{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T11:58:44Z","timestamp":1791547124450,"version":"4.3.4"},"reference-count":12,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T00:00:00Z","timestamp":1772668800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aims to assess the prevalence, patterns, and distribution of malnutrition among pediatric patients evaluated for cleft surgery in Madagascar.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>Design\/Setting: This Retrospective cross-sectional study assessed 658 patients who presented for cleft care between 2020 and 2023 during surgical programs of an International Cleft Surgical Non-Profit Organization in Madagascar.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention\/Outcome Measured<\/jats:title>\n                    <jats:p>\n                      Patient demographics and anthropometry of all patients were measured. The weight-for-length\n                      <jats:italic toggle=\"yes\">Z<\/jats:italic>\n                      score\/weight-for-height\n                      <jats:italic toggle=\"yes\">Z<\/jats:italic>\n                      score World Health Organization Growth Chart\n                      <jats:italic toggle=\"yes\">Z<\/jats:italic>\n                      scores, as well as mid-upper arm circumference for patients aged &gt; 6 months to 59 months, were measured and recorded. Patients were grouped based on gender and age.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 658 patients screened for surgery, 96% were malnourished (mild to severe malnutrition), and 83% of the screened patients had to be enrolled in the nutrition program (\n                      <jats:italic toggle=\"yes\">Z<\/jats:italic>\n                      scores \u2264 \u22122standard deviation) for nutritional optimization before surgery could be considered. At the time of this study, 239 patients had received surgery, while 309 were awaiting surgery. The majority had combined cleft lip and palate (59%), and over half of the mothers were unable to breastfeed their children at all due to the cleft condition(s) (53%). The highest prevalence (52.4%) and severity (68.1%) of malnutrition was observed among infants under 6 months old.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      The malnutrition status among patients with a cleft lip and\/or palate in Madagascar is high (96%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u2009.001). When children with cleft conditions who were malnourished (96%) were compared with the under-5 malnutrition status among non-cleft patients (47%) in Madagascar, it was a ratio of 2:1.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656261426268","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T18:17:41Z","timestamp":1773253061000},"page":"3768-3774","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence of Malnutrition in Children with Cleft Conditions in Madagascar: A Cross-Sectional Study"],"prefix":"10.1177","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5003-9427","authenticated-orcid":false,"given":"Daniel D.","family":"Otobo","sequence":"first","affiliation":[{"name":"Operation Smile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7160-2058","authenticated-orcid":false,"given":"Charlotte","family":"Steppling","sequence":"additional","affiliation":[{"name":"Operation Smile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Myles","sequence":"additional","affiliation":[{"name":"Operation Smile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8736-4902","authenticated-orcid":false,"given":"Natalie","family":"Torres","sequence":"additional","affiliation":[{"name":"Operation Smile"},{"name":"Princeton University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7658-369X","authenticated-orcid":false,"given":"Emily M.","family":"Jones","sequence":"additional","affiliation":[{"name":"Operation Smile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9946-3918","authenticated-orcid":false,"given":"Anthony","family":"Dwyer","sequence":"additional","affiliation":[{"name":"Operation Smile"},{"name":"Department of Surgery, University of Illinois, College of Medicine, Chicago, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2984-164X","authenticated-orcid":false,"given":"Caroline","family":"Yao","sequence":"additional","affiliation":[{"name":"Operation Smile"},{"name":"Princeton University"},{"name":"Department of Plastic Surgery, Shriners Hospital for Children, Pasadena, CA, USA"},{"name":"Division of Plastic Surgery, University of Southern California Keck School of Medicine, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,3,5]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"Malnutrition\u2014World Health Organization. https:\/\/www.who.int\/health-topics\/malnutrition"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000009591"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.79092"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.4314\/ahs.v18i4.31"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.7189\/jogh.12.04012"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000002743"},{"key":"e_1_3_3_8_2","unstructured":"UNICEF Demographic data on Madagascar. Madagascar (MDG) - Demographics Health & Infant Mortality - UNICEF DATA."},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1080\/16549716.2018.1452357"},{"key":"e_1_3_3_10_2","unstructured":"USAID Madagascar Profile 2017-2020. https:\/\/2017-2020.usaid.gov\/sites\/default\/files\/documents\/1864\/Madagascar-Nutrition-Profile-Mar2018-508.pdf"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.33137"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_3_3_13_2","volume-title":"Identification of severe acute malnutrition in infants under 6 months of age. e-Library of Evidence for Nutrition Actions (eLENA)","author":"World Health Organization","year":"2023","unstructured":"World Health Organization. Identification of severe acute malnutrition in infants under 6 months of age. e-Library of Evidence for Nutrition Actions (eLENA). Geneva: WHO; 2023. https:\/\/www.who.int\/tools\/elena\/interventions\/sam-identification-infants"}],"container-title":["The Cleft Palate Craniofacial Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10556656261426268","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10556656261426268","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10556656261426268","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T11:48:11Z","timestamp":1791546491000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10556656261426268"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,5]]},"references-count":12,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["10.1177\/10556656261426268"],"URL":"https:\/\/doi.org\/10.1177\/10556656261426268","relation":{},"ISSN":["1055-6656","1545-1569"],"issn-type":[{"value":"1055-6656","type":"print"},{"value":"1545-1569","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,5]]}}}