A cross-sectional study conducted by AIIMS in coordination with NGO ‘CURE International India Trust’ on children diagnosed with clubfoot reflected a male-female divide in treatment. The study found that a female child is 2.6 times more likely to be irregular for a check-up as compared to a male child.
The study was conducted on 238 patients from January to March 2014 and recently published in the Journal of Orthopaedic Surgery. The aim of the study was to understand how many patients come for a follow-up, as regular visits are an important aspect of clubfoot management.
“Our study tried to identify those children who are likely to miss hospital visits in India. Our hypothesis was that female children, especially those in families with three or more children, get neglected and miss scheduled appointments at the clubfoot clinic. The study, too, confirmed it,” said Dr Shah Alam Khan, lead author of the study and professor at department of orthopaedics at AIIMS. The institute runs weekly clinics that sees 50-70 children a week.
Clubfoot is a condition where either or both feet are twisted inward, causing the child to walk on his ankles. If left untreated, it causes severe lifelong disability.
Various factors that could affect compliance such as family size, number of children, literacy of caregiver, occupation, and time taken to travel to hospital were studied. Caregivers were probed regarding the reason for their irregularity. Only two factors, age and sex of the child, remained significantly different between the two groups.
Of the total patients, divided on the basis of their visits, 138 formed the “regular” group and the remaining 100 formed the “irregular” group. The study found that the mean follow-up period in the regular group was 28.1 months, and 33.8 months in the irregular group.
On uni-variate analysis, factors such as age, duration of follow-up, and transport duration were found to be significant between the two groups. However, a multi-variate analysis revealed that female children with clubfoot are more likely to be irregular as compared to males.
“It is extremely important to educate people so that the disease can be prevented at an early stage. Some efforts should be taken by the government to ensure that people come up for a follow-up, irrespective of gender,” said Dr Alam.
Around 40,000-50,000 children in India are affected by the condition every year, said Dr Khan.