Reasons for late presentation of cleft deformity in Nepal.

OBJECTIVES

To determine the causes of late presentation of patients with cleft lip and palate in Nepal.

DESIGN

Cross-sectional survey using interviews of patients' parents.

SETTING

The study was carried out between April 1999 and September 1999 in Western Regional Hospital (WRH), Pokhara, Nepal, a secondary care center.

PATIENTS

All patients with cleft lip and palate coming to WRH outpatient department or coming for surgery were included in the study. Those without parents were excluded. A total of 53 patients were included.

RESULTS

Forty-two (79%) presented after 3 months. The most common reasons were lack of knowledge of availability of repair (31%), lack of accessibility of care (29%), and lack of finances (24%).

CONCLUSIONS

In Nepal, the majority of patients with cleft present late, mainly because of a lack of awareness of cleft services, the remoteness of available services, or a lack of finances. These obstacles can be largely surmounted through itinerant services.