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      Prevalence and associated factors of clubfoot in the eastern province of Saudi Arabia: A hospital-based study

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          Abstract

          BACKGROUND

          Clubfoot, or congenital talipes equinovarus, is a widely recognized cause of disability and congenital deformity worldwide, which significantly impacts the quality of life. Effective management of clubfoot requires long-term, multidisciplinary intervention. It is important to understand how common this condition is in order to assess its impact on the population. Unfortunately, few studies have investigated the prevalence of clubfoot in Saudi Arabia.

          AIM

          To determine the prevalence of clubfoot in Saudi Arabia via the patient population at King Fahad University Hospital (KFUH).

          METHODS

          This was a retrospective study conducted at one of the largest hospitals in the country and located in one of the most densely populated of the administrative regions.

          RESULTS

          Of the 7792 births between 2015 to 2023 that were included in the analysis, 42 patients were diagnosed with clubfoot, resulting in a prevalence of 5.3 per 1000 live births at KFUH.

          CONCLUSION

          The observed prevalence of clubfoot was significantly higher than both global and local estimates, indicating a substantial burden in the study population.

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          Most cited references27

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          The etiology of idiopathic congenital talipes equinovarus: a systematic review

          Vito Pavone, Emanuele Chisari, Andrea Vescio … (2018)
          Background Also known as clubfoot, idiopathic congenital talipes equinovarus (ICTEV) is the most common pediatric deformity and occurs in 1 in every 1000 live births. Even though it has been widely researched, the etiology of ICTEV remains poorly understood and is often described as being based on a multifactorial genesis. Genetic and environmental factors seem to have a major role in the development of this disease. Thus, the aim of this review is to analyze the available literature to document the current evidence on ICTEV etiology. Methods The literature on ICTEV etiology was systematically reviewed using the following inclusion criteria: studies of any level of evidence, reporting clinical or preclinical results, published in the last 20 years (1998–2018), and dealing with the etiology of ICTEV. Results A total of 48 articles were included. ICTEV etiology is still controversial. Several hypotheses have been researched, but none of them are decisive. Emerging evidence suggests a role of several pathways and gene families associated with limb development (HOX family; PITX1-TBX4), the apoptotic pathway (caspases), and muscle contractile protein (troponin and tropomyosin), but a major candidate gene has still not been identified. Strong recent evidence emerging from twin studies confirmed major roles of genetics and the environment in the disease pathogenesis. Conclusions The available literature on the etiology of ICTEV presents major limitations in terms of great heterogeneity and a lack of high-profile studies. Although many studies focus on the genetic background of the disease, there is lack of consensus on one or multiple targets. Genetics and smoking seem to be strongly associated with ICTEV etiology, but more studies are needed to understand the complex and multifactorial genesis of this common congenital lower-limb disease.
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            The Saudi Initiative for Asthma - 2021 Update: Guidelines for the diagnosis and management of asthma in adults and children

            Mohamed Al-Moamary, Sami Alhaider, Abdullah A Alangari … (2021)
            The Saudi Initiative for Asthma 2021 (SINA-2021) is the fifth version of asthma guidelines for the diagnosis and management of asthma for adults and children, which is developed by the SINA group, a subsidiary of the Saudi Thoracic Society. The main objective of the SINA is to have guidelines that are up to date, simple to understand, and easy to use by healthcare workers dealing with asthma patients. To facilitate achieving the goals of asthma management, the SINA panel approach is mainly based on the assessment of symptom control and risk for both adults and children. The approach to asthma management is aligned for age groups: adults, adolescents, children aged 5–12 years, and children aged less than 5 years. SINA guidelines have focused more on personalized approaches reflecting better understanding of disease heterogeneity with the integration of recommendations related to biologic agents, evidence-based updates on treatment, and the role of immunotherapy in management. Medication appendix has also been updated with the addition of recent evidence, new indications for existing medication, and new medications. The guidelines are constructed based on the available evidence, local literature, and the current situation at national and regional levels. There is also an emphasis on patient–doctor partnership in the management that also includes a self-management plan.
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              Multistate study of the epidemiology of clubfoot.

              Megan Parker, R S Olney, Russel Rickard … (2009)
              Although clubfoot is a common birth defect, with a prevalence of approximately 1 per 1000 livebirths, the etiology of clubfoot remains largely unknown. Studies of the prevalence and risk factors for clubfoot in the United States have previously been limited to specific states. The purpose of this study was to pool data from several birth defects surveillance programs to better estimate the prevalence of clubfoot and investigate its risk factors. The 10 population-based birth defects surveillance programs that participated in this study ascertained 6139 cases of clubfoot from 2001 through 2005. A random sample of 10 controls per case, matched on year and state of birth, was selected from birth certificates. Data on infant and maternal risk factors were collected from birth certificates. Prevalence was calculated by pooling the state-specific data. Conditional logistic regression was used to investigate the association between risk factors and clubfoot. The overall prevalence of clubfoot was 1.29 per 1000 livebirths; 1.38 among non-Hispanic whites, 1.30 among Hispanics, and 1.14 among non-Hispanic blacks or African Americans. Maternal age, parity, education, and marital status were significantly associated with clubfoot. Maternal smoking and diabetes also showed significant associations. Several of these observed associations were consistent between surveillance programs. We estimated the prevalence of clubfoot using data from several birth defects programs, representing one-quarter of all births in the United States. Our findings underline the importance of birth defects surveillance programs and their utility in monitoring population-based prevalence and investigating risk factors.
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                Author and article information

                Contributors
                Ammar K Alomran
                Bandar A Alzahrani
                Bader S Alanazi
                Mohammed A Alharbi
                Loay M Bojubara
                Eman M Alyaseen
                Journal
                Journal ID (nlm-ta): World J Orthop
                Journal ID (publisher-id): WJO
                Title: World Journal of Orthopedics
                Publisher: Baishideng Publishing Group Inc
                ISSN (Electronic): 2218-5836
                Publication date Collection: 18 July 2024
                Publication date (Electronic): 18 July 2024
                Volume: 15
                Issue: 7
                Pages: 635-641
                Affiliations
                Department of Orthopedic, College of Medicine, Imam Abdulrahman bin Faisal University, Dammam 34212, Saudi Arabia. aomran@ 123456iau.edu.sa
                Department of Orthopedic, College of Medicine, Imam Abdulrahman bin Faisal University, Dammam 34212, Saudi Arabia
                College of Medicine, Imam Abdulrahman bin Faisal University, Dammam 34212, Saudi Arabia
                College of Medicine, Imam Abdulrahman bin Faisal University, Dammam 34212, Saudi Arabia
                College of Medicine, Imam Abdulrahman bin Faisal University, Dammam 34212, Saudi Arabia
                College of Medicine, Arabian Gulf University, Manama 329, Bahrain
                Author notes

                Author contributions: Alomran AK, Alzahrani BA, and Alanazi BS designed the research study; Alzahrani BA, Alanazi BS, and Alharbi MA performed the research; Alomran AK, Alzahrani BA, Alanazi BS, Alharbi MA, Bojubara LM, and Alyaseen EM analyzed the data and wrote the manuscript; and all authors critically examined and approved the final text, and agreed to be responsible for the manuscript’s content and similarity index.

                Corresponding author: Ammar K Alomran, MBBS, Assistant Professor, Department of Orthopedic, College of Medicine, Imam Abdulrahman bin Faisal University, King Faisal St. Dammam 34212, Saudi Arabia. aomran@ 123456iau.edu.sa

                Article
                Other ID: jWJO.v15.i7.pg635 Publisher-manuscript ID: 93847
                DOI: 10.5312/wjo.v15.i7.635
                PMC ID: 11271697
                PubMed ID: 39070938
                SO-VID: 64578404-704a-44ce-b960-9981635981f6
                Copyright © ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
                License:

                This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.

                History
                Date received : 6 March 2024
                Date revision received : 30 May 2024
                Date accepted : 18 June 2024
                Categories
                Subject: Retrospective Study

                Keywords: clubfoot,talipes equinovarus,congenital talipes equinovarus,prevalence,saudi arabia
                Data availability:
                Keywords: clubfoot, talipes equinovarus, congenital talipes equinovarus, prevalence, saudi arabia

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