]}},"alternative-id":["10.1002\/lary.24747"],"URL":"https:\/\/doi.org\/10.1002\/lary.24747","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,5,27]]}}}