A Community Audit of 300 “Drop-Out” Instances in Children Undergoing Ponseti Clubfoot Care in Bangladesh—What Do the Parents Say?

Evans, Angela Margaret; Chowdhury, Mamun; Khan, Sharif

doi:10.3390/ijerph18030993

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A Community Audit of 300 “Drop-Out” Instances in Children Undergoing Ponseti Clubfoot Care in Bangladesh—What Do the Parents Say?

Angela Margaret Evans

^1,2,*

Mamun Chowdhury

² and

Sharif Khan

FFPM RCPS(Glasg), Discipline of Podiatry, School of Science, Health and Engineering, La Trobe University, Bundoora, Melbourne 3083, Australia

Walk for Life—Clubfoot Project, Dhaka 1213, Bangladesh

Author to whom correspondence should be addressed.

Int. J. Environ. Res. Public Health 2021, 18(3), 993; https://doi.org/10.3390/ijerph18030993

Received: 7 January 2021 / Accepted: 21 January 2021 / Published: 23 January 2021

(This article belongs to the Special Issue Advances in Foot Posture Assessment and Health Implications)

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Abstract

Introduction: Drop-out before treatment completion is a vexing problem for all clubfoot clinics. We and others have previously identified better engagement with parents as a crucial method of ameliorating incomplete clubfoot treatment, which increases deformity relapse. Materials and methods: The novel use of community facilitators enabled an audit of over 300 families who had dropped-out from a child’s clubfoot treatment. A questionnaire standardized the parent interviews. Parents were encouraged to present for clinical review of their child’s clubfeet. Results: When treatment was discontinued for six months, 309 families were audited. A social profile of families was developed, showing that most lived in tin houses with one working family member, indicating low affluence. Family issues, brace difficulty, travel distances, and insufficient understanding of ongoing bracing and follow-up were the main reasons for discontinuing treatment. Overt deformity relapse was found in 9% of children, while half of the children recommenced brace use after review. Conclusions: Identifying families at risk of dropping out from clubfoot care enables support to be instigated. Our findings encourage clinicians to empathize with parents of children with clubfoot deformity. The parent load indicator, in parallel with the initial clubfoot severity assessment, may help clinicians to better appreciate the demand that treatment will place on parents, the associated risk of drop-out, and the opportunity to enlist support. View Full-Text

Keywords: Ponseti; relapse; clubfoot; barriers; parents; children

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Evans, A.M.; Chowdhury, M.; Khan, S. A Community Audit of 300 “Drop-Out” Instances in Children Undergoing Ponseti Clubfoot Care in Bangladesh—What Do the Parents Say? Int. J. Environ. Res. Public Health 2021, 18, 993. https://doi.org/10.3390/ijerph18030993

AMA Style

Evans AM, Chowdhury M, Khan S. A Community Audit of 300 “Drop-Out” Instances in Children Undergoing Ponseti Clubfoot Care in Bangladesh—What Do the Parents Say? International Journal of Environmental Research and Public Health. 2021; 18(3):993. https://doi.org/10.3390/ijerph18030993

Chicago/Turabian Style

Evans, Angela M., Mamun Chowdhury, and Sharif Khan. 2021. "A Community Audit of 300 “Drop-Out” Instances in Children Undergoing Ponseti Clubfoot Care in Bangladesh—What Do the Parents Say?" International Journal of Environmental Research and Public Health 18, no. 3: 993. https://doi.org/10.3390/ijerph18030993

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A Community Audit of 300 “Drop-Out” Instances in Children Undergoing Ponseti Clubfoot Care in Bangladesh—What Do the Parents Say?

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