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. 2023 May;60(5):526-535.
doi: 10.1177/10556656211069827. Epub 2022 Jan 4.

Adapting Elements of Cleft Care Protocols in Low- and Middle-income Countries During and After COVID-19: A Process-driven Review With Recommendations

Matthew Fell  1   2 , Michael Goldwasser  3   4 , B S Jayanth  5 , Rui Manuel Rodrigues Pereira  6   7 , Christian Tshisuz Nawej  8 , Rachel Winer  9 , Neeti Daftari  9 , Hugh Brewster  9 , Karen Goldschmied  4 , Collaborators Fernando Almas  10 , Mekonen Eshete  11 , George W Galiwango  12 , Larry H Hollier Jr  13   14 , Akhter Hussain  5   15 , Lun-Jou Lo  16   17 , Paul Salins  5   18 , Debbie Sell  19 , Amanuel Tafase  10 , Ronald M Zuker  20   21
Affiliations

Adapting Elements of Cleft Care Protocols in Low- and Middle-income Countries During and After COVID-19: A Process-driven Review With Recommendations

Matthew Fell et al. Cleft Palate Craniofac J. 2023 May.

Abstract

A consortium of global cleft professionals, predominantly from low- and middle-income countries, identified adaptations to cleft care protocols during and after COVID-19 as a priority learning area of need.

A multidisciplinary international working group met on a videoconferencing platform in a multi-staged process to make consensus recommendations for adaptations to cleft protocols within resource-constrained settings. Feedback was sought from a roundtable discussion forum and global organizations involved in comprehensive cleft care.

Foundational principles were agreed to enable recommendations to be globally relevant and two areas of focus within the specified topic were identified. First the safety aspects of cleft surgery protocols were scrutinized and COVID-19 adaptations, specifically in the pre- and perioperative periods, were highlighted. Second, surgical procedures and cleft care services were prioritized according to their relationship to functional outcomes and time-sensitivity. The surgical procedures assigned the highest priority were emergent interventions for breathing and nutritional requirements and primary palatoplasty. The cleft care services assigned the highest priority were new-born assessments, pediatric support for children with syndromes, management of acute dental or auditory infections and speech pathology intervention.

A collaborative, interdisciplinary and international working group delivered consensus recommendations to assist with the provision of cleft care in low- and middle-income countries. At a time of global cleft care delays due to COVID-19, a united approach amongst global cleft care providers will be advantageous to advocate for children born with cleft lip and palate in resource-constrained settings.

Keywords: COVID-19; circle of cleft professionals; comprehensive cleft care; low- and middle-income countries.

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Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
A flow diagram to describe an overview of the process used.
See this image and copyright information in PMC

References

    1. Allori AC, Kelley T, Meara JG, Albert A, Bonanthaya K, Chapman K, Cunningham M, DaskalogiannakisvJ de Gier H, Heggie AA, Hernandez Cet al. A standard Set of outcome measures for the comprehensive appraisal of cleft care. Cleft Palate Craniofac J. 2017;54(5):540‐554. - PubMed
    1. American Cleft Palate-Craniofacial Association 2020a. Statement on cleft Lip/palate related surgeries and team care during the COVID-19 pandemic. Available at: https://acpa-cpf.org/wp-content/uploads/2020/04/ACPA-Position-Statement-.... (Accessed October 14, 2021).
    1. American Cleft Palate-Craniofacial Association 2020b. Statement on speech and audiology services during the COVID-19 pandemic. Available at: https://acpa-cpf.org/wp-content/uploads/2020/04/ACPA-Position-Statement-.... (Accessed October 14, 2021).
    1. Breik O, Tivey D, Umapathysivam K, Anderson P. Mandibular distraction osteogenesis for the management of upper airway obstruction in children with micrognathia: a systematic review. Int J Oral Maxillofac Surg. 2016;45(6):769‐782 - PubMed
    1. Breugem C, Smit H, Mark H, Davies G, Schachner P, Collard M, Sell D, Autelitano L, Rezzonico A, Mazzoleni Fet al. Prioritizing cleft/craniofacial surgical care after the COVID-19 pandemic. Plast Reconstr Surg Glob Open. 2020;8(9):e3080. - PMC - PubMed

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